Stomach cancer is a disease in which cancer cells grow in the stomach. There are 5 layers of tissue in the stomach. Types of cancer include:
- Adenocarcinoma—tumors of the mucosa (the innermost layer), which make up over 90% of stomach cancers
- Lymphoma—a cancer of the immune system, which is sometimes found in the stomach wall
- Gastric stomal tumors—tumors of the stomach wall
- Carcinoid tumors—tumors of the hormone-producing cells of the stomach
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Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Stomach cancer is more common in men and in people aged 50 years and older. Other factors that may increase your chances of stomach cancer:
- Helicobacter pylori infection (H. pylori)
- High intake of smoked, salted, pickled food and meat, high-starch/low-fiber foods
- Low intake of certain vegetables, such as garlic scallions, onions, chives, and leeks
- Alcohol use disorder
- Previous stomach surgery
- Pernicious anemia
- Ménétrier disease (a disease that causes large folds in the stomach lining)
- Barrett esophagus
- Blood type A
- Familial cancer syndromes—hereditary nonpolyposis colon cancer and familial adenomatous polyposis
- Family history of stomach cancer
- Stomach polyps
In some people, stomach cancer may have no symptoms. In those that have them, stomach cancer may cause:
- Indigestion or gastroesophageal reflux disease (GERD)
- Abdominal pain or vague abdominal discomfort
- Nausea and vomiting
- Diarrhea or constipation
- Stomach bloating or sense of fullness after eating
- Loss of appetite
- Weakness, fatigue
- Bleeding in vomit or stool
- Stool that has turned black or tarry
- Unintended weight loss
- Fluid swelling in abdomen
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
- Blood tests
- Fecal occult blood test—to test for blood in the stool
- Biopsy—a tissue sample that can be examined under a microscope
Imaging tests to evaluate the stomach and surrounding structures may include:
- Upper gastrointestinal (GI) series
- Chest x-ray
- Upper GI endoscopy
- CT scan
- positron emission tomography (PET) scan
The physical exam, combined with all of your test results, will help to determine the type and stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, stomach cancer is staged from I to IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Cancer treatment varies depending on the stage and type of cancer. Stomach cancer is most often detected in the later stages. A combination of therapies may be more effective. For example, surgery may be used in conjunction with chemo- or radiation therapy.
Treatment options for stomach cancer include:
Surgery is the most common treatment for stomach cancer. The type of surgery depends on the stage of the disease. There are 3 types of stomach surgery that may be done:
- Endoscopic mucosal resection—This surgery is generally done in the early stages where the tumor is removed through an endoscope.
- Subtotal gastrectomy—This is the removal of the lower part of the stomach, leaving part of the stomach to reattach to the esophagus and small intestine.
- Total gastrectomy—This is the removal of the entire stomach. It often includes removal of nearby lymph nodes. The esophagus is attached directly to the small intestine.
This is the use of high-energy rays to kill or shrink cancer cells. Radiation therapy may be used after surgery to destroy cancer cells that could not be seen or removed during surgery.
In cases where stomach cancer has spread, chemotherapy combined with radiation therapy may increase the chance of survival and reduce the risk of cancer returning. Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms including: pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
To help reduce your chances of stomach cancer:
- Follow your care plan for any health problems such as H. pylori infection or GERD.
- Avoid diets high in salted, pickled, and smoked foods.
- Eat at least 5 servings of fresh fruits, vegetables, and whole grain foods a day.
- Limit red meat intake.
- If you smoke, talk to your doctor about how to quit.
- Avoid or drink alcohol only in moderation. This means 2 drinks per day for men and 1 drink per day for women.
American Cancer Society
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Gastric carcinoma. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116155/Gastric-carcinoma. Updated September 15, 2017. Accessed October 10, 2017.
General information about gastric cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq#section/_1. Updated April 27, 2017. Accessed October 10, 2017.
Ménétrier disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/menetriers-disease. Updated March 2014. Accessed October 10, 2017.
Stomach cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/stomach-cancer.html. Accessed October 10, 2017.
4/29/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116155/Gastric-carcinoma: Zhou Y, Zhuang W, Hu W, Liu GJ, Wu TX, Wu XT. Consumption of large amounts of allium vegetables reduces risk for gastric cancer in a meta-analysis. Gastroenterology. 2011;141(1):80-89.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 8/7/2020