Stomach Cancer

November 29, 2020

3 min read

Stomach cancer is also called gastric cancer. The American Cancer Society (ACS) reports that there are about 27,600 new cases of stomach cancer diagnosed every year, and each year, about 11,000 people lose their lives due to this form of cancer. Stomach cancer affects primarily people older than age 65. Men are more likely than women to develop stomach cancer: the ACS says that a man's risk of developing stomach cancer in his life are approximately 1 in 95, while women's risk is approximately 1 in 154. Almost 100 years ago, stomach cancer was the number one cause of U.S. cancer death, but its incidence has been decreasing over time.

What are the symptoms of stomach cancer?

According to the Mayo Clinic, stomach cancer symptoms can include:

Feeling bloated after eating
Feeling full after only eating a small amount of food
Heartburn
Indigestion
Stomach pain
Difficulty swallowing
Unintended weight loss
Vomiting

Risk factors for stomach cancer

Stomach cancer has been decreasing in incidence, and researchers suspect the reasons it is declining are linked to the cancer's risk factors, particularly fewer infections with Helicobacter pylori (H. pylori), a type of bacteria that can infect the lower part of the stomach. Although most of the people who have H. pylori in their stomach don't develop cancer, it is still a potential cause and risk factor.

Other risk factors for stomach cancer include eating diets with a lot of smoked foods, salted fish and cured meats. Additional risk factors include:

Tobacco smoking
Overweight or obesity
Previous stomach surgery
Hypertrophic gastropathy (abnormal changes in stomach lining)
Having Type A blood
Ethnicity - Asian/Pacific Islanders, Native Americans, Hispanic Americans and Black Americans have higher risks of stomach cancer
Advanced age - most stomach cancers occur in people who are over age 60
Stomach polyps
A diet low in fruits and vegetables

Subtypes of stomach cancer

Cancer of the stomach can occur in different locations. In North America, the most common location for stomach cancer is at the gastroesophageal junction, where the esophagus meets the stomach. In other parts of the world, stomach cancers form more frequently in the main body of the stomach.

In 2014, researchers identified four sub-types of stomach cancer:

Cancers associated with the Epstein Barr virus (EBV)
Cancers associated with high microsatellite instability (MSI) producing frequent DNA mutations
Cancers with low-level somatic copy number alterations (SCNAs) in their genetic information
Cancers with high levels of somatic copy number alterations (SCNAs) in their genetic information

Genetic research continues into how and why the different sub-types of stomach cancer develop and how they can be treated or prevented.

Stages of stomach cancer

Clinicians will diagnose stomach cancer using endoscopy with a small camera, biopsy, and imaging tests, including CT and PET scans. They determine the extent or stage of stomach cancer using blood tests, an endoscopic ultrasound, imaging tests, and potentially, exploratory surgery. Stomach cancer has five stages:

Stage 0 (Carcinoma in Situ)
Stage I
Stage II
Stage III
Stage IV

The higher the number, the more the cancer has spread. Stage IV stomach cancer has spread through the wall of the stomach and to other organs. Stage IA cancer is in the mucosa, or first layer of tissue in the stomach. Stage II stomach cancer may have spread beyond the mucosa into other surrounding tissues.

Stomach cancer treatment

Stomach cancer treatment uses a variety of methods to remove the cancer or to stop or slow its growth. Treatment methods include:

Surgery - which can include removal of all or part of the stomach, called a gastrectomy
Chemotherapy
Radiation therapy
Targeted drug therapy
Immunotherapy

Clinicians will also offer palliative or supportive care. Palliative care isn't aimed at curing the cancer, but at improving the quality of life for patients and their families.

How can you reduce stomach cancer risk?

Tobacco smoking isn't just a risk for lung cancer, it also increases risk for other cancers, including stomach cancer. According to the NIH, stopping smoking is one way to reduce stomach cancer risk. You can also reduce stomach cancer risk by eating a diet high in fruits, vegetables, and fiber, as well as low in smoked or salted meats and fish. If you have a chronic H. pylori infection, treating it will also reduce your risk of stomach cancer.