| Stomach cancer is cancer that occurs in the
stomach — the muscular sac located in the upper middle of your
abdomen, just below your ribs. Your stomach is responsible for
receiving and holding the food you eat and then helping to break
down and digest it.
Another term for stomach cancer is gastric
cancer. These two terms most often refer to stomach cancer that
begins in the mucus-producing cells on the inside lining of the
stomach (adenocarcinoma). Adenocarcinoma is the most common type of
stomach cancer.
Stomach cancer is uncommon in the United
States, and the number of people diagnosed with the disease each
year is declining. Stomach cancer is much more common in other areas
of the world, particularly Japan.
Signs and symptoms of stomach cancer may
include:
- Fatigue
- Feeling bloated after eating
- Feeling full after eating little
- Heartburn
- Indigestion
- Nausea
- Stomach pain
- Vomiting
- Weight los
Doctors aren't sure what causes stomach
cancer. There is a strong correlation between a diet high in smoked,
salted and pickled foods and stomach cancer. As the use of
refrigeration for preserving foods has increased around the world,
the rates of stomach cancer have declined.
In general, cancer begins when an error
(mutation) occurs in a cell's DNA. The mutation causes the cell to
grow and divide at a rapid rate and to continue living when normal
cells would die. The accumulating cancerous cells form a tumor that
can invade nearby structures. And cancer cells can break off from
the tumor to spread throughout the body.
Types of stomach cancer
The cells that form the tumor determine the type of stomach cancer.
The type of cells in your stomach cancer helps determine your
treatment options. Types of stomach cancer include:
- Cancer that begins in the
glandular cells (adenocarcinoma). The glandular cells
that line the inside of the stomach secrete a protective layer
of mucus to shield the lining of the stomach from the acidic
digestive juices. Adenocarcinoma accounts for more than 90
percent of all stomach cancers.
- Cancer that begins in immune
system cells (lymphoma). The walls of the stomach
contain a small number of immune system cells that can develop
cancer. Lymphoma in the stomach is rare.
- Cancer that begins in
hormone-producing cells (carcinoid cancer).
Hormone-producing cells can develop carcinoid cancer. Carcinoid
cancer is rare.
- Cancer that begins in nervous
system tissues. A gastrointestinal stromal tumor (GIST)
begins in specific nervous system cells found in your stomach.
GIST is a very rare form of cancer.
Because the other types of stomach cancer are
rare, when people use the term "stomach cancer" they generally are
referring to adenocarcinoma.
Factors that increase your risk of stomach
cancer include:
- A diet high in salty and smoked foods
- A diet low in fruits and vegetables
- Eating foods contaminated with aflatoxin
fungus
- Family history of stomach cancer
- Infection with Helicobacter pylori
- Long-term stomach inflammation (chronic
gastritis)
- Pernicious anemia
- Smoking
- Stomach polyps
Your treatment options for stomach cancer
depend on the stage of your cancer, your overall health and your
preferences. Treatment for the adenocarcinoma type of stomach cancer
may include:
Surgery
The goal of surgery is to remove all of the stomach cancer and a
margin of healthy tissue, when possible. Options include:
- Removing early-stage tumors from
the stomach lining. Very small cancers limited to the
inside lining of the stomach may be removed using endoscopy. The
endoscope is a lighted tube with a camera that's passed down
your throat into your stomach. The doctor uses special tools to
remove the cancer and a margin of healthy tissue.
- Removing a portion of the stomach
(subtotal gastrectomy). During subtotal gastrectomy,
the surgeon removes only the portion of the stomach affected by
cancer.
- Removing the entire stomach
(total gastrectomy). Total gastrectomy involves
removing the entire stomach and some surrounding tissue. The
esophagus is then connected directly to the small intestine to
allow food to move through your digestive system.
- Removing lymph nodes to look for
cancer. The surgeon examines and removes lymph nodes in
your abdomen to look for cancer cells.
- Surgery to relieve signs and
symptoms. Removing part of the stomach may relieve
signs and symptoms of a growing tumor in people with advanced
stomach cancer. In this case, surgery can't cure stomach cancer,
but it can make you more comfortable.
Surgery carries a risk of bleeding and
infection. If all or part of your stomach is removed, you may
experience digestive problems, such as diarrhea, vomiting and
dumping syndrome, which occurs when the small intestine fills too
quickly with undigested food.
Radiation therapy
Radiation therapy uses high-powered beams of energy to kill cancer
cells. The energy beams come from a machine that moves around you as
you lie on a table.
Radiation therapy can be used before surgery (neoadjuvant
radiation) to shrink a stomach tumor so it's more easily removed.
Radiation therapy can also be used after surgery (adjuvant
radiation) to kill any cancer cells that might remain around your
stomach. Radiation is often combined with chemotherapy. In cases of
advanced cancer, radiation therapy may be used to relieve side
effects caused by a large tumor.
Radiation therapy to your stomach can cause
diarrhea, indigestion, nausea and vomiting.
Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer
cells. Chemotherapy drugs travel throughout your body, killing
cancer cells that may have spread beyond the stomach.
Chemotherapy can be given before surgery (neoadjuvant
chemotherapy) to help shrink a tumor so it can be more easily
removed. Chemotherapy is also used after surgery (adjuvant
chemotherapy) to kill any cancer cells that might remain in the
body. Chemotherapy is often combined with radiation therapy.
Chemotherapy may be used alone in people with advanced stomach
cancer to help relieve signs and symptoms.
Chemotherapy side effects depend on which
drugs are used. The type of stomach cancer you have determines which
chemotherapy drugs you'll receive.
Clinical trials
Clinical trials are studies of new treatments and new ways of using
existing treatments. Participating in a clinical trial may give you
a chance to try the latest treatments. But clinical trials can't
guarantee a cure. In some cases, researchers might not be certain of
a new treatment's side effects.
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