Stomach cancer refers to the abnormal and uncontrolled growth of cells present in the stomach lining. As the abnormal cells grow in number, a tumor is formed, which gradually grows deeper into the stomach and spreads to different parts of the body.
There are different types of stomach cancer based on the type of cell from which they arise. Further, they are categorized into various stages depending on the extent of the disease’s spread.
Becoming aware of various aspects of stomach carcinoma may help one receive the right care at the right time.
Stomach cancer refers to the growth of cancerous cells in any part of the stomach. However, in most cases, the tumors in the stomach originate in the stomach's inner lining.
Also known as gastric cancer or gastric malignancy, stomach carcinoma that is not caught early can spread to nearby lymph nodes and various organs in the body.
Stomach cancer is one of the most common cancers occurring worldwide. The prevalence of gastric malignancy among patients is influenced by aspects such as family history, dietary habits, age groups, gender, and Helicobacter pylori infection.
There are different types of stomach cancer based on the type of cell from which it starts. The most commonly reported types of stomach cancer are adenocarcinomas, gastrointestinal stromal tumors (GIST), neuroendocrine tumors, and lymphomas.
Adenocarcinomas are one of the most common types of stomach tumors that develop in the stomach's glandular cells. These glandular cells are found in the innermost layer of the stomach, which is known as the mucosa. These glandular cells are responsible for producing digestive enzymes and mucus.
Adenocarcinomas can be classified into two subtypes: intestinal adenocarcinomas and diffuse adenocarcinomas.
Intestinal adenocarcinomas are often bulky tumors and can be diagnosed quite early as compared to other types of stomach cancers. This stomach cancer type is more common among older people.
Diffuse adenocarcinomas are aggressive and tend to grow faster, with a risk of metastasizing to other organs rapidly. Also, diffuse adenocarcinomas are common among younger people.
Gastrointestinal stromal tumors, or GIST, are a rare type of stomach tumor found in the gastrointestinal tract, comprising the stomach, esophagus, small intestine, and other parts of the digestive system as well. This is a rare form of stomach cancer.
These gastrointestinal stromal tumors originate in the cells present in the stomach lining called interstitial cells of Cajal (ICCs).
Neuroendocrine tumors originate from the neuroendocrine cells and can occur throughout the body. However, these tumors are quite prevalent in the digestive system, including the stomach, colon, rectum, and appendix, and in other organs, such as the lungs, the adrenal glands, and the pancreas.
Lymphomas refer to the carcinoma of the immune system tissue and may originate anywhere in the body where the lymph tissues are present, including the stomach. As the name suggests, lymphoma of the stomach forms in the lymph tissues present in the lining of the stomach.
The TNM staging of stomach cancer is one of the most common methods adopted for determining stomach cancer stages. As per this method, the stage of stomach carcinoma is classified based on the size of the tumor, lymph node involvement, and to what extent the cancer has spread or metastasized
The TNM staging of stomach cancer involves obtaining TNM scores by carrying out various tests like biopsy, endoscopy, and imaging tests. These tests help specialists study various aspects of cancer growth, such as the size of the tumor and the extent of the disease’s spread. The following are the different stages of stomach cancer:
Stage 1 stomach cancer refers to the earliest stage of the cancer and is limited to the mucosa or inner lining of the stomach. At this stage, cancer has not yet spread to the deeper layers of the stomach and other organs.
The prognosis for stage 1 stomach cancer is highly favorable as the cancer remains localized at this stage.
Stage 2 and 3 stomach cancers are known to be locally advanced cancers as, at this stage, cancer invades the mucosa and other deeper layers of the stomach and nearby lymph nodes.
Stage 4 stomach cancer is also classified as a metastatic or advanced cancer stage. At this stage, the cancer is known to spread to distant organs, lymph nodes, and tissues. Stage 4 stomach cancer symptoms include unexplained weight loss, nausea, abdominal pain, and weakness.
The most challenging aspect of stomach carcinoma is that its symptoms are not easily recognizable. In fact, some individuals may not experience any of the early symptoms of stomach cancer at all, making it one of the most harrowing diseases.
Some stomach tumor symptoms may be similar to those of other less serious gastric problems, such as GERD, gastritis, peptic ulcers, etc. In these cases, the signs of stomach cancer are not given enough attention, and early detection becomes a challenge.
Stomach cancer may present itself in different ways. Stomach or gastric cancer symptoms are often similar to those of other less-serious diseases. Thus, it is essential not to ignore any stomach-related symptoms and see a doctor for a prompt evaluation. Here are some of the stomach tumor symptoms that should not be ignored:
One of the common stomach tumor symptoms is a sense of fullness in the stomach, especially in the upper abdomen, even after having small meals.
Heartburn and indigestion are the first symptoms of stomach cancer in most cases. However, they are often brushed off as non-serious GI issues. If these symptoms last for more than two weeks, they should not be ignored.
Some of the patients may also experience nausea and vomiting as signs of stomach cancer.
Loss of appetite is also considered a common symptom of stomach carcinoma.
Passing black stools or vomiting blood could also be stomach tumor symptoms.
Difficulty swallowing is one of the rare symptoms of stomach carcinoma.
Unexplained weight loss is also a sign of stomach carcinoma. Those who are losing weight without trying should see a doctor and get themselves thoroughly evaluated.
Abdominal pain is also a symptom of stomach cancer, and it should not be taken lightly, especially if one experiences it along with vomiting and nausea, unexplained weight loss, and black stools.
Another sign of stomach cancer is fatigue or weakness, especially in the disease's advanced stages.
The buildup of fluid in the stomach, known as ascites, is also a common sign of stomach carcinoma.
We do not have clear information as to what causes stomach cancer yet. However, certain factors have been identified as possible causes of stomach cancer. Being associated with these risk factors can increase one’s chances of developing stomach cancer.
Here are nine possible stomach cancer causes that one must keep an eye on:
Smoking is one of the biggest risk factors for stomach cancer. The risk of stomach cancer is significantly lower among those who do not smoke. Many studies have reported that quitting tobacco can remarkably reduce the risk of various types of cancer, including stomach cancer.
Another prominent and possible risk factor for stomach carcinoma is Heliobacter pylori infection. H. pylori is a type of bacteria residing in the stomach lining that can lead to inflammation.
Consuming a nutrition-less diet that does not include fresh fruits, vegetables, fibers, etc. can also increase the risk of developing stomach cancer and should be avoided.
Many studies have reported that consuming salted foods, such as pickles, can increase stomach cancer risk.
Alcohol consumption is another potential reason for stomach cancer. Alcohol, along with smoking, increases stomach cancer risk even more as alcohol enhances the carcinogenic effects of tobacco.
Obesity, or excessive weight, is also identified as one of the possible stomach cancer causes.
Coal, metal, and rubber contain a large number of carcinogens. Thus, frequent exposure to these can increase one’s stomach cancer risk.
Autoimmune atrophic gastritis is a condition when the human immune system attacks the stomach's lining cells, increasing the risk of developing stomach cancer.
Having a family history of stomach cancer is also a possible reason for stomach cancer.
If you are persistently experiencing the symptoms listed above, you should consider visiting your primary care doctor for a check-up. After assessing your symptoms and risk factors, the doctor may recommend a consultation with an oncologist for a conclusive evaluation.
Making an accurate stomach cancer diagnosis is the first step toward developing an effective stomach cancer treatment plan. The doctors make use of a variety of tests while diagnosing stomach cancer, and these tests are important for doctors to arrive at a conclusive diagnosis.
Similar to any other cancer type, an early-stage diagnosis of cancer goes a long way toward achieving better stomach cancer recovery rates. Thus, it is advisable to go for regular checkups and immediate consultation if any of the stomach cancer symptoms appear.
Doctors recommend various tests and examination methods for stomach cancer detection. Initially, the doctor will perform a physical examination to understand the cause of the symptoms experienced. If the findings from these initial tests are alarming, doctors will recommend additional tests. The following tests help in detecting stomach cancer:
Endoscopy is one of the most common stomach cancer diagnostic tests. Endoscopic procedures help doctors have a detailed look at the inner lining of the stomach, take out tissue samples for biopsy, and evaluate the extent of the spread of the disease.
Esophagogastroduodenoscopy (EGD) is a type of endoscopic procedure that allows the doctor to view the lining of the stomach, esophagus, and the initial part of the small intestine. It is also known as upper endoscopy, in which the doctor inserts a flexible and thin tube with a light source at its end through the patient's mouth into the esophagus.
Endoscopic ultrasound is a combination of endoscopy and ultrasound images to get detailed images of the stomach, digestive tract, pancreas, and bile ducts. During this procedure, the doctor inserts a flexible and thin tube with an ultrasound probe on its tip through the mouth into the esophagus.
A biopsy is an important stomach cancer test recommended to obtain a definitive diagnosis. A stomach biopsy involves taking out a small tissue sample from the suspected area of the stomach lining. This sample is then examined under a microscope for the presence of cancer cells. A biopsy also helps in determining the type of stomach cancer and its stage.
Doctors may also recommend specific lab tests for a stomach cancer diagnosis. That said, lab tests alone are not sufficient for stomach cancer diagnosis and need to be combined with different tests, such as imaging, endoscopy, and other tests. Some of the standard lab tests include blood tests for stomach cancer, stool tests, and molecular and genetic testing. The following lab tests are commonly recommended for stomach cancer detection:
Advanced genomic testing is used for analyzing cancerous cells to identify and classify the mutations, genetic alterations, and biomarkers present.
Complete blood tests, or CBC, are not directly used for stomach cancer detection but may offer essential information that may help in arriving at an accurate diagnosis. For example, a CBC can detect low levels of hemoglobin in the blood, which can be a sign of stomach cancer-induced anemia.
Liver function tests are not usually used for primary stomach cancer diagnosis, but they can offer information that may help in the proper detection of the disease. These tests come in handy to check if stomach cancer has metastasized to the liver or if the cancer is causing bile obstruction.
Imaging tests lend a helping hand to doctors in visualizing the cancer, finding out its type, size, and location, and determining the extent of its spread. These imaging tests create detailed images of the stomach and nearby organs from different angles. These imaging tests also help in stomach cancer staging.
CT scans can be used to obtain cross-sectional images of the complete abdomen and pelvis area from various angles. A CT scan helps evaluate the involvement of lymph nodes and determine the exact location and size of the cancer.
Magnetic resonance imaging, or MRI, makes use of radio and magnetic waves to create detailed images of the stomach's soft tissues. MRI scans help check if there is lymph node involvement or metastasis. These scans also help in determining the type and stage of the cancer in cases where a CT scan cannot be recommended.
A PET/CT scan also helps determine the stage of the disease. This scan combines two different scans, namely a PET scan and a CT scan. A PET scan is conducted to look for abnormal metabolic activities, and a CT scan produces 3D images of the internal structures. Together, these scans help specialists determine the extent of the disease accurately.
Ultrasound creates detailed and high-definition images of the stomach using sound waves. This test helps in detecting tumors and staging.
X-rays, especially chest X-rays, are often used by doctors to check for any signs of the spread of cancer to other organs, such as the lungs.
Doctors recommend various approaches to treat stomach cancer, and the right treatment plan is devised after considering the type of stomach cancer, its stage and size, and the patient's health condition.
Gastrectomy refers to a surgical procedure used to treat stomach cancer that involves partial or complete removal of the stomach. This procedure is used as a treatment when the cancer has not spread to other organs and is still localized.
During a subtotal gastrectomy, a part of the stomach where the cancer is located is removed, and the remaining parts are connected to the small intestine.
During a total gastrectomy, the doctor removes the entire stomach. This procedure is recommended when the disease has spread throughout the stomach. After this procedure, the doctor connects the esophagus to the small intestine.
Endoscopic mucosal removal refers to the removal of precancerous or abnormal tissues present in the stomach's inner lining. This method of treatment is effective in the early stages of stomach cancer and comes in handy when the cancer is limited to the mucosa or the stomach's inner lining.
Hyperthermic intraperitoneal chemotherapy (HIPEC) involves a combination of heated chemotherapy and surgery to treat stomach cancer. The goal of the treatment is to remove as much cancer as possible.
Liver excision is a line of treatment used by doctors when stomach cancer has metastasized to the liver. Liver excision, or liver surgery, involves the removal of the liver portion that is affected by cancer.
Radiation therapy is a stomach cancer therapy that uses high-energy radiation, such as X-rays, to target and kill cancerous cells. Doctors use it in combination with surgery and chemotherapy, depending on the patient's health, the type and size of the cancer, and the extent of the spread of the cancer.
Intensity-modulated radiation therapy (IMRT) enables a very accurate and targeted radiation exposure with minimal damage to nearby tissues. IMRT is recommended along with other treatments, such as surgery and chemotherapy.
Trilogy is a special form of linear accelerator that is used to treat stomach cancer with the use of image guidance. This platform rotates 360 degrees around the patient to precisely target the tumor and destroy the cancer cells.
TomoTherapy is a type of image-guided radiation therapy (IGRT) that works by combining radiation therapy and high-end imaging to target and kill stomach tumors. By precisely targeting the tumor, TomoTherapy reduces treatment-related side effects and supports faster recovery.
Interventional radiology refers to a sub-specialty within the radiology line. It uses imaging and minimally invasive methods to diagnose and treat stomach cancer. The following are some of the commonly used IR methods to manage stomach cancer:
Immunotherapy is a procedure that uses drugs to enhance the immune system’s ability to recognize and attack cancerous cells in the stomach.
Targeted therapy for stomach cancer, or gastric cancer therapy, involves targeting specific molecules that are present on the cancer cells and certain cellular pathways that are responsible for the growth and spread of the cancerous cells. Targeted therapy blocks the growth of cancer cells or destroys them by targeting these molecules and cellular pathways.
The goal of stomach cancer chemotherapy may be to shrink the tumor before surgery (neo-adjuvant chemotherapy) or destroy the cancerous cells that remain after surgery (adjuvant chemotherapy). Some of the commonly recommended chemotherapy drugs for stomach cancer include 5-FU, oxaliplatin, cisplatin, and epirubicin.
Systemic chemotherapy is used to target cancerous cells present throughout the body. This treatment is recommended for aggressive and advanced stomach cancers.
Intraperitoneal chemotherapy refers to the chemotherapy method according to which the drugs are directly injected into the peritoneal cavity, the space between the visceral (lining of the abdominal organs) and parietal layers of the peritoneum (lining of the abdomen).
Palliative care is recommended for patients with advanced-stage stomach cancer. It includes alleviating pain and other symptoms of the disease, offering support and comfort to the patients, and improving the patient's quality of life.
Stomach cancer diagnosis and treatment always require specialized expertise. At HCG, we have skilled oncologists who are trained to treat different types of stomach cancer with modern treatment approaches. In addition, HCG has state-of-the-art equipment and advanced technologies, which come in handy for the effective diagnosis and treatment of stomach cancer.
Learning about the different stomach cancer risk factors plays an essential role in the potential primary prevention of the disease. In fact, understanding these risk factors goes a long way in diagnosing, preventing further spread of the cancer, and designing a treatment plan.
As per experts, a risk factor is something that increases an individual's chances of developing the disease. Some of these risk factors are modifiable, such as obesity, diet, and tobacco and alcohol consumption; others are non-modifiable, for example, age, gender, and family history.
Here are some of the common risk factors, and learning about them can help one possibly avoid stomach cancer.
Age is considered to be one of the most significant stomach cancer risk factors. Hormonal changes, a weak immune system, long exposure to H. pylori infection, the diminishing ability of the body to repair damage to the DNA, and chronic inflammation of the stomach's lining are some of the factors that are associated with increasing age and form a link between age and the risk of developing stomach cancer.
Gender is also a major risk factor associated with stomach cancer, as it is found to be more common among men as compared to women. Though the reason for this differentiation is not completely known, studies have suggested hormonal differences as one of the possible causes.
According to a few studies, women have a higher level of estrogen, which may offer protection against stomach carcinoma.
Infections associated with certain bacteria, mainly Helicobacter pylori, or H. pylori, are also considered one of the stomach cancer risk factors. H. pylori infects the stomach lining and the small intestine's upper part and causes stomach ulcers. CagA, a toxin produced by H. pylori, can cause the stomach cells to become cancerous and divide uncontrollably.
A positive family history wherein close family members, such as siblings, parents, or kids, are diagnosed with stomach cancer may increase the likelihood of developing this condition. Genetic mutations, cancer clusters, and shared environments are some of the most important factors associated with family history.
Geographic variations, lifestyle aspects associated with race and ethnicity, and genetic factors linked to certain races mark a link between race and ethnicity as a risk factor for stomach cancer.
Hispanics, Blacks, and Asians are more likely to develop stomach cancer when compared to other races.
Specific dietary habits, such as high salt intake, low levels of fruits and vegetables included in the diet, inadequate consumption of folate, and consumption of processed and red meat, increase the risk of stomach cancer. Though there are no particular foods that prevent stomach cancer, making certain dietary changes may help one reduce their stomach cancer risk.
Exposure to certain harmful chemicals, such as asbestos, high-salted food items, nitrates and nitrites, and PAHs found usually in coal, gas, oil, and tobacco, can increase one’s stomach cancer risk.
Chronic irritation of the bladder could also be a result of the changes that occur in the stomach lining. This chronic irritation of the bladder can be caused by H. pylori infection, tobacco and alcohol use, dietary issues, and autoimmune conditions, such as autoimmune gastritis.
Previous gastric surgery, chronic gout, pernicious anemia, gastric polyps, and gastroesophageal reflux disease are some of the medical conditions that increase the risk of developing stomach cancer.
Excessive tobacco and alcohol consumption are also identified as stomach cancer risk factors. According to studies, those who smoke have a 1.5-fold higher risk of developing stomach cancer than those who don’t.
Obesity leads to significant metabolic changes and inflammation in the body, which can increase one’s risk of developing stomach cancer.
It is not possible to prevent stomach cancer; however, certain measures can help reduce its risk. Here are some possible ways to prevent stomach cancer:
Quitting smoking can help increase the chances of stomach cancer prevention.
Limiting the intake of salted and pickled foods helps reduce the risk of stomach cancer.
Since fruits and vegetables are a rich source of fiber, antioxidants, and phytochemicals, consuming them on a daily basis can help one reduce their stomach cancer risk.
H. pylori infection can lead to stomach lining inflammation, which can increase the chances of stomach cancer. Thus, treating H. pylori can significantly help in offering protection against stomach carcinoma.
A stomach cancer diagnosis can be challenging. However, an early diagnosis of stomach cancer is really helpful in getting a favorable prognosis for the patient. Thus, it is essential to be aware of the different risk factors associated with stomach cancer and its symptoms and see a doctor in the case of persistent symptoms.
