Understanding Stomach Cancer: Causes, Symptoms,& Treatment
What is Stomach Cancer?
Stomach cancer, or gastric cancer, develops when cells in the stomach begin to grow uncontrollably and abnormally.
It can develop anywhere in the stomach but most commonly forms where the stomach meets the esophagus, at the gastroesophageal junction. In regions with higher incidences of gastric cancer, it usually originates in the main body of the stomach.
Approximately 95 % of stomach cancers start in the stomach lining and tend to progress slowly. Without treatment, these cancers can form a tumour that invades more profound layers of the stomach wall and potentially spread to nearby organs like the liver and pancreas.
Who is at Risk for Stomach Cancer?
Stomach cancer can affect anyone, but certain factors may increase your risk:
Age: Most cases occur in individuals aged 65 or older.
Gender: Stomach cancer is more commonly diagnosed in men than in women.
Ethnicity: The highest prevalence is seen in individuals of East Asian, South—or Central American, or Eastern European descent.
How Common is Stomach Cancer?
Globally, stomach cancer is one of the most prevalent cancers, but it is less common in the US, where it accounts for about 1.5 % of all cancer cases. The incidence has been steadily declining over the past decade in the US.
What are the symptoms of stomach cancer?
In its early stages, stomach cancer typically doesn’t cause noticeable symptoms. When symptoms eventually arise, they are often subtle and can resemble those of other illnesses. Common signs and symptoms of stomach cancer include:
- Loss of appetite.
- Difficulty swallowing
- Fatigue or weakness
- Nausea and vomiting.
- Unexplained weight loss.
- Persistent heartburn and indigestion.
- Black stool or vomit with blood.
- Feeling bloated or gassy after meals.
- Stomach pain, significantly above the belly button.
- Early satiety, or feeling full after small meals.
If you experience these symptoms, consult a healthcare provider for evaluation, as they could be indicative of stomach cancer or another health issue.
What are the risks? Treatment of a smaller symptomatic hiatal hernia with reflux
Hiatal hernia treatment varies by severity and symptoms, focusing on symptom management and complication prevention.
Lifestyle Changes: For mild cases, adjustments like weight management, avoiding reflux triggers, eating smaller meals, and not lying down post-meal can help.
Medications: Antacids neutralize stomach acid, while proton pump inhibitors (PPIs) and H2 blockers reduce acid production, alleviating heartburn and reflux damage.
Endoscopic Procedures: Suitable for those avoiding surgery, these minimally invasive repairs use a camera-equipped tube.
Surgical Intervention: Required for severe cases or when other treatments fail, surgery repairs the hiatus and strengthens the oesophagal sphincter, with methods including Nissen fundoplication or laparoscopic techniques.
Can You Feel stomach cancer lump in the abdomen?
In advanced stages of stomach cancer, a mass may be palpable during a physical exam. However, early symptoms typically involve sensations like swelling, fullness, or pain in the stomach.
Causes of Stomach Cancer
Stomach cancer develops from genetic mutations in the DNA of stomach cells, which disrupt average cell growth and death processes. Key factors that might contribute to these mutations include:
- Family History: A family history of stomach cancer can increase risk.
- H pylori Infection: Chronic infection with Helicobacter pylori is linked to stomach cancer.
- GERD and Gastritis: Conditions such as gastroesophageal reflux disease (GERD) and chronic gastritis can raise cancer risk.
- Epstein-Barr Virus: This virus is associated with certain types of stomach cancer.
- Previous Stomach Conditions: Ulcers or polyps can elevate risk.
- Diet: A diet high in fatty, salty, smoked, or pickled foods, combined with a low intake of fruits and vegetables, can elevate the risk of developing stomach cancer.
- Environmental Exposures: Frequent exposure to coal, metal, and rubber substances.
- Lifestyle Factors: Tobacco use, heavy alcohol intake, and obesity.
Several genetic conditions also increase risk, including:
- Lynch syndrome
- Peutz-Jeghers syndrome
- Li-Fraumeni syndrome
- Familial adenomatous polyposis
- Hereditary diffuse gastric cancer
- Common variable immunodeficiency (CVID)
Types of Stomach Cancer
Stomach cancer is classified based on the type of cells where it originates. Here are the main types:
Adenocarcinoma: This is the most common type, starting in the stomach’s mucus-producing cells. Almost all stomach cancers are adenocarcinomas.
Gastrointestinal Stromal tumours (GISTs): These tumours originate in the particular nerve cells within the stomach wall and other digestive organs. GISTs are a form of soft tissue sarcoma.
Carcinoid tumours: These tumours develop from neuroendocrine cells with nerve and hormone-producing functions.
Lymphoma: This cancer originates in the immune system cells and can occasionally develop in the stomach. Most stomach lymphomas are a type of non-Hodgkin’s lymphoma.
Diagnosis and Tests
Diagnosing stomach cancer involves a combination of medical history review, physical examination, and diagnostic tests:
Upper Endoscopy: The process entails the utilisation of an endoscope, a slim, flexible tube containing a light and camera, to conduct a visual assessment of the stomach and retrieve biopsy specimens.
Endoscopic Ultrasound: Combines endoscopy with ultrasound to assess cancer spread to the stomach wall.
Imaging Tests: CT scans, MRIs, and barium swallows help identify tumours and check for cancer spread. PET scans can reveal if cancer has metastasized.
Blood Tests: Assessing organ function can reveal whether cancer has spread to other parts of the body.
Laparoscopy: A surgical procedure using a tiny camera to visualise and assess cancer spread directly.
In the US, routine screening for stomach cancer is not common due to its lower prevalence. However, individuals at higher risk may undergo regular screenings.
Stomach Cancer Treatment
Treatment for stomach cancer is based on the disease’s stage, the patient’s overall health, and individual preferences. Available options include:
Surgery
Upper Endoscopy: For early-stage cancer, the tumour can be removed via endoscopic procedures.
Gastrectomy: For more advanced cancer, surgery may involve removing part (subtotal gastrectomy) or all (total gastrectomy) of the stomach. The esophagus is connected to the small intestine to facilitate digestion.
Chemotherapy: Chemotherapy involves using drugs to reduce or destroy cancer cells. It can be administered either before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy), and is frequently combined with radiation therapy.
Radiation Therapy: This Targets cancer cells with high-energy rays. It is usually combined with chemotherapy to enhance effectiveness and help manage symptoms.
Targeted Drug Therapy: This therapy Focuses on specific molecules involved in cancer cell growth. Often used in conjunction with chemotherapy for advanced cases.
Immunotherapy: Enhances the immune system’s ability to recognise and eliminate cancer cells, especially in cases of advanced or recurrent cancer.
Palliative Care: Palliative care concentrates on enhancing the quality of life by addressing symptoms and offering support, and can be used in conjunction with other therapeutic approaches.
Prevention
While stomach cancer cannot be entirely prevented, risk can be reduced by:
- Treating H. pylori infections and other stomach conditions.
- Adopting a diet that emphasises fruits and vegetables while minimising salt and processed meats.
- Avoiding tobacco use and excessive alcohol consumption.
- Maintaining a healthy weight.
Consult Dr Balaji Nagammapudur for Stomach Cancer Treatment in Dubai
Dr Balaji Nagammapudur is a highly experienced consultant surgeon with over 30 years of practice specialising in Bariatric and Upper GI Surgery. He has dedicated over 15 years to improving general and laparoscopic weight loss care for adolescents with obesity. Since 2009, he has been a consultant surgeon in India and the UK.
Dr Balaji focuses on Roux-en-Y Gastric Bypass, revisional bariatric, esophageal, and adolescent bariatric surgeries at the Saudi German Hospital in Dubai. He is known for his honest and patient-centric approach and prioritises non-surgical solutions when possible.
Consult Dr Balaji Nagammapudur for expert care and genuine advice on stomach cancer treatment and weight loss surgery in Dubai.
FAQs
The survival rate for stomach cancer largely depends on the stage at which it is diagnosed. Early-stage stomach cancer generally has a better prognosis compared to advanced stages.
For example, if the cancer is detected early and is confined to the stomach, there is a 69.9 % chance of surviving five years after diagnosis. If the cancer has metastasized to distant areas of the body, the five-year survival rate significantly decreases to 5.5 %.
The NCI estimates that the five-year survival probability for stomach cancer patients is around 32 %.
Most of these survivors have localised cancer, meaning the cancer originated in the stomach and has not metastasized. Diagnosing and staging the cancer becomes more challenging when the primary origin is unknown, complicating treatment efforts.
Stomach cancer can be cured if detected and treated early. However, advanced stomach cancer is more challenging to cure, and treatment often focuses on managing symptoms and improving quality of life.
Chemotherapy for stomach cancer often leads to side effects such as nausea, vomiting, hair loss, fatigue, and a higher susceptibility to infections. The intensity of these effects can differ from person to person and is influenced by the particular medications administered.
Stomach cancer staging assesses the tumour’s size and spread, including its impact on nearby lymph nodes and whether it has metastasized to other body areas. Stages range from 0 (in situ) to IV (advanced metastatic cancer).
Research is ongoing to develop new treatments for stomach cancer. Recent advancements include improved targeted therapies, immunotherapies, and minimally invasive surgical techniques. Clinical trials are also exploring innovative treatment approaches.