Health Encyclopedia

Gastric cancer

Definition

Gastric cancers are malignancies of the stomach.

Alternative Names

Cancer - stomach; Stomach cancer; Gastric carcinoma

Causes, incidence, and risk factors

Several different types of cancer can occur in the stomach. The most common type is called adenocarcinoma, which refers to the way the cancer looks under the microscope. There are several types of adenocarcinoma. Because other types of gastric cancer occur much less frequently, this article focuses on adenocarcinoma.

Adenocarcinoma of the stomach is a common cancer of the digestive tract worldwide, although it is relatively uncommon in the US. It occurs most frequently in men over 40 years old. The incidence of this form of gastric cancer is extremely high in Japan, Chile, and Iceland. The incidence of most types of gastric adenocarcinoma in the US has declined over the years. Experts think the decrease may be related to reduced intake of salted, cured, and smoked foods, and increased vitamin C consumption.

However, the incidence of adenocarcinoma in the high part of the stomach where it connects with the esophagus has increased markedly, along with an increase in cancers of the lower esophagus. The reason for this increase is unknown.

Diagnosis is often delayed by the absence of symptoms in early disease or by self-treatment of symptoms that may be common to other, less serious gastrointestinal disorders (bloating, gas, and a sense of fullness).

Risk factors for gastric cancer are a family history of gastric cancer, Helicobacter pylori infection, blood type A, a history of pernicious anemia, a history of chronic atrophic gastritis, a condition of decreased gastric acid, and a prior history of adenomatous gastric polyp.

Symptoms

Loss of appetite
Difficulty swallowing, particularly difficulty that increases over time
Vague abdominal fullness
Nausea and vomiting
Vomiting blood
Abdominal pain
Excessive belching
Breath odor
Excessive gas (flatus)
Unintentional weight loss
A general decline in health
Premature abdominal fullness after meals

Signs and tests

An upper GI series showing gastric cancer
An EGD (esophagogastroduodenoscopy) and biopsy showing gastric cancer
A CBC showing anemia (although there are many other reasons for anemia)
A stool test that is positive for blood

Treatment

Surgical removal of the stomach (gastrectomy) is the only curative treatment. Radiation therapy and chemotherapy may be beneficial. A recent study showed that for many patients, chemotherapy and radiation therapy given after surgery improve the chance of a cure.

For patients in whom surgery is not an option, chemotherapy or radiation can improve symptoms. For some patients, a surgical bypass procedure may provide relief of symptoms.

Support Groups

The stress of illness may often be eased by joining a support group with members who share common experiences and problems. See cancer - support group and gastrointestinal disorders - support group.

Expectations (prognosis)

There is a wide variation in prognosis of gastric tumors. Tumors in the lower stomach are more often cured than those in the higher area -- gastric cardia or gastroesophageal junction. The depth to which the tumor invades the stomach wall and whether lymph nodes are involved influence the chances of cure.

In circumstances in which the tumor has spread outside of the stomach, cure is not possible and treatment is directed toward improvement of symptoms.

Complications

Cancer spreading (metastasizing) to other organs or tissues
Weight loss
Fluid accumulation in the belly (ascites)

Calling your health care provider

Call your health care provider if symptoms of gastric cancer develop.

Prevention

In Japan, where the risk of gastric cancer is very high, mass screening programs have been successful in detecting disease in the early stages. The value of screening in the United States and other countries with lower rates of gastric cancer is not clear. Avoiding smoking may reduce risk.

Review Date:9/11/2006
Reviewed By:Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.

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