Gastric Cancer

• The Stomach
• What Is Gastric Cancer?
• Who Is At Risk for Gastric Cancer?
• What Are the Signs and Symptoms of Gastric Cancer?
• How Is Gastric Cancer Diagnosed?
• Treatment for Gastric Cancer
   

The Stomach

The stomach holds and stores food. Located just beneath the lower portion of the rib cage on the left side, the stomach is shaped like a large pouch and connected to the mouth and throat by the esophagus.
 

What Is Gastric Cancer?

Gastric cancer is cancer of the stomach. It can either be benign (non-cancerous) or malignant (cancerous). In gastric cancer, abnormal cells form tumors in the stomach and invade normal tissues in the body.

Approximately 90 percent of gastric cancers arise from the lining of the stomach, where glands are located. this is known as "adenocarcinoma." Other gastric cancers include leimyosarcoma, lymphomas and squamous cell.
 

Who Is At Risk for Gastric Cancer?

Research has not been able to show an exact cause for stomach cancer; however, studies have concluded that risk factors include:

• Age (rare to see gastric cancer under the age of 40)
• Sex (men are more likely to develop stomach cancer)
• Race (more common in Asians, Pacific Islanders, Hispanics and African Americans)
• Diet (diets that are high in foods that are smoked, salted or pickled)
• Helicobacter pylori infection (bacteria that commonly lives in the stomach)
• Smoking
• History of health problems such as chronic gastritis, pernicious anemia or a history of stomach surgery

Even though studies show the factors mentioned above may increase the risk, the majority of gastric cancers develop without any known risk factors.
  

What Are the Signs and Symptoms of Gastric Cancer?

The majority of gastric cancer patients have non-specific complaints, such as:

• Indigestion
• Abdominal discomfort (bloating, belching, gas pains, etc.)
• Loss of appetite
• Occasional vomiting
• Decreased ability to eat a large meal

These symptoms are similar those someone would experience when suffering from gastritis or peptic ulcer disease. Patients could be treated for peptic ulcers or gastritis for a long period of time before the diagnosis of gastric cancer. Therefore, if symptoms persist, further investigation should be made.

Other less common symptoms are:

• Difficulty swallowing
• Vomiting blood

**These signs and symptoms should immediately be reported to your physician.**
 

How Is Gastric Cancer Diagnosed?

Diagnostic testing procedures for gastric cancer include:

• Upper endoscopy (routinely used for initial diagnosis and staging of gastric cancer)
• Ultrasound (may be used during endoscopy to identify how deep the cancer has grown into the gastric wall. The depth of the cancer in the wall and presence of lymph node spread are very important in determining how to operate.)
• CT or CAT scan (determines if the cancer has spread to other organs like the lungs or liver, or nearby lymph nodes)
• PET scan (requires radioactive solutions to identify abdominal spread of disease)

Other blood screening tests are done to ensure blood counts are within normal limits in the kidneys, liver and other organs.
  

Treatment for Gastric Cancer

Surgery is the primary treatment for gastric cancer. However, treatment depends on diagnostic tests and staging. Staging determines the extent of the disease and is an important factor in determining what surgical treatment is best.

Most gastric cancers are cured by surgery alone, if it is found in the early stages. When treating the disease in advanced stages, radiation therapy and chemotherapy are recommended to decrease the chance of recurrence.

The National Comprehensive Cancer Network (NCCN) provides guidelines for the treatment of gastric cancer.

Surgery

The most common surgical treatments for gastric cancer are:

Partial gastrectomy (procedure done for small tumors)

• Total gastrectomy (procedure done for large tumors)
• Resection (may include removal of the spleen, pancreas, small intestines and lymph nodes)

Note: When a portion or the whole stomach is remove the two ends are rejoined together and “dumping syndrome” can occur. “Dumping syndrome” occurs when the stomach is removed and the intestine is filling quickly with undigested food. Symptoms include shortness of breath, nausea, vomiting, diarrhea and bloating. These symptoms may be controlled by diet.

Radiation Therapy

Radiation therapy is administered according to the type and stage of the cancer. It may be recommended prior to surgery, after surgery or in combination with chemotherapy.

Chemotherapy

Chemotherapy may be recommended as a single agent or in combination with other drugs. The way chemotherapy is administered depends on the type and stage of cancer.