Stomach Cancer

Stomach (Gastric) Cancer: The Facts

What is it?

Stomach Cancer, which is also called Gastric Cancer, is the term used for cancer that originates in the lining of the stomach. The stomach is the J-shaped organ in the upper abdomen, and is part of the digestive system. It is connected to the esophagus (food-pipe) and the small intestine. Food travels down the esophagus and into the stomach. There it is mixed with digestive juices from the lining of the stomach and broken down. Two or three hours later, the partially digested food moves into the small intestine, and then to the large intestine (colon).

Stomach Cancer usually begins in the lining of the stomach. The stomach has four layers of lining. The innermost lining, the mucosa, contains the glands that produce the digestive juices. Ninety to ninety-five percent of Stomach Cancers begin in the mucosa layer. The second layer, the submucosa, contains blood vessels that feed blood and oxygen to the glands of the mucosa. The third layer, the muscularis, contains muscles, which contract to make a rippling motion. This motion moves the food through the stomach and mixes it with the digestive juices. The fourth and outermost layer, the serosa, protects the other layers and keeps the acidic digestive juices confined to the stomach.

The different types of Stomach Cancer are usually identified by how they grow and spread. If left untreated, Stomach Cancer can eventually spread to many other organs. Stomach Cancer is normally associated with four typical growth patterns:

• Superficial Spread: The Cancer forms only a thin layer over the mucosa. This is the least aggressive type of Stomach cancer.
• Ulcer Forming: The Cancer creates an ulcer in the stomach wall. A biopsy can tell whether or not an ulcer is cancerous.
• Polypoid: The Cancer forms tumors that resemble a cauliflower.
• Infiltrating: This type of Cancer is the most common and the most aggressive.

Stomach Cancer is also classified using a staging system. This system is based on the extent that the cancer has spread and to what areas of the body. This classification system ranges from “stage 0” (cancer that is localized in the stomach) through “stage IV” (cancer that has spread to lymph nodes and distant organs).

Who gets it?

Annually in the United States, approximately 21,500 people will be diagnosed with Stomach Cancer. Most Stomach Cancer patients are in their 60’s and 70’s. Men are twice as likely to get Stomach Cancer as women. The disease is also more common in African-Americans than in Caucasians.

Near the beginning of the 20^th century, Stomach Cancer was a leading cause of death in the United States. With improvements in food production, preservation, and preparation, Stomach Cancer has become relatively uncommon in the United States. It is most common in Japan, Eastern Europe, and Latin America. Rhode Island has a 25% higher rate of Stomach Cancer cases than the national average.

The exact cause of Stomach Cancer is still unknown, but certain factors can place you at a higher risk:

· Helicobacter Pylori Infection: A bacterial infection that can injure and shrink the stomach lining.

· Diet: A diet high in smoked or salted meat and fish, high starch/low fiber foods, pickled vegetables, and nitrate preservatives

· Smoking and Alcohol: Smoking and excess alcohol use have been linked to Stomach Cancer

· Prior Stomach Surgeries

· Pernicious Anemia: A condition in which no acidic digestive juices are produced.

· Sex: Males are at higher risk

· Family History: People with 3 or more first degree relatives (parents, sisters and brothers) who have had stomach cancer are at a higher risk.

· Blood Type: People with type A blood are at higher risk. Researchers have no idea why this is so.

· Occupational Hazards: Exposure to substances of coal mining and industrial processing of nickel, rubber, and timber.

How is it detected?

There is no officially accepted screening test for Stomach Cancer. If a physician suspects Stomach Cancer, he or she will usually perform a physical exam, a chest X-ray, and one or more of the following diagnostic tests:

• Upper GI Series: The patient swallows a barium mixture and a series of x-rays of the digestive tract are taken. The barium makes abnormal tissues, ulcers, and tumors more visible on the screen.
• Upper Endoscopy: The patient is sedated. A lighted probe is sent down through the esophagus and into the stomach. The doctor can examine the stomach and its lining for abnormal tissue. A sample of stomach tissue is usually taken and sent to a lab, where it is examined under a microscope by a pathologist for the presence of Cancer cells. This is called a biopsy.
• CT Scan: A computer image of the abdomen, pelvis, or chest that can be used to determine if Cancer has spread to other organs.
• Endoscopic Ultrasound (EUS): The patient is sedated. A probe is inserted through the esophagus that uses sound waves to make a screen image of the stomach that can be used to detect tumors or abnormal tissues. The EUS, unlike the CT scan or Upper GI Series, allows the doctor to see how deep the tumor is and how many layers of the stomach it has invaded.
• Laparoscopic Ultrasound (LUS): The patient is given a local anesthetic. A small incision is made near the belly button, and a probe is inserted directly into the abdomen. An ultrasound is done from inside the body to create a screen image, which can then be used to locate tumors and abnormal tissue.
• Fecal Occult Blood Test: A stool sample is analyzed to determine if there are microscopic amounts of blood present.

Symptoms

Early stages of Stomach Cancer usually show no symptoms, making it difficult to diagnose and treat. All of the following symptoms have been associated with Stomach Cancer, but none definitely indicate that Cancer is present:

· Unexplained weight loss

· Abdominal pain or vague pain above the belly button

· Indigestion/vomiting

· Weakness/fatigue

· Blood in vomit or stool

· Feelings of fullness

If the cancer has spread to the liver:

· Jaundice: Yellowing of the skin

· Ascites: Enlarged belly from fluid

Symptoms normally do not appear until Stomach Cancer has begun to develop into later stages. Report any symptoms to your doctor immediately! The earlier the cancer is detected, the better the chances of survival.

Is it curable?

Stomach Cancer is a very difficult disease to treat. Since the early cancer stages show few symptoms, Stomach Cancer is usually diagnosed in advanced stages. It is relatively uncommon in the U.S., so there are not routine screenings of the population for Stomach Cancer. RI has a 50% higher death rate from stomach cancer than the national average.

If detected early, Stomach Cancer can be successfully treated with no serious lasting effects. Advanced stages involve more extensive treatments, but can sometimes still be cured if the cancer hasn’t spread too much. In cases in which the cancer has spread to multiple organs, treatment of these other areas must be considered as well. The more the cancer has spread, the more difficult it is to treat successfully.

When detected in a late stage, the 5-year survival rate for Stomach Cancer is low. However, every case is different so patients with Stomach Cancer should not base their chances of survival on statistics alone. The seriousness of this disease must be kept in mind, but there are always new treatments that may offer hope.

It is easier to prevent cancer than to cure it…

Certain lifestyle changes can help decrease your risk of developing Stomach Cancer (as well as other types of cancer):

· A well balanced diet that avoids salted or smoked foods, avoids excess starch, and includes sufficient daily fiber.

· Prepare and refrigerate food properly

· Not smoking

· Use alcohol in moderation

· Avoid exposure to coal, nickel, or rubber processing