Stomach cancer (also called gastric cancer) is second only to skin cancer as the most common cancer in the world. In the U.S., stomach cancer is not nearly as common, but is still the sixth leading cause of cancer-related death. Unfortunately, early symptoms are vague and the diagnosis is often made after the cancer has spread.

In the early 1900s, stomach cancer was the most common cause of cancer death in the United States. This is thought to be due to the high incidence of using salting and smoking as methods of food preservation. As refrigeration became widely available in the U.S., stomach cancer rates decreased.

Stomach cancer affects men twice as often as women and is uncommon before the age of 40. Nonwhites are affected more often than whites. Unfortunately, early stomach cancer usually causes no symptoms.

What are the symptoms and how is it diagnosed?

The first symptoms of stomach cancer are usually stomach discomfort and vague abdominal pain, the same symptoms that occur with a stomach ulcer. Stomach ulcers are much more common that cancer, and persons with this complaint are usually given antacids or other stomach medications (e.g. Pepcid, Zantac, Tagamet, Prilosec, etc.) for these symptoms.

You may also be given antibiotics to treat a certain bacteria that often has a role in causing ulcers (and probably stomach cancer as well). If the symptoms do not respond to these medications, however, and a person is over 40 years old, usually an endoscopy procedure is recommended.

Endoscopy involves place a thin tube into the stomach through the mouth. The tube has a light and a camera on the end of it to allow the doctor to examine the inside of the esophagus (the food tube that connects the mouth to the stomach) and stomach.

Stomach Cancer: Risk Factors According to the American Cancer Society, risk factors for developing stomach cancer include: Male gender Age over 50 Having the blood type group A Having a long-term Helicobacter pylori infection of the stomach Eating a diet containing large amounts of smoked foods, salted fish and meat, certain foods high in starch that are also low in fiber, and pickled vegetables. (Eating whole grain products, fresh fruits, and vegetables that contain vitamins A and C appear to lower the risk of stomach cancer.) Abusing tobacco and alcohol Having a history of previous stomach surgery, pernicious anemia (vitamin B12 deficiency), Menetriers disease (hypertrophic gastropathy), or adenomatous stomach polyps Having a family history of stomach cancer or the inherited genetic disorders hereditary nonpolyposis colon cancer (Lynch Syndrome or HNPCC) or familial adenomatous polyposis

The procedure is uncomfortable but usually painless and patients are often given some sedation to ease their anxiety and discomfort. People are usually able to go home an hour or so after the procedure (if someone else can drive them).

The person who does the procedure is a stomach specialist, known as a gastroenterologist. They can look at the gut carefully and takes small biopsies of any suspicious areas.

Ninety-five times out of 100, the biopsies are benign and are simple stomach ulcers, which usually respond to medications. Rarely, however, the biopsy may reveal a cancer.

Occasionally, patients may be asked to undergo a barium swallow test instead of or before an endoscopy. This test involves drinking a special liquid and then having an x-ray taken of the stomach. The liquid shows up on the x-ray and may reveal an abnormality of the digestive tract. The test is painless and easy.

Late symptoms of stomach cancer include early satiety (feeling full after only a few bites of food), loss of appetite, weight loss, and anemia from blood loss into the stools. These are worrisome symptoms in a person over the age of 40 and usually warrant a full investigation. If you are having these symptoms, let your doctor know right away. If the cause turns out to be stomach cancer, further testing will be warranted to determine the extent of spread of the tumor.

What is the treatment?

Usually, a CT (computed tomography) scan (a special x-ray) is ordered to help determine if the cancer has spread beyond the stomach, which will change the treatment. Surgery is generally the best hope for cure, but if the cancer has spread outside the stomach, this may not be helpful.

Usually, when surgery is done, the stomach is removed and the esophagus is connected to the small intestine so that food may still pass normally. Sometimes, surgery is done to improve quality of life even when cure is not hopeful, as it allows patients to eat and reduces bleeding from the tumor. Chemotherapy or radiation may also be of some benefit. Unfortunately, stomach cancer has a very poor prognosis overall.

Because of this poor prognosis, it is important to follow up with your doctor if your stomach ulcer symptoms do not resolve after six weeks of medical therapy, especially if you are over the age of 40. Chances are, you simply have an ulcer that is slow to heal, but the possibility of stomach cancer needs to be investigated. Unfortunately, early detection is usually the only hope for a cure.

 

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