We’ve all experienced our fair share of stomach issues. From the occasional tummy ache and pesky bouts of bloating and gas to the discomfort of post-heavy meal indigestion, possibly even digestive conditions like gastroesophageal reflux disease (GERD.)

Our stomachs have a way of making themselves known, and not always in the most pleasant manner. These familiar signs of gastrointestinal distress are usually nothing to worry about, typically caused by everyday factors. However, it’s important to be aware that some of these symptoms can signal something much more severe– stomach cancer.

Again, sporadic gastrointestinal discomfort is a common part of life and rarely indicates stomach cancer. Nonetheless, it’s important to know that stomach cancer is common, and certain individuals are at a higher risk of developing this condition.

November is Stomach Cancer Awareness Month, a time to shed light on the disease and underscore the importance of awareness, early detection, and support for those affected.

In this article, we will discuss what stomach cancer entails, going over its various types and stages, identifying crucial symptoms to watch for, and understanding when concern is warranted. Additionally, we’ll shed light on the individuals at higher risk of developing stomach cancer, how it is diagnosed, available treatments, and much more.

 

What is Stomach Cancer?

Stomach cancer, also known as gastric cancer, is a disease that originates in the lining of the stomach. It occurs when cells in the stomach lining undergo abnormal changes and begin to multiply uncontrollably. Over time, these malignant cells can form a tumor, potentially spreading to nearby tissues and, in advanced stages, to other parts of the body.

One of the concerning factors of stomach cancer is that it often develops slowly and silently. Its early stages do not typically present any noticeable symptoms. Additionally, its behavior can vary from one individual to another. As a result, detecting stomach cancer in its initial phases can be challenging. 

Early diagnosis and treatment are crucial for improved outcomes. Understanding the causes, symptoms, and risk factors associated with stomach cancer is essential for early detection and effective management, which we’ll discuss in more detail throughout this blog.

Types of Stomach Cancer

Stomach cancer is a category of cancer. Within this category, there are several different types of stomach cancer that can present differently and affect various parts of the stomach.

Adenocarcinoma

This is the most prevalent form of gastric cancer, accounting for over 90% of all cases. Adenocarcinoma develops in the inner lining of the stomach. Symptoms of adenocarcinoma may include digestive discomfort, unexplained weight loss, fatigue, and abdominal pain.

Lymphoma

Stomach lymphoma is more rare, comprising about 4% of all stomach cancers. This type of stomach cancer typically arises from the immune system rather than the stomach’s mucosal lining.

Lymphoma can be categorized into two subtypes:

  • Primary Lymphoma: This form initially involves the stomach and can subsequently affect lymph nodes, bone marrow, and other body parts. Symptoms of primary lymphoma may include abdominal pain, bloating, and fatigue.

  • Secondary Lymphoma: Initially originating in other parts of the body, such as the blood, lymph nodes, bone marrow, or other organs, it can later spread to the stomach. Symptoms of secondary lymphoma vary depending on the affected areas. They may include generalized symptoms like fever, night sweats, and unexplained weight loss.

Gastrointestinal Stromal Tumor (GIST)

GIST is a unique type of soft tissue sarcoma that can develop within the connective tissues of the stomach. While relatively rare, GIST can present with symptoms such as abdominal pain, gastrointestinal bleeding, or an abdominal mass that can be felt.

Neuroendocrine Cancer (Carcinoid Tumors)

Neuroendocrine cancer, also known as carcinoid tumors, originates from cells in the endocrine and nervous systems of the intestine. This type of stomach cancer is relatively uncommon.

Symptoms of neuroendocrine cancer can vary widely depending on the location and size of the tumor. Common symptoms may include flushing, diarrhea, abdominal pain, and, in advanced cases, symptoms related to hormone production by the tumor.

What are the Stages of Stomach Cancer?

Like other cancers, stomach cancer is typically categorized into several stages, each with its own characteristics and implications for prognosis and treatment. Each of these stages can then be further subdivided based on specific criteria.

Accurate staging is essential for healthcare professionals to tailor a personalized treatment plan that offers the best chance of managing stomach cancer effectively. Treatment options, which we will discuss further down, will also differ based on the stage in which stomach cancer is diagnosed.

Stage 0 (Carcinoma in situ)

Cancer is limited to the innermost layer of the stomach lining at this very early stage. It hasn’t spread beyond this layer, making it highly treatable with surgery to remove the affected tissue.

Stage I

Cancer at this stage has penetrated deeper into the stomach wall but remains confined to the stomach. Surgery is often the primary treatment, and the prognosis is generally favorable when the tumor is completely removed.

Stage II

In this stage, cancer has infiltrated the deeper layers of the stomach lining and may have reached nearby lymph nodes. Treatment typically involves surgery to remove both the tumor and affected lymph nodes. The prognosis can vary depending on the extent of lymph node involvement.

Stage III

Cancer at this stage has extended further into the stomach wall and may have spread to multiple nearby lymph nodes. Treatment options may include surgery, chemotherapy, and radiation therapy, often used in combination to target both the primary tumor and any remaining cancer cells in the lymph nodes.

Stage IV

This is the most advanced stage of stomach cancer, where cancer has spread to distant organs or tissues, such as the liver, lungs, or other parts of the body. Treatment primarily focuses on palliative care to manage symptoms and improve quality of life, as a cure is less likely at this stage.

How Common is Stomach Cancer?

We’ve seen a decline in the incidence of stomach cancer in the United States in recent years. However, it still maintains a significant presence and ranks among the leading causes of cancer-related deaths.

Globally, stomach cancer is currently ranked the fifth most prevalent cancer. In the United States, current statistics project that about 26,500 new cases of stomach cancer will be diagnosed in 2023. This comprises about 1.5% of all new cancer cases recorded annually in the US.

While it’s important to understand that certain risk factors can come into play, such as age, gender, family history, and dietary habits, stomach cancer exhibits a notable gender bias, with a higher prevalence in men compared to women. Moreover, it primarily affects older individuals, with the average age of diagnosis being around 68 years.

Even though stomach cancer may not be as common as some other cancers, it remains a significant public health concern, warranting attention, awareness, and continued research for effective prevention and management.

What Causes Stomach Cancer? 

Like many other diseases, stomach cancer doesn’t discriminate, and various factors can influence its development. That said, specific risk factors might increase the likelihood of developing stomach cancer.

It is important to remember that these risk factors do not guarantee the development of stomach cancer. Many people with one or more of these risk factors never develop the disease, while others without any apparent risk factors may still be diagnosed.

However, staying informed about these factors can aid in early detection and proactive measures to reduce risk. Some common contributors that increase your chances of developing stomach cancer include:

Age

Stomach cancer tends to occur more frequently in older individuals, with most cases diagnosed in people over 65.

Gender

Stomach cancer has a notable gender bias, with men being more susceptible to it than women. The reasons for this gender difference are not entirely clear and may involve a combination of factors, including hormonal differences, lifestyle choices, and dietary habits.

Family History

A family history of stomach cancer can significantly elevate an individual’s risk. If you have close relatives, such as parents or siblings, who have been diagnosed with stomach cancer, your risk may be higher.

Diet

Dietary habits are believed to play a role in stomach cancer risk. Some research suggests that consuming a diet rich in salted, smoked, or pickled foods increases the likelihood of developing this type of cancer. On the other hand, diets that are high in fresh fruits and vegetables may offer some protective benefits.

Certain Infections

Infections, particularly Helicobacter pylori (H. pylori) infection, are associated with an increased risk of stomach cancer. This bacterium can lead to chronic inflammation in the stomach lining, which, over time, may contribute to the development of cancer.

What are the Symptoms of Stomach Cancer?

Most people do not have any apparent symptoms until stomach cancer has progressed. Additionally, stomach cancer often presents symptoms similar to other digestive issues and diseases, making early detection challenging.

For instance, experiencing persistent heartburn and regurgitation might be a symptom of gastroesophageal reflux disease (GERD). However, these same symptoms can indicate gastric cancer or esophageal cancer.

If you have been diagnosed with GERD and notice that these symptoms are progressively worsening or persisting for a long time, it is crucial to contact your doctor for re-evaluation. 

Other symptoms of stomach cancer to be aware of include:

  • Persistent indigestion that doesn’t improve with over-the-counter medications or dietary changes.

  • Significant, unexplained, or unintended weight loss over a short period.

  • A reduced desire to eat, even when you haven’t eaten for an extended period.

  • Discomfort or pain in the abdominal area, especially in the upper abdomen.

  • A sensation of fullness or bloating after eating only a small amount of food.

  • Frequent bouts of nausea and vomiting, sometimes containing blood.

  • Difficulty or discomfort when swallowing food or liquids.

  • Persistent fatigue, tiredness, or weakness, often unrelated to activity.

How is Stomach Cancer Diagnosed?

Getting an accurate diagnosis is the first step toward effective treatment. This often involves a team of specialized healthcare professionals who work together to determine the most suitable course of action for your unique case.

If you are experiencing symptoms of stomach cancer, you should make an appointment with a gastrointestinal (GI) specialist as soon as possible. You might first need to see your primary care doctor if you have insurance requiring a specialist referral.

The GI specialist will discuss your symptoms, perform a medical exam, and possibly order tests such as endoscopy, imaging scans like CT or MRI, and biopsy procedures. They will evaluate your condition and test results and might be the one to diagnose your cancer.

Alternatively, they may refer you to a more specialized medical team, such as a surgical oncologist, for further evaluation and diagnosis.

How is Stomach Cancer Treated?

If stomach cancer is confirmed, your next steps will depend on the type and extent of the cancer. Stomach cancer treatment is complex, often involving a combination of therapies tailored to your specific condition.

The field of cancer treatment is continually evolving, and new therapies and strategies may emerge. But to date, the following are the most common stomach cancer treatment approaches:

Active Surveillance

There are cases where a “watch and wait” approach, also known as active surveillance, may be considered for stomach cancer. This approach is typically reserved for certain situations, such as small, slow-growing tumors in older individuals or those with other significant health issues who may not tolerate aggressive treatments well.

In such cases, the medical team closely monitors the tumor’s growth and progression, and treatment may only be initiated if there is a notable change or advancement in the cancer.

Surgery

Surgical intervention is a common approach to treating stomach cancer. A surgical oncologist is the specialist responsible for performing these procedures, which can involve the removal of the tumor and/or nearby lymph nodes, depending on the disease’s extent.

In some scenarios, more extensive surgeries may be necessary, such as a partial gastrectomy, where a portion of the stomach is removed. In more advanced cases, a total gastrectomy may be required to eliminate the entire stomach, along with adjacent lymph nodes and fatty tissue.

Our team might also explore minimally invasive surgical techniques. These advanced approaches may include laparoscopic procedures, robotic-assisted surgeries, and other innovative methods that provide effective treatment while prioritizing your well-being.

Chemotherapy

Chemotherapy involves the use of medications to target and eradicate cancer cells. It can be administered before surgery to reduce tumor size, post-surgery to eliminate residual cancer cells, or as the primary treatment for advanced stages of stomach cancer.

Radiation Therapy

Radiation therapy employs high-energy rays to target and eliminate cancer cells. It can complement surgery and chemotherapy to enhance treatment effectiveness. Radiation oncologists meticulously plan and administer radiation to minimize damage to healthy tissue.

Targeted Therapy

Targeted therapy medications are designed to specifically target cancer cells and obstruct their growth or spread. These therapies are particularly effective when certain genetic alterations are present in the cancer cells.

Immunotherapy

Immunotherapy leverages the body’s immune system to identify and combat cancer cells. While still under investigation for stomach cancer, it exhibits promise as a treatment option, particularly when other treatments yield limited results.

Palliative Care

In advanced stages or when a cure is not feasible, palliative care concentrates on alleviating symptoms, managing pain, and enhancing overall quality of life. It provides crucial support to both patients and their families.

What Doctor Treats Stomach Cancer?

The type of physician that treats your stomach cancer will depend on the kind of stomach cancer you are diagnosed with, what stage it is in, and your chosen treatment path.

For example, if your treatment plan includes chemotherapy, hormone therapy, targeted therapy, or immunotherapy, you will see a medical oncologist. They are experts in using these systemic treatments to combat cancer.

For cases where radiation therapy is deemed necessary, a radiation oncologist will become a vital part of your care team. They specialize in administering radiation treatments to target cancerous cells.

When surgery is recommended, a surgical oncologist steps in to perform the procedure. These highly skilled surgeons are experts in surgically addressing cancerous growths. 

Most people with stomach cancer do not have only one doctor treating them; they have a team working together to receive the most appropriate and comprehensive care possible.

What is the Prognosis for Stomach Cancer? 

In the early 20th century, stomach cancer held the unfortunate distinction of being the leading cause of cancer-related fatalities in the United States. However, the landscape has shifted significantly, with stomach cancer now having a much lower mortality rate.

A significant contributing factor to this positive change is believed to be the decline in Helicobacter pylori (H. pylori) bacterial infections, a bacterium long associated with stomach cancer development.

That’s the good news, but it’s important to note that stomach cancer is still prevalent and continues to be a leading cause of cancer-related deaths. One reason being that it is often silent and undetected until advanced stages or when it spreads to nearby tissues, organs, or regional lymph nodes.

Stomach cancer presents unique challenges, and each case is distinctive, influenced by factors like the stage at diagnosis, treatment effectiveness, and overall health. Therefore, it is difficult to say what your prognosis might be if you are diagnosed with stomach cancer.  

Early detection plays a pivotal role in improving the prognosis. When stomach cancer is diagnosed and treated before spreading beyond the stomach, the 5-year survival rate offers hope at around 72%.

However, the 5-year survival rate drops to around 33% if it spreads. This is why regular check-ups and timely screenings are crucial, particularly if you possess risk factors or experience concerning symptoms. 

While a complete cure for stomach cancer may not always be possible, treatments can alleviate symptoms, enhance your quality of life, and potentially extend survival. Additionally, advances in medical science continue to broaden our treatment options and improve outcomes for stomach cancer patients.

Stomach Cancer Awareness Month in November

The month of November isn’t just about Thanksgiving feasts and football games; it’s also Stomach Cancer Awareness Month. An entire month dedicated to raising awareness about this often silent type of cancer. 

Stomach Cancer Awareness Month also syncs perfectly with another important occasion – National Family History Day, a time to comprehend our genetic heritage and the potential health risks it might carry. This is important because, like other cancers, stomach cancer and some gastrointestinal diseases that can lead to stomach cancer can be hereditary.

Another reason Stomach Cancer Awareness Month is likely placed in November is to remind us to be sensitive to those fighting stomach cancer during the holidays. While everyone else is savoring delicious holiday meals, they might be navigating different challenges, including diet changes, treatments, and other side effects.

Spreading stomach cancer awareness is essential – not just during this month– but every single day of the year. You can help create awareness for stomach cancer by sharing information, supporting those affected, and encouraging regular health check-ups.

Surgical Oncology and GERD Treatment Center at The Surgical Clinic in Nashville and Middle Tennessee 

Whether you’ve received a stomach cancer diagnosis or face gastrointestinal issues like GERD, know you’re not alone. At The Surgical Clinic in Nashville and Middle Tennessee, our expert physicians include surgical oncologists and GERD specialists, all dedicated to providing top-quality care.

Stomach cancer may present challenges, but with timely intervention and expert care, there is hope. Whether you’re seeking treatment, guidance, or answers to your questions, our physicians are here to offer the best solutions tailored to your unique needs. 

Don’t hesitate to reach out to our team. We are here to provide the care and support you need on your journey toward better health.