Stomach cancer, also known as gastric cancer, usually begins in the lining in the upper part of the stomach.
Stomach cancer is a common cancer, however the number of people diagnosed has been falling. It is rare in people under 50 years of age and affects more men than women.
Stomach cancer affects nearly twice as many men as women. The risk of being diagnosed with stomach cancer by age 85 is 1 in 63 for men compared to 1 in 136 for women.
Stomach cancer symptoms
In the early stages, stomach cancers often do not cause any symptoms.
Signs of early stomach cancer include:
- a painful or burning sensation in the abdomen
- heartburn or indigestion (dyspepsia).
Other symptoms that can occur later include:
- a sense of fullness, even after a small meal
- nausea and/or vomiting
- loss of appetite and/or weight loss
- swelling of the abdomen
- unexplained tiredness or weakness
- blood in vomit
- black-coloured faeces.
Causes of stomach cancer
The causes of stomach cancer are not known, but factors that put some people at higher risk are:
- age over 50
- being male - stomach cancers are more common in men than in women
- infection with the bacteria Helicobacter pylori
- a diet high in smoked, pickled and salted foods and low in fresh fruit and vegetables
- a family history of stomach cancer
- partial gastrectomy for ulcer disease (after about 20 years)
- inheriting a genetic change that causes the bowel disorders familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer.
Screening for stomach cancer
There is no routine screening test for stomach cancer.
Diagnosis for stomach cancer
The most common tests to diagnose stomach cancer are an endoscopy or gastroscopy (possibly with biopsy). The doctor will use a thin, flexible tube with a camera (endoscope), which passes into the mouth, down the throat and oesophagus into the stomach in order to look at the digestive tract.
Other tests, used less often, are barium swallow/upper gastrointestinal x-ray or endoscopic ultrasound.
Treatment for stomach cancer
After stomach cancer is diagnosed, one or more of the following tests are used to determine the extent of the cancer (its stage):
- CT scan
- ultrasound scan
- PET scan
- bone scan.
The staging system used for stomach cancer is the TNM system, which describes the stage of the cancer from stage I to stage IV.
Types of treatment
The main treatment for stomach cancer is surgery – a total or partial gastrectomy (removing all or part of the stomach). Chemotherapy may be given before and/or after surgery, usually:
- Three cycles of pre-operative chemotherapy (epirubicin/cisplatin/fluorouracil) and three cycles of post-operative chemotherapy (the MAGIC protocol) or
- Post-operative chemotherapy with fluorouracil, folinic acid and radiation (Intergroup protocol).
Depending on your treatment, your team of health professionals may consist of a number of different specialists, including:
- an endoscopist who diagnoses and treats diseases of the gastrointestinal tract
- upper gastrointestinal surgeon who treats diseases of the upper digestive system using surgery
- medical oncologist who prescribes the course of chemotherapy
- radiation oncologist who prescribes the course of radiation therapy
- cancer nurse
- other health professionals such as a dietician, physiotherapist, social worker or counsellor.
Prognosis for stomach cancer
An individual's prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. Treatment is most effective if the cancer is found in its early stages; stomach cancer can be cured if the cancer is removed before it spreads. However, because of the absence or vagueness of symptoms in the early stages, stomach cancers are often not discovered until they are more advanced. The five year survival rate for people diagnosed with stomach cancer is around 27%.
Preventing stomach cancer
The exact cause of stomach cancer is not known but there are steps you can take to minimise the risks including:
- not smoking or quitting smoking
- reducing consumption of smoked, pickled and salted food
- a diet high in fresh vegetables and fruit
- treatment of Helicobacter pylori infection may be protective.