Stomach Cancer

Signs and symptoms of stomach cancer may include:

• Fatigue
• Feeling bloated after eating
• Feeling full after eating small amounts of food
• Heartburn that is severe and persistent
• Indigestion that is severe and unrelenting
• Nausea that is persistent and unexplained
• Stomach pain
• Vomiting that is persistent
• Weight loss that is unintentional

The cells that form the tumor determine the type of stomach cancer. The type of cells in your stomach cancer helps determine your treatment options. Types of stomach cancer include:

• Cancer that begins in the glandular cells (adenocarcinoma). The glandular cells that line the inside of the stomach secrete a protective layer of mucus to shield the lining of the stomach from the acidic digestive juices. Adenocarcinoma accounts for the great majority of all stomach cancers.
• Cancer that begins in immune system cells (lymphoma).The walls of the stomach contain a small number of immune system cells that can develop cancer. Lymphoma in the stomach is rare.
• Cancer that begins in hormone-producing cells (carcinoid cancer). Hormone-producing cells can develop carcinoid cancer. Carcinoid cancer in the stomach is rare.
• Cancer that begins in nervous system tissues. A gastrointestinal stromal tumor (GIST) begins in specific nervous system cells found in your stomach. GIST is a rare form of stomach cancer.

Factors that increase your risk of stomach cancer include:

• A diet high in salty and smoked foods
• A diet low in fruits and vegetables
• Eating foods contaminated with aflatoxin fungus
• Family history of stomach cancer
• Infection with Helicobacter pylori
• Long-term stomach inflammation
• Pernicious anemia
• Smoking
• Stomach polyps

Tests and procedures used to diagnose stomach cancer include:

• A tiny camera to see inside your stomach (upper endoscopy). A thin tube containing a tiny camera is passed down your throat and into your stomach. Your doctor can look for signs of cancer. If any suspicious areas are found, a piece of tissue can be collected for analysis (biopsy).
• Imaging tests. Imaging tests used to look for stomach cancer include computerized tomography (CT) scan

The stage of your stomach cancer helps your doctor decide which treatments may be best for you. Tests and procedures used to determine the stage of cancer include:

• Imaging tests. Tests may include CT and positron emission tomography (PET).
• Exploratory surgery. Your doctor may recommend surgery to look for signs that your cancer has spread beyond your stomach within your abdomen. Exploratory surgery is usually done laparoscopically. This means the surgeon makes several small incisions in your abdomen and inserts a special camera that transmits images to a monitor in the operating room.

The stages of adenocarcinoma stomach cancer include:

• Stage I. At this stage, the tumor is limited to the layer of tissue that lines the inside of the stomach. Cancer cells may also have spread to a limited number of nearby lymph nodes.
• Stage II. The cancer at this stage has spread deeper, growing into the muscle layer of the stomach wall. Cancer may also have spread to more of the lymph nodes.
• Stage III. At this stage, the cancer may have grown through all the layers of the stomach. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.
• Stage IV. This stage indicates that the cancer has spread to distant areas of the body.

The goal of surgery is to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include:

• Removing early-stage tumors from the stomach lining.Very small cancers limited to the inside lining of the stomach may be removed using endoscopy in a procedure called endoscopic mucosal resection. The endoscope is a lighted tube with a camera that’s passed down your throat into your stomach. The doctor uses special tools to remove the cancer and a margin of healthy tissue from the stomach lining.
• Removing a portion of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer.
• Removing the entire stomach (total gastrectomy). Total gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system.
• Removing lymph nodes to look for cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells.
• Surgery to relieve signs and symptoms. Removing part of the stomach may relieve signs and symptoms of a growing tumor in people with advanced stomach cancer. In this case, surgery can’t cure advanced stomach cancer, but it can make you more comfortable.