Stomach Cancer

Symptoms and risk factors

Early signs of stomach cancer may be confused with other health conditions.

It's easy to miss early symptoms because they are common for other, less-serious health conditions, like acid reflux. These may include:

• Abdominal pain
• Heartburn
• Nausea
• Vomiting
• Weight loss
• Feeling full after small meals

Once it spreads, it can also cause additional symptoms, such as:

• Bloody stool
• Jaundice (eyes and skin turns yellowish)
• Trouble swallowing
• Build-up of fluid in the abdomen (ascites)

If you experience any of these, consult with your primary care doctor. They may refer you to a gastroenterologist for diagnostic testing.

Many risk factors are outside of your control.

A risk factor increases your chances of developing a disease. You cannot control all of your risk factors for this disease. For example, men are more likely to develop stomach cancer than women. And certain conditions elevate your risk, including:

• Presence of H. pylori: These stomach-dwelling bacteria can be treated with antibiotics. While not everyone who develops this cancer has H. pylori bacteria, those who do may be at increased risk.
• Certain inherited diseases: Diseases such as hereditary non-polyposis colon cancer (HNPCC), Lynch syndrome, and familial adenomatous polyposis (FAP), may be associated with this type of cancer.
• Pernicious anemia: A severe lack of red blood cells can lead to this type of cancer.
• Absence of acid production: Lack of sufficient acid in the stomach can contribute to the development of this cancer.
• Gastric polyps: Certain types of gastric polyps are more likely to develop into cancer.

Screening and prevention

You may lower your risk of cancer by maintaining a healthy weight.

There are some risk factors you can control. Smoking and heavy alcohol consumption increases your risk for developing this cancer, so you can lower your risk by avoiding use. You may also be at an increased risk for gastric cancer if you eat salty or smoked foods. In contrast, eating a healthy diet, including lots of fruits and vegetables, can lower your risk. A nutritious diet can also help you achieve and maintain a healthy weight, which is important for cancer prevention.

But this cancer can't always be prevented. And unless you have a high risk, we don't typically recommend routine screening for gastric cancer. However, if you have an inherited condition or several risk factors that increase your odds of developing it, like having Lynch syndrome, you may benefit from a screening test using endoscopy. This can help you catch the disease early when there may be more treatment options. If you are at an increased risk, we encourage you to talk to your doctor about the pros and cons of screening. You may benefit from a referral to our Gastrointestinal Cancer Prevention program, where a team of specialists will help you understand and manage your cancer risk.

Diagnosis

An accurate diagnosis will help us determine your best treatment options.

If you may have this cancer, your primary care physician will recommend that you meet with a gastroenterologist or surgical oncologist. Our team of gastroenterologists and surgical oncologists take great care to make an accurate diagnosis for each patient and carefully evaluate any symptoms with the following diagnostic tools and procedures:

• Medical history: We will ask you about your background, previous surgeries, and any family history of stomach cancer.
• Physical examination: We will perform a detailed physical exam to determine whether you have a stomach tumor and if it has spread anywhere else in your body.
• Diagnostic procedures: You may undergo any of the following:
  • Biopsy: This procedure allows your surgeon to carefully examine the cells of the tumor under a microscope to determine whether it is cancerous.
  • Endoscopy: In this procedure, your gastroenterologist will place an endoscope, which is a thin camera with a special light, into your stomach. With the endoscope, your surgical oncologist can locate the tumor and remove cells from it for a biopsy.
  • Endoscopic ultrasound: This is a specialized test that gastroenterologists use to determine specific details about the tumor, including how thick it is and whether the cancer is spreading to nearby lymph nodes.
  • CT scan: These are tests your gastroenterologist uses to create a computerized picture of other organs, such as your liver and lungs, to determine if your cancer is spreading.
  • PET scan: This diagnostic scan is considered on a case-by-case basis depending on the results of other diagnostic tests. A small amount of radioactive substance is used to characterize the metabolic activity of cells in different organs during a scan. This can sometimes help identify additional sites of cancer.
  • Barium swallow (Upper GI series): This test involves swallowing a silver-white metallic compound called barium. The liquid coats the esophagus and stomach before taking X-rays to help us spot abnormalities.
  • Laparoscopy: If your gastroenterologist determines that you have a stomach tumor, he or she will refer you to a surgical oncologist for further evaluation. The surgical oncologist will place a special camera in the abdomen to inspect the entire area for cancer through a surgical procedure called a laparoscopy. Laparoscopy determines whether the cancer is spreading and helps avoid additional surgical procedures.

Some of these tests also help us stage your cancer, which helps us understand:

• How deep the tumor is embedded in the lining of the stomach
• If cancer has spread to nearby lymph nodes
• If cancer metastasized (spread to other parts of the body)
  
  

Types of cancer

Most stomach cancers begin in the lining of the stomach wall (called adenocarcinoma).

Adenocarcinoma is the most common type of stomach cancer. It begins in the stomach lining (mucosa). There are also rare forms of cancer that begin in the stomach. The following types of cancer make up less than ten percent of stomach cancers:

• Gastrointestinal stromal tumors (GIST), which begin in the stomach connective tissue

• Carcinoid tumors, or neuroendocrine tumors (NET), which begin in hormone-producing cells

• Lymphoma, which begins in immune cells

Support services

We believe the right support at the right time can help to minimize your stress and uncertainty. We provide comprehensive services and programs designed to care for your physical, emotional, mental, and spiritual needs so you can focus on healing.

Learn More About Cancer Support Services

Genetic counseling

A small percentage of these cancers are caused by inherited gene mutations. If someone in your family carries this mutation, you may benefit from genetic counseling. Our genetic counselors can help you understand your cancer risk and help you manage it through an individualized approach.

Learn More About Genetic Counseling

Personalized rehabilitation

We offer comprehensive rehabilitation services to help you feel like yourself again after treatment. Stomach surgery and/or cancer treatment can affect your appetite, strength, balance, concentration, and more. We'll develop a treatment plan that will help address your unique concerns, including managing pain and nausea as you return to your life.

Learn More About Cancer Rehabilitation

Survivorship

You may feel a combination of different feelings at the end of your treatment. It's common to experience both relief and stress simultaneously as you prepare to transition back to home life, work, and the community with the risk of recurrence in the back of your mind. We're here to help ease that transition through help with nutrition, follow-up care, counseling, and other support services that can help you successfully navigate survivorship.

Learn More About the Cancer Survivorship Program