Stomach cancer, also called gastric cancer, develops when cells in the stomach lining begin to grow out of control. People usually don’t experience any symptoms in the early stages, which makes early detection and treatment more difficult. Healthy lifestyle habits can reduce the risk of stomach cancer. Stomach cancer is rare in the United States and more common worldwide.
Overview Overview What Is Stomach Cancer? Stomach cancer, also known as gastric cancer, develops when the cells in the stomach proliferate abnormally. It typically originates in the stomach’s lining, growing deeper into the stomach walls as the cancer progresses.e60dc2a1-f33c-4a05-9b50-8e3e8e59762993bb74cc-9fda-43cb-bf10-e76c554b12d0 It is one of the leading causes of cancer deaths worldwide.e60dc2a1-f33c-4a05-9b50-8e3e8e59762916c6eb4f-4523-47d7-b96b-6cf1e0add939 Types of Stomach Cancer There are several different types of stomach cancer, which vary depending on the types of cells they affect. Adenocarcinoma of the Stomach Adenocarcinomas account for 90 to 95 percent of stomach cancer cases. This type of cancer originates in the glandular, mucus-producing cells of the innermost lining of the stomach.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dd063b6c-a62b-4102-9b60-a9bd1c82ddb6 There are two main classes of adenocarcinoma of the stomach: If the cancer begins in the top inch of the stomach right below the esophagus, it is called gastric cardia cancer; otherwise, it is known as non-cardia gastric cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629117bc986-1987-4cc7-a6dc-928a6a2dacf3 Adenocarcinomas are also classified as either intestinal or diffuse, based on how the cancerous cells appear under a microscope.e60dc2a1-f33c-4a05-9b50-8e3e8e59762902dcbb9d-3b27-45a8-b87b-3d593db29d00 Intestinal adenocarcinomas have cancer cells that look very similar to normal cells. Diffuse adenocarcinomas contain cells that don’t resemble normal cells, and these cancers tend to be more aggressive, meaning that they grow and spread more quickly and are harder to treat. Gastrointestinal Stromal Tumors (GISTs) These originate in very early forms of cells in the stomach wall called the interstitial cells of Cajal. GISTs usually start in the stomach, but they can arise anywhere in the digestive tract.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f9e512c8-8c37-4903-97a2-09de277348f5 Gastrointestinal Neuroendocrine Tumors This type of cancer begins in neuroendocrine cells — cells that act like a combination of nerve cells and hormone-producing cells — that line the digestive tract.e60dc2a1-f33c-4a05-9b50-8e3e8e59762944220586-a70a-475a-b970-0d7b4751689f Primary Gastric Lymphomas This is a type of non-Hodgkin lymphoma . It’s a cancer of the immune system tissues and cells found in the stomach wall.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294e3456e5-8bc4-4927-95c1-f5f94a220e30 Rarely, other types of cancer can also start in the stomach — squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas, for example.
Signs and Symptoms of Stomach Cancer Symptoms Early-stage stomach cancer often has no symptoms, making it challenging to detect. If there are symptoms, they will be mild and unremarkable. These first or early signs of stomach cancer include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f8551ffc-e588-44ed-b456-52b0bd32290d Bloating, especially after eating Heartburn Indigestion Loss of appetite Mild nausea As the disease progresses, symptoms may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ae475b5a-05fa-4d8b-b3c2-0fadee576f7e Persistent indigestion, heartburn, or stomach pain or discomfort Unexplained weight loss Jaundice, or yellowing of the skin or eyese60dc2a1-f33c-4a05-9b50-8e3e8e597629cc4c8ca0-57b6-4f09-a832-0c67e2eccf71 Bloating, swelling, or fluid buildup in the abdomen Feeling full after eating small amounts of food Loss of appetite Nausea Vomiting, sometimes with blood Bloody or black stools Fatigue Diarrhea or constipation
Causes and Risk Factors of Stomach Cancer Causes Generally speaking, stomach cancer develops when something damages the cells in the inner lining of the stomach, resulting in changes in their DNA. The cells multiply more quickly and live beyond their natural life cycle. With that said, stomach cancer’s exact cause is unknown. Researchers have identified many risk factors for the disease that increase your chance of getting it or increase the chance of DNA changes within cells.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d9d7f3e4-d70e-47fb-afe6-1b5fbfc21637 Infection with the Helicobacter pylori ( H. pylori ) bacteria is a major risk factor for stomach cancer, especially cancer in the lower part of the stomach. A chronic infection with the microorganism, which infects the inner lining of the stomach, causes long-lasting inflammation that may lead to atrophic gastritis (a thinning of the stomach lining) and other precancerous changes to the stomach lining. H. pylori has also been linked to a stomach lymphoma called gastric MALT lymphoma . Most people with H. pylori infection, however, never go on to develop stomach cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c3034c92-c326-435b-a2dc-b6697bcc6d5b Other medical conditions that may increase your risk of stomach cancer include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629c169c9be-3a94-4881-8cbc-a395c1bc513b Atrophic gastritis with intestinal metaplasia, which occurs when cells in the stomach lining are replaced with cells that line the intestinese60dc2a1-f33c-4a05-9b50-8e3e8e597629b9881c6f-dc69-4d30-a6f5-b32de2399e67 Pernicious anemia, an autoimmune condition in which you can’t properly absorb vitamin B12, resulting in a low red blood cell count Epstein-Barr virus infection Acid reflux or chronic indigestion Other risk factors include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629c169c9be-3a94-4881-8cbc-a395c1bc513be60dc2a1-f33c-4a05-9b50-8e3e8e5976296a73f2a6-eee3-4982-a7ea-00d20bff1194e60dc2a1-f33c-4a05-9b50-8e3e8e59762924b3e333-a572-410f-9817-cba2a0b08cc4 Being born male Older age, particularly 55 and above Overweight or obesity A diet high in salt-preserved foods (salted fish, meat, and pickled foods) A diet low in fruits and vegetables, and high in processed, grilled, or charcoaled meats Smoking, which doubles your risk of stomach cancer Alcoholic beverages History of stomach surgery to remove part of the stomach for a noncancerous condition, such as an ulcer Chronic stomach inflammation and intestinal polyps Blood type A Work in the rubber, metal, or coal industries Exposure to high levels of radiation A family history of stomach cancer A family history of certain genetic syndromes, such as hereditary diffuse gastric cancer, Lynch syndrome, juvenile polyposis syndrome, Li-Fraumeni syndrome, Peutz-Jeghers syndrome, and familial adenomatous polyposis
How Is Stomach Cancer Diagnosed? Diagnosis A stomach cancer diagnosis begins with a physical examination and a review of your medical and family history. During the exam, your doctor will feel for anything abnormal in your stomach and ask about your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762943674e03-159f-4631-b8b2-20a31be07f5b From there, they may request a combination of diagnostic tests and procedures, including: Upper endoscopy with biopsy, which is a procedure to view and take tissue samples of the esophagus, stomach, and parts of the small intestine using a flexible tube with a camera (an endoscope) Imaging tests such as CT scans, PET scans, X-rays, and MRIs Blood tests to check for anemia, tumor markers (proteins) that may be produced by cancer, and the function of organs such as the liver and kidneys Fecal occult blood test to detect trace amounts of blood in the stool, which may be indicative of cancer bleeding in the stomache60dc2a1-f33c-4a05-9b50-8e3e8e597629e1bd93d3-76ec-415a-8d88-a8baf4e872e8 Endoscopic ultrasound, which allows your provider to see how far your cancer might have spread into your stomach wall or nearby lymph nodes Biomarker testing to see if your cells carry certain gene or protein changes, including HER2, PD-L1, and NTRKe60dc2a1-f33c-4a05-9b50-8e3e8e5976294c815245-ea46-44f3-95df-68c467d3c055
Treatment and Medication Options for Stomach Cancer Treatment Treatment options for stomach cancer depend on the cancer’s type, stage, and location. Surgery There are various types of surgical procedures available for treating stomach cancer, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cb0e8965-26eb-4d91-a5fa-be60b5019474 Endoscopic resection: A procedure that can be used for very early stage cancers to remove the tumor and parts of the normal stomach wall below and around it Gastrectomy: An invasive procedure to remove part or all of the stomach, and possibly nearby lymph nodes, other parts of the gastrointestinal tract, other tissues near the tumor, and the spleen In some cases, a tumor may grow within the passage into or out of the stomach, affecting the ability to eat normally. Surgeons may insert a thin, expandable tube called an endoluminal stent from the esophagus to the stomach or from the stomach to the small intestine. In other cases, they may use endoluminal laser therapy to cut through and open a blockage.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293144b257-9fe6-4be4-b8b0-c34229b50e83 Chemotherapy Chemotherapy uses drugs to kill cancer cells, often used before or after surgery. It may also be the main treatment course if the cancer has spread (metastasized) to other parts of the body, or if surgery is not an option for some reason.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ed44858a-d694-4b52-8be1-8e995f54d523 Many different chemotherapy drugs may be used alone or in combination with one another. The drugs used will differ depending on the stage of stomach cancer. Some of the chemotherapy drugs used for stomach cancer include: Capecitabine Carboplatin Cisplatin Docetaxel Epirubicin Irinotecan Oxaliplatin Paclitaxel Chemotherapy may be delivered into the vein using a needle or catheter, or into the abdominal cavity through a port. These drugs may cause a range of side effects, including nausea and vomiting, hair loss, mouth sores, and fatigue. Targeted Drug Therapy During targeted drug therapy, drugs or other substances target specific changes in cells that cause cancer. It works differently than chemotherapy and is sometimes effective when chemotherapy is not. It may also be used in conjunction with chemo.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b0ab979b-61a5-4738-a29b-8a4e366240b0 For example, the drug trastuzumab (Herceptin) targets the HER2 protein that is sometimes over-produced in people with stomach cancer. Trastuzumab blocks HER2-positive cells from sending chemical signals that tell them to grow, while also stimulating the immune system to kill cells with lots of HER2. Side effects of trastuzumab tend to be mild, and include fever, chills, nausea, and headache. Other targeted drugs may have more serious side effects.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ebce251-97dd-4378-bbb4-765284a5aea9 Targeted drugs used for stomach cancer include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b0ab979b-61a5-4738-a29b-8a4e366240b0 trastuzumab (Herceptin) fam-trastuzumab deruxtecan (Enhertu) ramucirumab (Cyramza) larotrectinib (Vitrakvi) entrectinib (Rozlytrek) zolbetuximab (Vyloy) Immunotherapy Sometimes considered a form of targeted therapy, immunotherapy works by helping the immune system better find and destroy cancer cells. Drugs like nivolumab (Opdivo) and pembrolizumab (Keytruda) target a protein called PD-1 that keeps the immune system’s T-cells from attacking other cells in the body. The drugs block PD-1, allowing T-cells to attack cancer cells. Common side effects include fatigue, itching and rash, loss of appetite, muscle pain, and joint pain, among others.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e514f12-0c1b-45ba-a4e9-4639bd9ae1f5 Radiation Therapy Radiation therapy uses high-energy rays to target and destroy cancer cells. Like chemotherapy, radiation therapy may be used before or after surgery. Sometimes it’s used along with chemotherapy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6984953-926f-4584-817f-27e59b3dff6d Radiation therapy is administered using a machine outside the body. Computers are used to aim the radiation directly at the cancer from multiple angles, limiting the damage to nearby tissues. You may experience some skin problems like redness and peeling, gastrointestinal issues like vomiting and diarrhea, and fatigue from radiation therapy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6984953-926f-4584-817f-27e59b3dff6d
Prevention of Stomach Cancer Prevention There is no surefire way to prevent stomach cancer, but making changes to reduce your risk factors can lower your odds of getting the disease.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292cee781a-c548-4734-be36-8f7a2d551c62 Preventive measures include: A healthy diet rich in fresh fruits and vegetables Reduced consumption of smoked, charcoaled, pickled, or salted foodse60dc2a1-f33c-4a05-9b50-8e3e8e597629ae33d2e5-e5a9-4d0d-9a05-15270388a290 Not smoking Limited alcohol consumption Treatment for H. pylori infections, which most people will have for years without knowing it because they don’t experience any symptoms Regular medical checkups, especially for those at higher risk Physical activity every day
Stomach Cancer Prognosis Prognosis and Outlook The prognosis for stomach cancer depends on the stage at diagnosis, the person’s overall health, and response to treatment. Early-stage cancer has a better prognosis, while advanced-stage cancer often has a poorer outlook. The overall five-year relative survival rate for stomach cancer — that is, the percentage of people diagnosed with the cancer who will live for the next five years, compared with the general population — is 36 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bdbd77f0-ba43-496c-adc6-ebc1761d39e1 The five-year survival rate for stomach cancer also depends on the cancer stage at diagnosis: 75 percent if the cancer is in the stomach only 35 precent if the cancer has spread beyond the stomach to nearby lymph nodes or organs 7 percent if the cancer has spread to a distant part of the body
Research and Statistics: Who Has Stomach Cancer? Research and Statistics Stomach cancer is the fifth most common cancer worldwide.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298cd7c844-5a09-4965-8a47-c280bac59780 Stomach cancer is less common in the United States and other Western countries than in East Asia, eastern Europe, and South and Central America. Stomach cancer accounts for about 1.3 percent of all new cancers diagnosed each year in the United States and is far less common than many other types of cancer, according to the National Cancer Institute.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b5d22274-deb6-4b7e-a91b-d9bcaf1b4074 It mostly affects older adults, with an average age at diagnosis of 68. The lifetime risk of developing stomach cancer is 1 in 101 for men and 1 in 155 for women.e60dc2a1-f33c-4a05-9b50-8e3e8e59762954ece422-c1b8-4ff8-8cf6-bc4aac61cda5 Stomach cancer accounts for 1.8 percent of all cancer deaths in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dc528d6d-6a27-4428-affa-75a57fe00349
Disparities and Inequities in Stomach Cancer Disparities Stomach cancer disproportionately impacts certain minority groups. If you’re white, you are less likely to develop stomach cancer, and more likely to survive it if you do, than other ethnic and racial groups. For example, the non-Hispanic Asian and Pacific Islander population has more than 70 percent higher probability of developing stomach cancer and double the chance of dying from it than the non-Hispanic white population, according to the American Association for Cancer Research. The reasons for this are unknown.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eab35ff3-f79a-4abd-98b2-07636d75c260 Stomach cancer rates also vary by region. Compared with people living in the contiguous United States, women and men in Hawaii are roughly 33 percent and 28 percent more likely to be diagnosed with stomach cancer, respectively. And some research suggests higher-poverty counties have up to a 27 percent higher incidence of stomach cancer than low-poverty counties.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298de700ea-6c06-4d2a-b830-e0b6eb90d067
Related Conditions and Comorbidities Related Conditions Conditions often associated with stomach cancer include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a00f86de-2961-46a3-9c7e-e9e95ad268ea H. pylori infection Peptic ulcer, or open sores in the lining of the stomach and upper portion of the small intestinee60dc2a1-f33c-4a05-9b50-8e3e8e597629abf612fa-ca33-4288-8a8c-5ab146002095 Diabetese60dc2a1-f33c-4a05-9b50-8e3e8e597629b8907579-0128-48f4-9a10-43df3d8a6eb1 Chronic gastritis, long-term inflammation of the stomach Pernicious anemia, an inability to absorb vitamin B12 Obesity
Support for Stomach Cancer Support Debbie’s Dream Foundation: Curing Stomach Cancer With chapters located throughout the continental United States, Debbie’s Dream focuses on raising awareness, funding research, and supporting stomach cancer patients. It has extensive resources that span lectures about the disease, survivor stories, and newsletters. Gastric Cancer Foundation Dedicated to improving the lives of people affected by stomach cancer, this foundation hosts a wealth of information about gastric cancer, a Gastric Cancer Registry to assist researchers studying the disease, a clinical trial finder , and more. Hope for Stomach Cancer Part of the Stomach Cancer Awareness Network, Hope for Stomach Cancer is a nonprofit that provides resources and programs to help those living with stomach cancer, as well as their caregivers and loved ones. Their website offers links to various support groups and workshops. No Stomach for Cancer This nonprofit patient advocacy organization offers one-on-one support, consultations with certified genetic counselors, and help finding local cancer centers.
The Takeaway Stomach cancer develops when cells in the lining of the stomach begin to grow out of control. Risk factors include Helicobacter pylori infection, smoking, and a diet high in salted or smoked foods, though practicing healthy lifestyle habits can reduce risks. Regular medical checkups, especially for those at high risk, can aid in earlier detection and improved treatment outcomes.
Resources We Trust Mayo Clinic: What You Should Know About Stomach CancerCleveland Clinic: 8 Potential Warning Signs of Stomach CancerMD Anderson Cancer Center: ‘How I Knew I Had Stomach Cancer’: Six Survivors Share Their SymptomsAmerican Cancer Society: Stomach CancerNational Cancer Institute: Questions to Ask Your Doctor About Treatment
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