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Stomach Cancer



What is stomach cancer?


Although stomach (gastric) cancer is the fourth most common cancer globally, its incidence in the United States has been declining. It is much more common in Asia and Latin America. Part of the digestive system, the stomach is a j-shaped organ in the upper abdomen. Stomach cancer originates in the lining of the stomach and then penetrates the wall with spread to the lymph nodes. They are classified by the type of tissue where they originate, with the common form identified as adenocarcinoma. As with other gastrointestinal cancers, stomach cancer is often more easily cured when detected in its early stages.  Gastric cancer mainly affects those who are older than 65 years of age and is more common in males. While gastric cancer rates are in decline, the disease isn’t often detected until its later stages. In its most advanced stages i.e., when it has spread to other organs, it’s rarely cured. It is estimated that nearly 11,000 people will succumb to gastric cancer along with 21,000 new diagnoses in 2009.


Cause and symptoms:


The exact cause of gastric cancer is unknown, but age, poor diet, smoking, excessive alcohol use, obesity and a family history may increase the risk. There is also evidence that bacteria (Helicobacter Pylori) may cause stomach cancer. Currently, there are tests available to identify this bacteria. Symptoms can be non-specific such as vague abdominal pain, loss of appetite, weight loss, indigestion, vomiting, or dark stools if the cancer bleeds.


Diagnostic tests:


Blood tests: a blood count may identify anemia due to blood loss. Cancer markers such as CEA or CA 19-9 may be elevated.

Flexible fiberoptic endoscopy: a tube is inserted into the stomach to visualize and biopsy the cancer.

Upper gastrointestinal series: by swallowing contrast, a deformity in the stomach may be identified.

CAT scan: a good quality CAT can demonstrates abnormalities in the wall of the stomach, and also surrounding structures, such as lymph nodes and the liver.

Endoscopic Ultrasound: a tube can be inserted into the stomach. With ultrasound, the depth of invasion through the wall of the stomach can be evaluated.




Removal of the cancer by surgery offers the best option. Radiation and chemotherapy given before or after surgery may further prolong survival.


The operation to remove the stomach is called a gastrectomy or partial gastrectomy (if part of the stomach can be preserved). Lymph nodes around the stomach are also removed to improve staging and reduce the chance of cancer returning. Minimally invasive techniques for removal of the stomach have been developed which can accelerate recovery. Even without a stomach, patients can eat normally and maintain a regular lifestyle. Patients are also evaluated in a multidisciplinary setting to come up with the most effective treatment strategy so that each patient’s care can be individualized.


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