Stomach Cancer

Stomach cancer occurs when cells in the stomach grow out of control. It typically develops slowly over many years, starting with pre-cancerous changes in the stomach lining.

Because these early changes rarely cause symptoms, they often go undetected. Stomach cancer is typically diagnosed when signs and symptoms of the disease, such as stomach pain, unexplained weight loss, poor appetite, nausea or vomiting, swelling of the abdomen, or indigestion, become more apparent and require a discussion with a doctor.

The exact cause of stomach cancer is unknown, but researchers have identified the following stomach cancer risk factors:

• Helicobacter pylori infection
• Long-term inflammation of the stomach
• Diets high in salted, smoked foods, pickled vegetables or foods containing nitrates and nitrites
• Smoking
• Alcohol use
• Family or personal history of certain inherited syndromes, including nonpolyposis colon cancer (Lynch syndrome), familial adenomatous polyposis (which causes cancer of the colon and rectum) and Menetrier disease (which causes large gastric folds)
• Previous stomach surgery
• History of stomach polyps
• Age – the average age at diagnosis is 69 years
• Men are more likely to develop stomach cancer than women
• Having a Type A blood type
• Pernicious anemia, in which the body’s immune system attacks and destroys the stomach’s mucosal cells
• Exposure to environmental factors, such as radiation or working in the rubber or coal industries

Having one or more risk factors does not mean you will definitely develop stomach cancer, and having no risk factors does not mean you cannot get it. It is advisable to review your family medical history with your doctor and understand your risk for stomach cancer.

Adenocarcinoma is by far the most common form of stomach cancer. It develops in the innermost layer of the stomach’s lining and then spreads through the outer two layers.

There are two main types of stomach adenocarcinomas:

• Intestinal – the more common form that typically has a better prognosis
• Diffuse – the less common form, although it spreads more easily and can be harder to treat

Other less common stomach cancer types include:

• Lymphoma
• Gastric sarcoma (also known as gastrointestinal stromal tumor, or GIST)
• Carcinoid tumors (also known as neuroendocrine tumors)

Stomach cancer is rare today in the U.S. and routine screening for people at average risk has not proved useful. Screening is only recommended for those at high risk for stomach cancer.

There are no standardized stomach cancer screening tests, but there are several other tests that may be recommended for individuals who are considered at high risk for developing stomach cancer.

These stomach cancer tests include the following:

• Upper endoscopy – uses a thin, flexible tube that is inserted into the mouth and guided down the throat to allow your doctor to view your stomach and remove a tissue sample for biopsy, if needed
• An upper gastrointestinal (GI) series (also called a barium swallow) – consists of X-rays of the upper digestive system (the esophagus, stomach and first section of the small intestine) with use of barium, an imaging agent, to outline any abnormal areas
• Blood tests measuring levels of pepsinogen in the blood – with low levels suggesting chronic gastric issues, which may lead to stomach cancer

Stomach cancer typically develops slowly over many years, starting with pre-cancerous changes in the stomach lining. Because these early changes rarely cause symptoms, they often go undetected.

Still, it's important to be aware of the signs that may help identify stomach cancer at an early stage, when treatment can be most effective.

Stomach cancer symptoms include:

• Indigestion or heartburn
• Discomfort or pain in the abdomen
• Nausea or vomiting
• Diarrhea or constipation
• Bloating after meals
• Loss of appetite
• Sensation of food getting stuck in the throat
• Weakness and fatigue
• Vomiting blood or blood in the stool
• Unexplained weight loss
• Swelling or fluid buildup in the abdomen

If you are experiencing any of these symptoms, contact your doctor as soon as possible. Keep in mind that these symptoms can also indicate conditions other than stomach cancer.

If stomach cancer is suspected, one or more of the following tests may be used to diagnose stomach cancer:

• Upper endoscopy – uses a thin, flexible tube that is inserted into the mouth and guided down the throat to allow your doctor to view your stomach and remove a tissue sample for biopsy, if needed. An ultrasound device on the tip of the scope may be used to obtain images of the stomach to help determine if the cancer has spread.
• A biopsy – removal of a sample of stomach tissue that is further examined under the microscope for the presence of cancer. The sample is usually obtained during an upper endoscopy procedure.
• Upper gastrointestinal (GI) series (also called a barium swallow) – combines X-rays of the upper digestive system (the esophagus, stomach and first section of the small intestine) with barium, an imaging agent, to help outline any abnormal areas in the stomach
• Fecal occult blood test – examines a small sample of stool for the presence of blood, which may indicate cancer

At Houston Methodist, we are dedicated to providing leading-edge diagnosis and treatment options for stomach cancer. Our goal is to provide effective treatments, while preserving healthy tissue and cells.

 

Learn more about the advanced stomach cancer treatment our experts offer >