Stomach cancer, also called gastric cancer, is a disease in which the cells in the stomach divide without control or order and take on an abnormal appearance. These cancerous cells often spread to nearby organs and to other parts of the body.
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How Does Stomach Cancer Develop?
The stomach is the sac-like organ located in the upper abdomen, under the ribs, which plays a role in the digestion of food. It connects the esophagus (e-SOF-a-gus), the tube that carries swallowed food, with the small intestine, which absorbs the nutrients needed by the body. When food enters the stomach, the muscles in its wall create a rippling motion that mixes and mashes it. The glands in the lining of the stomach release juices that help to digest the mixture. After a few hours, the food becomes a liquid and moves into the small intestine. This makes it easier for the intestine to absorb the substances that the body needs for energy.
Stomach cancer begins when some of the cells in its lining take on an abnormal appearance and begin to divide without control or order. If left untreated, these cancer cells can grow through the stomach wall, and they can spread to nearby organs, or to nearby lymph nodes. Through the lymphatic system, the cancer cells can spread to distant areas of the body, including the lungs and the ovaries.
Who Gets Stomach Cancer, and Why?
Each year, about 24,000 people in the United States learn that they have cancer of the stomach. Like most other forms of cancer, stomach cancer occurs most frequently in older people, usually aged 55 or older. Fortunately, for reasons that scientists cannot fully explain, the number of people who get this disease has been dropping steadily for the past 60 years.
Stomach cancer is much more common in other countries, especially Japan, Chile, and Iceland. Researchers think the reason may be that people in these countries eat many foods that are preserved by drying, smoking, salting, or pickling. Eating foods preserved in this way may raise someone's risk for developing stomach cancer. People who smoke cigarettes also may be at higher risk of developing stomach cancer.
What Happens When People Have Stomach Cancer?
At first, stomach cancer does not cause any symptoms. And when it does eventually cause symptoms, they often are mistaken for less serious stomach problems, such as indigestion, heartburn, or a virus. Therefore, it is hard to find stomach cancer early, which makes it more difficult to treat. Possible symptoms include:
- indigestion or a burning sensation in the stomach
- discomfort or pain in the abdomen
- nausea and vomiting after meals
- bloating of the stomach after meals
- weakness, fatigue, or weight loss
- vomiting blood or passing black, tar-like stools.
When people report these symptoms to their family doctor, they may be referred to a gastroenterologist (gas-tro-en-ter-OL-o-jist), a doctor who specializes in diagnosing and treating digestive problems. The gastroenterologist may order additional diagnostic tests to figure out what is wrong.
One of the most common procedures is called endoscopy (en-DOS-ko-pee), which involves passing a very thin, lighted tube down the esophagus and into the stomach. This allows doctors to look directly at the inside of the stomach. If an abnormal area is seen, they can remove some tissue through the tube and have it examined under a microscope. This process, called a biopsy (BY-op-see), determines whether or not cancer cells are present.
A person also might have an upper GI series, which is a series of x-rays of the upper gastrointestinal (gas-tro-in-TES-ti-nal) tract, including the esophagus and stomach. These pictures are taken after the person drinks a thick, chalky liquid called barium (BA-ree-um). The barium outlines the stomach on the x-rays, helping doctors locate tumors or other abnormal areas.
The doctor also might want to test for blood in the stool, the solid waste that people produce when they go to the bathroom. This involves placing a small amount of stool on a slide and having it tested in the laboratory. Sometimes, blood in the stool is a sign of stomach cancer or other cancers of the digestive tract.
If cancer is diagnosed, then doctors need to find out whether it has spread to other parts of the body. They often use imaging tests such as CT scans * or ultrasound * to check for this possibility.
How Is Stomach Cancer Treated?
Because the symptoms associated with stomach cancer seem so minor at first, people rarely report them right away. Therefore, the cancer usually has spread into the stomach wall or even beyond the stomach when it is found. This makes it difficult to cure.
The most common treatment is an operation called gastrectomy (gas-TREK-to-mee), during which surgeons remove part or all of the stomach and some of the surrounding tissue. If all of the stomach needs to be removed, then surgeons connect the esophagus directly to the small intestine. The nearby lymph nodes usually are removed, too.
People with stomach cancer may also be treated with radiation therapy or chemotherapy, either in an attempt to destroy some of the cancer cells or to ease some of their symptoms, such as pain. Radiation therapy focuses high-energy rays on the body to destroy cancer cells and to stop or slow their growth. During chemotherapy, anti-cancer drugs are given by mouth or by injection into a muscle or blood vessel.
Because stomach cancer is so difficult to cure, researchers are looking at new ways to treat this disease. Studies called clinical trials are being conducted to evaluate some of these new treatments in cancer patients. One example is biological therapy, which triggers the body's own immune system to attack and destroy cancer cells.
* CT scans (CAT scans) are computerized axial tomography (to-MOG-ra-fee), which uses x-rays and computers to view structures inside the body.
* ultrasound is a painless procedure in which sound waves passing through the body create images on a computer screen.
Living with Stomach Cancer
Because people with stomach cancer often have part or all of the stomach removed, they need time to readjust to eating after the surgery. At first, patients are fed intravenously (in-tra-VEE-nus-lee), through a vein in the hand or arm. Within several days, they usually can start taking in liquids, then soft foods, and then more solid foods. Often they need to follow a special diet until they can adjust to having a smaller stomach or none at all. People with stomach cancer need to work with dietitians and nutritionists to make sure that they are getting the nutrients their bodies need.
U.S. National Cancer Institute (NCI), Bethesda, MD 20892. NCI posts the
What You Need to Know About Stomach Cancer
at its website, along with a glossary, referrals, information about
healthy eating for cancer patients, and information about clinical
American Cancer Society (ACS), 1599 Clifton Road N.E., Atlanta, GA
30329-4251. ACS has a
Stomach Cancer Resource Center
at its website, which answers frequently asked questions and posts
information about survivorship, prevention, and treatment.
United Ostomy Association (UOA), 36 Executive Park, Suite 120, Irvine,