Stomach Cancer

Symptoms | Diagnosis | Treatment options

Stomach cancer has become much less common in the United States over the last half century. Nearly 25,000 cases of stomach cancer are diagnosed in this country every year, with most cases involving people over the age of 65.

The stomach is a J-shaped organ in the upper abdomen. After you chew and swallow food, it moves through the esophagus and into the stomach. The stomach digests the food particles by breaking them down with strong gastric juices.

The three main layers of the stomach:

• Mucosal (inner)
• Muscularis (middle)
• Serosal (outer)

Stomach cancer starts when cells in the inner layer (mucosal) change or mutate. This ‘change’ can sometimes develop into cancer, but thankfully most of the time it does not. When it does develop into cancer, it is referred to as adenocarcinomas. Stomach cancer usually grows slowly and will not show symptoms for many years. Considering stomach cancer shows minimal symptoms, this can be problematic because it gives the cancer time to spread to other parts of the body by growing beyond the stomach wall, entering the bloodstream, or reaching the lymphatic system.

Symptoms

As mentioned above, stomach cancer will rarely show any noticeable symptoms and the development and growth of this form of cancer will often be mistaken for less serious problems such as indigestion or heartburn. Therefore, it is very important to note the following symptoms attributed to stomach cancer:

• Abdominal pain or discomfort
• Loss of appetite
• Heartburn / Indigestion
• Nausea / vomiting
• Bloating
• Diarrhea or constipation
• Bloody or black stools

Experiencing these symptoms does not necessarily mean you have stomach cancer, but they may signal other health problems that should be addressed and checked out by your doctor.

Diagnosis

It is important for stomach cancer to be discovered and diagnosed correctly as soon and as accurately as possible. This helps increase your odds for successful treatment and survival.

Types of Diagnostic Tests

If you are experiencing symptoms that might be stomach cancer, your doctor will examine you, and then order a variety of diagnostic tests. Some of the most common tests are blood tests, X-rays of the gastrointestinal tract, testing a stool sample for traces of blood and possible upper endoscopy.

If the initial tests are inconclusive and your doctor is still concerned you may have stomach cancer, some of the following tests may be used to help diagnose your body’s current condition including:

• Blood tests
• Imaging tests:
  • CT or CAT (computed axial tomography) scans
  • PET (positron emission tomography) scans
  • MRI (Magnetic resonance imaging)
  • Barium swallow: Set of more conclusive X-rays of the esophagus and stomach
• Endoscopy (a procedure where a gastroenterologist places a scope into the esophagus and stomach): A biopsy is taken when an abnormal growth is observed. The biopsy is then examined under a microscope. The majority of stomach cancer biopsies are performed by endoscopy.
  • Endoscopic ultrasound: An endoscope equipped with a small ultrasound device inserted into the stomach producing sound waves that produce an image on a video screen.

Treatment options

At Alaska Surgical Oncology, we will design your stomach cancer treatment to ensure the highest chances of survival. Your treatment plan will depend on the type and stage of the cancer, the location of the cancer and your general health.

Surgery is the most common treatment option for stomach cancer, however surgery is sometimes combined with chemotherapy and radiation therapy. If all three therapies are needed, chemotherapy and radiation is given before surgery because it usually is more successful and better tolerated in that order.

Types of surgical treatments:

Endoscopic mucosal resection: An endoscope is inserted which allows doctors to remove certain types of early, non-invasive stomach cancers.

Subtotal (partial) gastrectomy: The cancerous area of the stomach, nearby lymph nodes and / or parts of other organs near the tumor is surgically removed.

Total gastrectomy: The entire stomach, nearby lymph nodes and sometimes the spleen, parts of the esophagus, intestines, pancreas and/or other organs where the cancer has spread, are removed. The esophagus is reconnected to the small intestine to allow you to continue to eat, swallow and digest food.

After surgery, you may have a feeding tube inserted into your small intestine to allow you to receive needed nutrients and vitamins while your body takes time to heal.

Other treatment options include:

• Chemotherapy
• Radiation therapy
• Targeted therapy
• Gene therapy