What is stomach cancer?

Stomach cancer, also called gastric cancer, is the growth of abnormal cells in the lining and wall of the stomach. It is the fourth most common cancer and occurs mainly in men over 40 years of age.

Stomach cancer is difficult to detect in its early stages because its early symptoms are absent or mild.

How does it occur?

A diet high in nitrates (a common meat preservative) and pickled or smoked foods may increase the risk of gastric cancer. Excess alcohol consumption also increases the risk of stomach cancer.

Several conditions may be precancerous and may increase the risk of stomach cancer. They include:

• atrophic gastritis, chronic gastritis (inflammation of the stomach lining), and gastric ulcer
• pernicious anemia: a chronic vitamin-deficiency anemia that occurs in older adults characterized by numbness and tingling in the extremities
• achlorhydria: low levels or absence of hydrochloric acid in gastric juice.

The four stages of stomach cancer progression are:

• Stage 1: Cancer cells are confined to the inner stomach lining. They are absent from the wall of the stomach or from lymph nodes.
• Stage 2: Cancer cells exist in the tissue of the gastric wall, and may or may not exist in the lymph nodes. There are no metastases (tumors that have spread from the original site).
• Stage 3: Cancer cells have spread (metastasized) to other areas adjacent to the stomach.
• Stage 4: Cancer cells exist in the lymph nodes and/or distant areas of the body.

What are the symptoms?

Symptoms of stomach cancer include:

• heartburn or indigestion
• stomach pain
• nausea
• sensation of pressure in the stomach
• loss of appetite (and decreased stomach capacity)
• weight loss.

How is it diagnosed?

Your doctor will review your symptoms and examine you. Initial diagnostic studies may include an "upper GI" x-ray, where you swallow barium which shows up on x-ray and outlines any abnormality in the stomach. You may also have a procedure called an endoscopy, where a slim, flexible, lighted tube is passed through your esophagus into the stomach. This telescope-like tube allows the doctor to see any abnormalities. The endoscopy also enables the doctor to take a piece of any abnormal tissue and send it for tests to determine if it is cancerous.

Your doctor may also order:

• blood count and blood chemistry tests, including liver tests
• chest x-rays
• CT scan of the abdomen, if there is concern about possible spread of the cancer.

How is it treated?

Surgical removal of the entire tumor and surrounding lymph nodes may cure some people, especially if the tumor is detected early.

Partial gastrectomies (partial stomach removal) are more often performed for lower-end tumors (closer to the small intestine); near-total gastrectomies are commonly done for tumors closer to the esophagus.

Radiation therapy does not offer a cure, but it may be used to help lessen pain.

Chemotherapy is often given as an adjuvant or palliation.

How long will the effects last?

The cancer may be curable in 85% of patients whose early cancers have not spread through the stomach lining tissues. Cancer may not be curable, however, in those individuals whose cancer has spread beyond the stomach lining. People with disease in the early stage account for 10% to 20% of all cases of gastric cancer. Ask your doctor for survival rates for gastric cancer in your stage of disease.

How can I take care of myself?

• Follow the full course of treatment prescribed by your doctor.
• Consult a dietitian to maximize your nutrition and therefore your strength within the limits of your dietary restrictions.
• Get plenty of rest.
• Ask your doctor to recommend appropriate exercise and activities.
• Join a cancer support group.
• Be candid with your family and your doctors about your concerns.
• Seek professional counseling help to deal with difficult issues.
• Identify those individuals and activities which you enjoy and enjoy them.

How can I help prevent stomach cancer?

Follow these suggestions:

• Limit smoked foods and nitrate and nitrite-preserved foods in your diet.
• Limit your alcohol intake and tobacco use.
• Have regular examinations if you are diagnosed with achlorhydria (lack of hydrochloric acid in stomach secretions).
• Follow your doctor's recommendation if you have been diagnosed with pernicious anemia.
• Contact your doctor immediately if symptoms recur.