The stomach is one of the organs located in the abdomen, within the digestive system. The American Cancer Society estimates that in 2009, 21,130 Americans were diagnosed with stomach cancer, and 10,620 deaths were expected from the disease.
What causes stomach cancer?
The exact cause of stomach cancer is unknown, but several risk factors likely contribute to the transformation of stomach cells into cancerous cells.
Risk factors for stomach cancer include:
• Helicobacter pylori bacterium
• Diet containing large amounts of smoked foods, salty meats, pickled vegetables, and nitrite-containing foods or beverages
• Tobacco use
• Heavy alcohol consumption
• Previous stomach surgeries
• Megaloblastic anemia (caused by vitamin B12 deficiency) associated with atrophic gastritis from Menetrier's disease
• Age (most cases are reported after the age of 50, and the majority of patients with stomach cancer are in their 60s to 80s)
• Higher incidence in men than women
• Blood type A
• Family history of non-polyposis colorectal cancer or stomach cancer
• History of polyps in the stomach
• Exposure to environmental factors such as dust, fumes at the workplace, and radiation (more common among Asians, Hispanics, and African Americans)
• Obesity
What are the symptoms of stomach cancer?
It is important to note that each patient may experience some of the following symptoms, which are among the most common signs of stomach cancer:
Digestive disturbances or discomfort, abdominal pain, nausea, and vomiting, loss of appetite, early satiety, unexplained weight loss, weakness and fatigue, bloody vomit or blood in the stool.
How is stomach cancer diagnosed?
In addition to medical history and physical examination, the diagnostic process for stomach cancer may include the following procedures:
• Stool occult blood test: This test involves placing a very small amount of stool on a special card, which is then tested either in the doctor's office or a laboratory.
• Upper gastrointestinal series (barium swallow): This procedure examines the upper part of the digestive system, including the esophagus, stomach, and duodenum (the first part of the small intestine). The patient drinks barium, a metallic, chalky substance, and then X-ray images are taken to evaluate the digestive system.
• Esophagogastroduodenoscopy (EGD or endoscopy): This procedure allows the doctor to examine the inside of the esophagus, stomach, and duodenum by inserting a thin, flexible, illuminated tube called an endoscope into the mouth and throat and then into the esophagus, stomach, and duodenum. An endoscope allows the doctor to see the inner part of this area of the body and also to add devices through the scope for biopsy sampling (if needed).
• Endoscopic ultrasound (EUS): An endoscopic examination with a device that also has ultrasound capabilities to assess the depth of stomach wall invasion.
• CT scan of the abdomen.
How is stomach cancer treated?
The treatment will be determined by the physician based on the following factors:
• Age of the patient
• General health status and medical history
• Extent of the disease
• Patient's ability to tolerate medical treatment
• Patient's preference
• Types of treatment available for stomach cancer
Treatment options may include:
• Surgery: Surgical procedures involve removing the cancerous tissue. The most common surgery is called gastrectomy. If only part of the stomach is removed, it is called partial gastrectomy. If the entire stomach is removed, it is called total gastrectomy.
• Radiation therapy: Precise radiation is directed at the cancer cells. The machine is controlled by the treating physician (oncologist). Radiation is used to kill cancer cells and shrink tumors, and special shields can be used to protect surrounding tissue from the treatment. External radiation therapy is usually painless and lasts for a few minutes. External radiation therapy may also be used to relieve symptoms such as pain or obstruction.
• Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop them from growing. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Sometimes, a combination of treatments may be recommended for stomach cancer.
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