Our specialists offer advanced treatments and comprehensive care for people with stomach cancer. As leaders in cancer care, we have experience treating all types and stages of this disease.
Overview
About Stomach Cancer
What is stomach cancer?
Stomach cancer develops in the stomach, an organ that is part of your digestive system. It secretes digestive juices that break down foods so they can pass to your intestines and out of your body. It’s located in the upper abdomen just below the esophagus (the thin tube that carries food down from your mouth). Tumors can grow in any part of the stomach, from the top part (close to the esophagus) to the bottom portion (near the intestines).
How does stomach cancer develop?
Stomach cancer happens when abnormal cells grow uncontrollably and form tumors. At first, the tumors might not cause symptoms, so some people don’t know they have cancer until it’s advanced. The earlier stomach cancer is diagnosed, the easier it is to treat.
Stomach cancer typically starts in the inner layer of the stomach and grows outward. It can spread to lymph nodes and organs such as the liver and lungs. Depending on the extent of the disease, stomach cancer treatments may focus on removing tumors, destroying the cancer, or improving quality of life.
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Stomach Cancer Symptoms
Cancer of the stomach often develops slowly over time, and it might not cause any symptoms early on. As the cancer grows and spreads, it can cause a range of issues. These symptoms can vary based on the part of the stomach in which tumors are growing. Signs of stomach cancer include:
- Abdominal pain or discomfort, usually just above the belly button area
- Blood in vomit or in stool
- Feeling full after small meals
- Indigestion, heartburn, nausea, or vomiting
- Loss of or decrease in appetite
- Unexplained weight loss
- Weakness or fatigue
Stomach cancer that spreads to the liver can cause swelling of the abdomen (ascites). This occurs when fluid builds up in the belly, causing it to swell and bloat. If cancer spreads to the liver, it can also lead to yellowing of the skin and whites of the eyes (jaundice).
Types of Stomach Cancer
About 90 percent of stomach cancers are adenocarcinomas. This cancer starts in epithelial tissue, which lines the surfaces and cavities of the body's organs. Epithelial tissue makes mucus that aids in digestion. Stomach adenocarcinoma grows in the innermost layer of the organ (mucosa).
Other, rare types of stomach cancer include:
- Gastric lymphomas: These are cancers of the immune system tissue located in the stomach. The immune system protects the body against infection and disease.
- Gastrointestinal stromal tumors: Also known as GIST, these stomach tumors can be benign (noncancerous) or cancerous. They form from cells in the stomach wall called interstitial cells of Cajal, a type of smooth muscle tissue.
- Neuroendocrine tumors (NETs): These stomach tumors are a rare, slow-growing type of cancer that originates in the cells of the nervous system and endocrine system. They are also called carcinoid tumors.
Risk Factors
Stomach Cancer Risk Factors
Risk factors increase the chance of developing certain types of cancer and other conditions. Your risk of stomach cancer is higher if you have some health conditions or a history of certain diseases, including:
- Stomach polyps: Small growths called stomach polyps can result from many conditions. People with a type called adenomatous polyps have a greater risk of stomach cancer.
- Previous stomach surgery: If you've already had surgery to remove part of your stomach for stomach ulcers, you are at increased risk of cancer occurring in the tissue that remains.
- Helicobacter pylori (H. pylori) infection: This bacterial infection can damage the lining of the stomach and cause stomach ulcers. People who have had this infection for long periods of time have a higher risk of stomach cancer.
- Megoloblastic (pernicious) anemia: This condition, which can result from some autoimmune diseases, leads to a vitamin B12 deficiency. It affects the bone marrow’s ability to produce red blood cells.
- Menetrier's disease: This rare disease may be linked to stomach cancer. Also known as hypertrophic gastropathy, Menetrier's disease causes large folds to develop in the stomach. The abnormal stomach lining produces too little stomach acid.
- Common variable immune deficiency (CVID): This immune system disorder increases the chance of infection and other health problems.
Many inherited cancer syndromes and gene mutations can put you at a higher risk of developing stomach cancer. Your risk is also higher if you have a family history of these conditions. They include:
- Lynch syndrome, or hereditary non-polyposis colorectal cancer (HNPCC), an inherited syndrome that increases the risk of several cancers, including stomach cancer
- Familial adenomatous polyposis (FAP), which causes polyps in the large intestine and stomach
- BRCA1 or BRCA2 gene mutations, which indicate a higher risk of certain cancers
- Hereditary diffuse gastric cancer (HDGC), a rare inherited condition that raises the risk of stomach cancer significantly
- Peutz-Jeghers syndrome, which causes polyps to grow in the digestive tract
- Li-Fraumeni syndrome, a rare disorder that significantly increases the risk of many cancers
Other factors that affect your risk of stomach cancer include:
- Age: People over 50 are more likely to develop this type of cancer.
- Gender: Men are twice as likely to develop stomach cancer than women.
- Family history: If you have close relatives (such as a parent, sibling, or child) who have had stomach cancer, your risk is higher.
- Diet and nutrition: People who eat a lot of processed or cured meats and salted, pickled, or smoked foods have a higher risk of stomach cancer. Excessive alcohol use also increases the risk.
- Ethnicity and geographic location: In the United States, stomach cancer is more common among some ethnic groups, including people who are Hispanic, African American, Asian, and Native American. This type of cancer occurs more often in Japan, South Korea, Mongolia, and other Asian countries than in other parts of the world.
- Weight: Obesity increases the risk of some cancers, including cancer of the upper stomach.
- Smoking and tobacco use: Your risk of developing stomach cancer increases with the number of cigarettes you smoke each day and the number of years you have smoked or used tobacco products. Quitting at any age lowers your risk of developing cancer.
- Exposure to chemicals: People who work with coal, rubber, or certain metals are at an increased risk.
- Blood type: People with type A blood are at a higher risk of getting stomach cancer.
Stages
Doctors use a process called staging to determine if cancer has spread and, if so, how far. Staging helps doctors develop a treatment plan. When determining the stage, doctors look at many factors.
TNM System
Your care team uses a T, N, M system to stage stomach cancer. This means they consider many factors, including:
- Tumor: Your doctor looks at the size and location of the tumor, including the layer of the stomach that contains the tumor.
- Nodes: Your doctor will check to see if cancer has spread to nearby lymph nodes.
- Metastasis: Your doctor will also check to see if cancer has spread (metastasized) to other organs or parts of the body farther away from the original tumor.
The staging system your doctor uses may vary depending on the location of the original tumor. Tumors that start in the top part of the stomach (the cardia) have a slightly different staging system than tumors that start where the esophagus and the stomach meet (the gastroesophageal junction). Below is an overview of these staging systems.
The stages of stomach cancer are:
Stage 0
Also known as carcinoma in situ, the cancer is only in the innermost layer of the stomach wall, called the mucosa. It has not spread anywhere else.
Stage 1
The cancer has grown in one of these ways:
- The cancer is in the first and second layers of the stomach wall (mucosa and submucosa). It has not spread to lymph nodes.
- The cancer is in the mucosa and submucosa. It has spread to one or two nearby lymph nodes.
- The cancer has grown into the third muscle layer (muscularis propria). It has not spread to lymph nodes or other organs.
Stage 2
The cancer has grown in one of these ways:
- The cancer has grown into the second layer of the stomach (submucosa). It has spread to seven to 15 lymph nodes very close to the tumor.
- The cancer has reached the third and maybe the fourth layer of the stomach wall (muscularis propria and subserosa). It has spread to one to six nearby lymph nodes.
- The cancer has gone through the outermost layer of the stomach wall (serosa). It has not spread to lymph nodes or other organs.
Stage 3
The cancer has grown in one of these ways:
- The cancer has grown into the third layer of the stomach wall (muscularis propria) or subserosa. It has spread to seven to 15 lymph nodes.
- It has invaded nearby organs, such as the liver or spleen. Cancer cells have not spread to lymph nodes or to distant organs.
- The cancer has penetrated through all five layers of the stomach wall (including the outer layers). It has spread to one to 15 lymph nodes very close to the tumor.
Stage 4
The cancer has grown in one of these ways:
- The cancer has grown into all five layers of the stomach wall. It has spread to more than 15 lymph nodes.
- The cancer has spread to nearby tissues and at least one lymph node.
- The cancer has spread to distant parts of the body.
Cancer staging can be very complicated. Your doctor will explain the staging process to you and help you understand the extent of the cancer you have.
Your doctor begins by doing a comprehensive physical examination. They will also ask questions about your:
- Symptoms
- Medical history, including any previous stomach surgeries or stomach ulcers
- Family history of cancer and other conditions
- Diet and lifestyle habits, such as whether you smoke or drink alcohol
- Other risk factors, such as a history of working with certain chemicals
To diagnose stomach cancer, your doctor may recommend specialized tests, such as:
To detect hidden blood in feces, your doctor takes a sample of your stool and examines it under a microscope.
To check for the presence of abnormal cells, your doctor inserts an endoscope (a long, thin tube with a tiny camera) down your throat and into your stomach. They may remove tissue for a biopsy during an endoscopy. They send the tissue to a lab to check for cancer cells and determine the type of cancer.
Helicobacter pylori (H. pylori) test
Your doctor may use a special breath test or biopsy to check for the presence of the H. pylori bacteria. An H. pylori infection is a risk factor for stomach cancer.
Your care team may recommend this minimally invasive procedure to explore the inside of the abdomen and look for signs of cancer.
To detect hidden blood in feces, your doctor takes a sample of your stool and examines it under a microscope.
To check for the presence of abnormal cells, your doctor inserts an endoscope (a long, thin tube with a tiny camera) down your throat and into your stomach. They may remove tissue for a biopsy during an endoscopy. They send the tissue to a lab to check for cancer cells and determine the type of cancer.
Helicobacter pylori (H. pylori) test
Your doctor may use a special breath test or biopsy to check for the presence of the H. pylori bacteria. An H. pylori infection is a risk factor for stomach cancer.
Your care team may recommend this minimally invasive procedure to explore the inside of the abdomen and look for signs of cancer.
Endoscopic ultrasound
While you are sedated, your doctor inserts an endoscope into your mouth and down your throat. The endoscope has an ultrasound probe on the end. The ultrasound probe uses sound waves to produce images of your stomach and other nearby structures, including lymph nodes.
Upper GI series
This diagnostic test and X-ray series looks at the digestive system. You swallow a liquid called barium that shows up on the X-ray and helps your doctor spot signs of cancer.
Computed tomography scan (CT scan)
This test uses special X-ray and computer equipment to create images of bones, tissues, and organs.
Magnetic resonance imaging (MRI)
An MRI uses powerful magnets, radio waves, and a computer to create pictures.
Positron emission tomography (PET scan)
A PET scan is a type of nuclear medicine imaging that measures cell activity in the body. You receive a small, safe amount of a tracer (a radioactive substance) that travels through your body. The tracer detects areas of increased cell activity, called hot spots. These hot spots show up brighter on the scan, which typically indicate cancerous cells.
PET/CT scan
The PET/CT combination provides more accurate diagnoses than the two scans performed separately.
Your doctor may take small samples of your blood to test in the lab. Blood tests provide information about your health, including how your organs are working and if the cancer has spread. To diagnose stomach cancer, your doctor may take a blood sample to check for anemia (low red blood cells). Anemia can result from bleeding in the stomach. Blood tests also check for tumor markers (substances in the blood that may indicate cancer).
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Stomach Cancer
We specialize in delivering the most advanced care and treatments for stomach cancer. Our team has experience treating all types and stages of the disease.
Stomach cancer treatment
stomach cancer symptoms
signs of stomach cancer
gastrectomy
h pylori
helicobacter pylori