Stomach cancer

Stomach cancer statistics

Gastric carcinoma (GC) is the fourth most common malignancy worldwide (989,600 new cases per year in 2008) and remains the second cause of death (738,000 deaths annually) of all malignancies worldwide. The disease becomes symptomatic in an advanced stage. Five-year survival rate is relatively good only in Japan, where it reaches 90%.In European countries, survival rates vary from ~10% to 30%.High survival rate in Japan is probably achieved by early diagnosis by endoscopic examinations and consecutive early tumor resection.

The incidence shows wide geographical variation. More than 50% of the new cases occur in developing countries. There is a 15–20-fold variation in risk between the highest- and the lowest-risk populations. The high-risk areas are East Asia (China and Japan), Eastern Europe, Central and South America. The low-risk areas are Southern Asia, North and East Africa, North America, Australia, and New Zealand.

Steady declines in GC incidence rates have been observed worldwide in the last few decades.This trend applies particularly to young patients with noncardia, sporadic, intestinal type of GC, as reported in the Japanese analysis. On the other hand, the American study differentiates race and age subpopulations, as well as the anatomic subtype of corpus gastric cancer, which have an increasing tendency. Nevertheless, the general declining incidence of GC may be explained by higher standards of hygiene, improved food conservation, a high intake of fresh fruits and vegetables, and by Helicobacter pylori (H. pylori) eradication.

What causes stomach cancer?

What are different types of stomach cancer?

Adenocarcinoma

Most (about 90% to 95%) cancers of the stomach are adenocarcinomas. A stomach cancer orgastric cancer almost always is an adenocarcinoma. These cancers develop from the cells that form the innermost lining of the stomach (the mucosa).

Lymphoma

These are cancers of the immune system tissue that are sometimes found in the wall of the stomach. The treatment and outlook depend on the type of lymphoma. For more detailed information, see Non-Hodgkin Lymphoma.

Gastrointestinal stromal tumor (GIST)

These rare tumors start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal. Some of these tumors are non-cancerous (benign); others are cancerous. Although GISTs can be found anywhere in the digestive tract, most are found in the stomach. For more information, see Gastrointestinal Stromal Tumor (GIST).

Carcinoid tumor

These tumors start in hormone-making cells of the stomach. Most of these tumors do not spread to other organs. These tumors are discussed in more detail in Gastrointestinal Carcinoid Tumors.

Other cancers

Other types of cancer, such as squamous cell carcinoma, small cell carcinoma, and leiomyosarcoma, can also start in the stomach, but these cancers are very rare.

How stomach cancer is diagnosed?

Since people with stomach cancer rarely show symptoms in the early stages, the disease is often not diagnosed until it’s more advanced.

To make a diagnosis, your doctor will first perform a physical exam to check for any abnormalities. They may also order a blood test, including a test for the presence of H. pylori bacteria.

More diagnostic tests will need to be done if your doctor believes that you show signs of stomach cancer. Diagnostic tests specifically look for suspected tumors and other abnormalities in the stomach and esophagus. These tests may include:

• an upper gastrointestinal endoscopy
• a biopsy
• imaging tests, such as CT scans and X-rays
• PET CT

How stomach cancer is treated?

Many treatments can fight stomach cancer. The one you and your doctor choose will depend on how long you’ve had the disease or how much it has spread in your body, called the stage of your cancer:

Stage 0. This is when the inside lining of your stomach has a group of unhealthy cells that may turn into cancer. Surgery usually cures it. Your doctor may remove part or all of your stomach, as well as nearby lymph nodes — small organs that are part of your body’s germ-fighting system.

Stage I. At this point, you have a tumor in your stomach’s lining, and it may have spread into your lymph nodes. As with stage 0, you’ll likely have surgery to remove part or all of your stomach and nearby lymph nodes. You might also get chemotherapy or chemoradiation. These treatments can be used before surgery to shrink the tumor and afterward to kill any cancer that’s left.

You usually have surgery to remove your entire stomach, along with chemo or chemoradiation. This can sometimes cure it. If not, it can at least help with symptoms.

If you’re too sick for surgery, you may get chemo, radiation, or both, depending on what your body can handle.

Stage IV. In this last stage, cancer has spread far and wide to organs like the liver, lungs, or brain. It’s much harder to cure, but your doctor can help manage it and give you some relief from symptoms.

If the tumor blocks part of your GI system, you may get: