Stomach cancer is a disease in which cancer cells grow in the stomach. There are 5 layers of tissue in the stomach. Types of cancer include: Adenocarcinoma—tumors of the mucosa (the innermost layer), which make up over 90% of stomach cancersLymphoma—a cancer of the immune system, which is sometimes found in the stomach wallGastric stomal tumors—tumors of the stomach wallCarcinoid tumors—tumors of the hormone-producing cells of the stomach
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Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Stomach cancer is more common in men, and in people aged 50 years and older. Other factors that may increase your chance of stomach cancer include: Ethnicity and geography, more common in: Hispanics and African Americans than CaucasiansPeople from Japan, Korea, parts of Eastern Europe, and Latin AmericaHelicobacter pylori
High intake of smoked, salted, pickled food and meat, high starch/low fiber foodsLow intake of certain vegetables, such as garlic scallions, onions, chives, leeksSmokingAlcohol use disorderPrevious stomach surgeryPernicious
anemiaMénétrier disease (a disease that causes large folds in the stomach lining)Barrett's esophagusBlood type A
Familial cancer syndromes: hereditary nonpolyposis
colon cancer and
familial adenomatous polyposisFamily history of stomach cancerStomach polyps
In some people, stomach cancer may have no symptoms. In those that have them, stomach cancer may cause:
heartburnAbdominal pain or vague abdominal discomfortNausea and vomitingDiarrhea
constipationStomach bloating or sense of fullness after eatingLoss of appetiteWeakness, fatigueBleeding in vomit or stoolStool that has turned black or tarryUnintended weight lossFluid swelling in abdomen
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include: Blood testsFecal occult blood test—to test for blood in the stoolBiopsy—a tissue sample that can be examined under a microscope
Imaging tests to evaluate the stomach and surrounding structures may include: Upper GI seriesChest x-rayEndoscopyUltrasoundCT scanPET scan
The physical exam, combined with all of your test results, will help to determine the type and stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, stomach cancer is staged from I to IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Cancer treatment varies depending on the stage and type of cancer. Stomach cancer is most often detected in the later stages. A combination of therapies may be more effective. For example, surgery may be used in conjunction with chemo- or radiation therapy.
Treatment options for stomach cancer include:
Surgery is the most common treatment for stomach cancer. The type of surgery depends on the stage of the disease.
There are 3 types of stomach surgery that may be done:
Endoscopic mucosal resection—This surgery is generally done in the early stages where the tumor is removed through an endoscope.Subtotal gastrectomy—This is the removal of the lower part of the stomach, leaving part of the stomach to reattach to the esophagus and small intestine.Total gastrectomy—This is the removal of the entire stomach. It often includes removal of nearby lymph nodes. The esophagus is attached directly to the small intestine.
This is the use of high-energy rays to kill or shrink cancer cells.
may be used after surgery to destroy cancer cells that could not be seen or removed during surgery.
In cases where stomach cancer has spread,
combined with radiation therapy may increase the risk of survival and reduce the risk of cancer returning. Chemotherapy
is the use of drugs to kill cancer cells. It may be given in many forms including: pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
To help reduce your chance of stomach cancer: Avoid diets high in salted, pickled, and smoked foods.Eat at least 5 servings of fresh fruits, vegetables, and whole grain foods a day.Limit red meat intake.If you smoke, talk to your doctor about how to quit.Avoid or drink alcohol only in moderation. This means 2 drinks per day for men and 1 drink per day for women.
Cashen AF, Wildes TM.
The Washington Manual; Hematology and Oncology Subspeciality Consult.
2nd ed. New York, NY: Wolter Kluwers; 2008.
Ménétrier disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/menetriers-disease/Pages/facts.aspx. Updated March 12, 2014. Accessed September 30, 2014.
Stomach cancer. American Cancer Society website. Available at:
http://www.cancer.org/acs/groups/cid/documents/webcontent/003141-pdf.pdf. Accessed September 30, 2014.
Stomach (gastric) cancer—for patients. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/types/stomach. Accessed September 30, 2014.
Last reviewed September 2016 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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