Stomach Cancer


stomach illustrated

WHAT IS STOMACH CANCER?


Stomach cancer, also known as gastric cancer, is a type of cancer that starts in cells in the lining of the stomach. As a part of your digestive tract - a series of hollow, muscular organs reaching the mouth to the anus, your stomach breaks down the food you’ve eaten and helps with the process of sending nutrients through the tract. 

This growth of cells can occur in any part of the stomach but is most likely to occur in the gastroesophageal junction which is the part where your esophagus meets your stomach. 

 

 

 

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CAUSE

The direct cause of stomach cancer is still unknown, but experts believe most stomach cancers develop due to an injured stomach lining which can cause changes in the damaged cell’s DNA. The stomach lining can become damaged due to an infection in the stomach, chronic acid reflux, or a diet extremely high in salty foods. However, many people with these risk factors don’t always get stomach cancer.

The changes lead to cells multiplying quickly, causing an excessive number of cells in the stomach. These cells then result in a mass called a tumor and invade healthy tissue in the stomach. 

COMMON TYPES OF STOMACH CANCER 

The type of stomach cancer you’re diagnosed with is based on the type of cell the cancer began with. The different types of stomach cancer include:

ADENOCARCINOMA

Adenocarcinoma is the most common type of stomach cancer and begins in cells that produce mucus. Most cancers that begin in the stomach are adenocarcinoma cells.

GASTROINTESTINAL STROMAL TUMORS (GIST)

Gastrointestinal stromal tumors, or GIST, is a type of soft tissue sarcoma and begins in special nerve cells found in the wall of the stomach and other organs in the digestive tract.

CARCINOID TUMORS

Carcinoid tumors are a type of neuroendocrine tumor. This type of cancer begins in neuroendocrine cells, which are found in many places throughout the body. These cells perform some nerve functions and assist in hormone production. 

LYMPHOMA

Lymphoma begins in immune system cells, which help your body fight germs. Sometimes, lymphoma can start in the stomach if your body sends immune system cells there to fight off an infection. Typically, lymphomas that originate in the stomach are a type of non-Hodgkin’s lymphoma.

RISK FACTORS

At this point, researchers aren’t quite sure what causes the cells to mutate. However, certain factors seem to increase the risk of stomach cancer, including:

  • Family history of stomach cancer
  • Helicobacter pylori (H. pylori) infection
  • Gastroesophageal reflux disease (GERD)
  • Gastritis
  • Epstein-Barr virus infection
  • History of stomach ulcers or stomach polyps
  • A diet high in fatty, salty, smoked, or pickled food
  • A diet low in fruits and vegetables
  • Frequent exposure to substances like coal, metal, and rubber
  • Smoking, vaping, or chewing tobacco
  • Excessive alcohol use
  • Obesity
  • Autoimmune atrophic gastritis

There are several genetic conditions associated with increased gastric cancer risk, including:

  • Lynch syndrome
  • Peutz-Jeghers syndrome
  • Li-Fraumeni syndrome
  • Familial adenomatous polyposis
  • Hereditary diffuse gastric cancer
  • Common variable immunodeficiency (CVID)

Stomach cancer seems to be more common in people with Type A blood, but researchers are not sure why this is a cause.

SYMPTOMS

Some signs and symptoms of stomach cancer may include:

  • Trouble swallowing
  • Abdominal pain
  • Feeling bloated after eating
  • Feeling full after eating small amounts of food
  • Lack of appetite when you would expect to be hungry
  • Heartburn
  • Indigestion
  • Nausea
  • Vomiting
  • Losing weight without trying
  • Feeling very tired
  • Stools that look black

In the early stages, stomach cancer doesn't always show symptoms. Some symptoms to look out for are indigestion and pain in the upper part of the stomach. The later stages of stomach cancer might show symptoms of extreme fatigue, unexpected weight loss, vomiting blood, and black stools.

If stomach cancer becomes metastatic, meaning it has spread to other parts of the body, it may cause symptoms specific to the location it has spread. For example, if the cancer has spread to the liver, you might experience yellowing of the skin and eyes. 

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WHEN TO SEE A DOCTOR

If you’re experiencing signs or symptoms that are causing you worry, schedule an appointment with one of our GI specialists in Charleston. Many GI conditions share similar symptoms, so it’s important to seek the help of a professional. Our team will perform the right tests and evaluations to get to the bottom of your symptoms.

DIAGNOSTIC TEST 

UPPER ENDOSCOPY

Upper endoscopies are commonly used to diagnose stomach cancer. The procedure involves your GI doctor inserting a small tube with a tiny camera on the tip, known as an endoscope, into your mouth until it reaches your stomach. Your doctor will most likely take a biopsy (tissue sample) using very small surgical instruments passed through the endoscope. The biopsy will then be tested.

ENDOSCOPIC ULTRASOUND

An endoscopic ultrasound is a special type of endoscopy, which uses an endoscope with an ultrasound probe attached to its tip. This endoscope can take photos of your stomach and show if the cancer has spread from the stomach lining to the stomach wall.

STOMACH CANCER SCREENING

In some cases, tests are used to detect stomach cancer in those who don’t have symptoms. The goal of these screenings is to detect stomach cancer while it’s small and more likely to be cured.

RADIOLOGIC TESTS

Radiologic tests can include a CT scan, barium swallow, or an MRI to help identify tumors, and abnormalities that could be cancer-related or determine if the cancer has spread. 

BLOOD TESTS

Blood tests give your doctor a look into how your organs are functioning. Evidence of poor organ function can be a sign that the cancer has spread to that organ.

LAPAROSCOPY

A laparoscopy is a type of surgery where your provider inserts a tiny camera into small cuts in your abdomen to see your organs. This helps your doctor assess the state of your cancer when methods such as imaging do not provide enough information.

WHAT TO EXPECT DURING YOUR CANCER SCREENING APPOINTMENT

PREPARING FOR VISIT

  • Be mindful of any pre-appointment restrictions or expectations. When you make your appointment, ask our office about anything you need to do in advance to make the procedure go seamlessly.
  • Take written notes of any symptoms you’re experiencing to discuss during your appointment.
  • Make a note of any key personal information, including any recent life changes or major stressors.
  • Create a list of all medications, vitamins, and supplements you’re taking.
  • Take note of what seems to improve or worsen your symptoms. This includes any foods, medications, or other factors that influence your symptoms.
  • Think about bringing along a family member or friend to help you remember what was discussed during the appointment.
  • Write down a list of questions to ask your doctor.

WHAT QUESTIONS TO ASK DOCTOR 

When it comes time for your appointment, prepare a list of questions to make the most of your time with your doctor. Rank them from most important to least important to ensure you get the crucial information covered up front. For stomach cancer, some basic questions include:

  • What type of stomach cancer do I have?
  • How advanced is my stomach cancer?
  • What other kinds of tests do I need?
  • What are my treatment options?
  • How successful are the treatments?
  • What are the benefits and risks of each option?
  • Is there one option you feel is best for me?
  • How will treatment affect my life? Can I continue to work?
  • Should I seek a second opinion? What will that cost and will my insurance cover it?
  • Are there brochures or other printed materials that I can take with me? What websites do you recommend?

In addition to the prepared questions you brought with you, don't hesitate to ask other questions you think of during your appointment.

WHAT TO EXPECT YOUR DOCTOR TO SAY

Your provider is likely to ask you questions. Being ready to answer them may allow more time later to cover other points you want to address. Your provider may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

TREATMENT

The treatment plan prescribed by your gastroenterologist will depend on the location of the stomach cancer and the stage, as well as your overall health and preferences. Treatments can include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or palliative care.

CHEMOTHERAPY

Chemotherapy uses specific drugs to kill cancer cells, either directly in the stomach or throughout the body. It may be prescribed before surgery or as the primary treatment for your cancer.

IMMUNOTHERAPY

Immunotherapy uses your immune system to fight cancer. It boosts the immune system so it can find the cancer cells and attack them. This type of treatment is often used for advanced stomach cancer or if cancer has returned after initial treatment.

PALLIATIVE CARE

Palliative care focuses on optimizing the quality of life for those with serious illnesses like cancer. It is designed to help manage pain and symptoms while treating the cancer directly. 

RADIATION THERAPY

Radiation therapy targets cancer cells using high-energy beams designed to destroy these cells. It can be used on its own or in addition to chemotherapy.

SURGERY

When it comes to surgery for your stomach cancer, the goal is to remove all the cancer present if possible. For early-stage stomach cancer, surgery may be the initial treatment prescribed. Other treatments may be considered first for later-stage cancer or cancer that has spread into the lymph nodes.

TARGETED THERAPY

Targeted therapy uses medication with specific chemicals to directly target cancer cells. This treatment is typically used alongside chemotherapy for advanced stomach cancers.

PREVENTION

To lower the risk of stomach cancer, here are some things to do:

  • Eat plenty of fruits and vegetables daily. Choose a variety of colorful fruits and vegetables.
  • Reduce the amount of salty and smoked foods in your diet. Limiting these foods can help protect your stomach.
  • Don’t smoke. Smoking increases your risk of stomach cancer and many other types of cancer. Talk to your healthcare provider if you need assistance.
  • Talk to your doctor about your family’s history of stomach cancer. If you have a strong family history, they may suggest you have a stomach cancer screening. These tests can detect stomach cancer before symptoms appear.

NEED STOMACH CANCER SCREENING IN CHARLESTON, SC? CHARLESTON GI CAN HELP! 

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FREQUENTLY ASKED QUESTIONS


Can stomach cancer be cured?

If your cancer is operable, surgery can be a cure as long as all the cancerous tissue can be removed. This surgery is known as a gastrectomy. 

Is stomach cancer usually fatal?

If stomach cancer is detected early, there is a greater chance of recovery. Advanced stages of stomach cancer can be treated but can rarely be cured.

What is the first stage of stomach cancer?

The first stage of stomach cancer is stage one, which means the cancer is in the inner supportive layer or muscle layer of the stomach. Stage one is split into two groups, stage 1A and stage 1B, and stage 1B may include cancer that has spread into one or two nearby lymph nodes. 

Does stomach cancer spread fast?

Most of the time, stomach cancer progresses slowly after starting in your stomach lining. Untreated stomach cancer can grow deeper into the walls of the stomach and can spread to other nearby organs.

Who does stomach cancer affect?

Anyone can be affected by stomach cancer, but certain demographic characteristics may increase your risk, including:

  • Individuals 65 or over
  • Males
  • Ethnic backgrounds of East Asian, South or Central American or Eastern European.

How common is stomach cancer?

Stomach cancer is one of the most common cancers around the world but is less common within the United States. In the U.S., only 1.5% of stomach cancers are diagnosed and that rate has been steadily decreasing in the last decade.

Can you feel a tumor in your stomach?

Depending on how advanced your cancer is, your doctor may be able to detect a mass through a physical exam. More often, stomach cancer is diagnosed through symptoms or sensations felt in your stomach. Pain may worsen as the cancer progresses if not diagnosed.

Where is stomach cancer pain felt?

Most often, stomach cancer pain is felt in your upper abdomen or behind your breastbone.

Can blood tests detect stomach cancer?

Blood tests are used to give your doctor insight into your health, but they alone cannot diagnose stomach cancer. Your doctor may use a blood test to look at liver function, for example, to evaluate its function and look for signs that the cancer has spread to your liver. They may also use blood tests to detect cancer cells in your blood.

What does stomach cancer breath smell like?

Bad breath associated with stomach cancer is commonly caused by the H. pylori bacterium which causes inflammation and ulcers. The presence of this bacteria can lead to stomach cancer. 

What is cancer restaging?

When cancer is diagnosed, it is assigned a stage to define its progression. Throughout your treatment, this diagnosed stage remains the same, as it helps your doctor determine your treatment plan for your prognosis. 

If cancer comes back or spreads, it can be restaged. This reevaluation is done by your doctor so they can appropriately treat the cancer. Restaging is depicted as a lowercase “r” when describing this new prognosis. For example, if your cancer spreads to your lymph nodes, the restaging would be defined as “rN1.” 

What are the red flags of stomach cancer?

Some of the main symptoms to watch out for when it comes to stomach cancer are heartburn, acid reflux, difficulty swallowing, indigestion, nausea, and vomiting. If you’re experiencing symptoms you’re concerned about, don’t hesitate to reach out to Charleston GI to schedule an appointment!

 

Sources: American Cancer Society & National Cancer Institute.


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Source: Cancer.gov, MayoClinc.org, & National Cancer Institution.

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