Stomach Cancer: Causes, Symptoms, Diagnosis and Treatment

What is Stomach Cancer?

Stomach cancer, also known gastric cancer, develops in the cells that line the stomach. The cancerous cells grow in an uncontrolled way and as the disease progresses, the cancer spreads into the stomach wall. Stomach cancer can develop anywhere in the stomach.

What are the Symptoms of Stomach Cancer?

Early-stage stomach cancer may not produce any noticeable symptoms, and the most common symptoms, such as pain in the stomach and weight loss, may not appear until the disease is more advanced. These symptoms can also be confused with the symptoms of other less serious conditions.

Common symptoms of stomach cancer may include:

• Loss of appetite
• Unexplained weight loss
• Tiredness or fatigue
• Feeling weak
• Trouble swallowing
• Nausea and vomiting
• Indigestion or heartburn
• Dark colored stool
• Blood in the vomit
• Feeling bloated after food
• Feeling full after eating a small amount
• Pain in the stomach, usually above the belly button.

What Causes Stomach Cancer?

Cancer of the stomach happens when a change occurs in the DNA of the stomach cells. This change means that the growth and normal death of the cells isn’t regulated, and they grow out of control and don’t die when they should. Cancer cells soon outnumber healthy cells, and a tumor forms. The cancer can spread to other parts of the body if not treated.

Doctors don’t fully understand what causes stomach cancer, but certain factors are believed to increase the chance of it developing. These include:

• A family history of the disease
• A history of stomach polyps or ulcers
• Hereditary diffuse gastric cancer
• Common variable immunodeficiency (CVID)
• Li-Fraumeni syndrome
• Familial adenomatous polyposis
• Infection with Helicobacter pylori (H. pylori)
• Infection with the Epstein-Barr virus
• Lynch syndrome
• Peutz-Jeghers syndrome
• Gastritis
• Gastroesophageal reflux disease (GERD)
• Autoimmune atrophic gastritis.

Certain lifestyle factors may also increase the risk of developing stomach cancer:

• Obesity
• Drinking too much alcohol
• A high fat diet with limited fresh fruit and vegetables
• A high salt diet
• Smoking or using tobacco products
• Regular exposure to certain substances such as coal, metal and rubber.

How Can I Prevent Stomach Cancer?

Stomach cancer can’t be prevented, but there are certain things you can do to reduce the risk:

• Maintain a healthy diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while limiting the consumption of red meat, saturated fat and salt.
• Engage in regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise each week to promote a healthy digestive system.
• Avoid tobacco and limit alcohol consumption: Quit smoking and limit alcohol to moderate levels.
• Treat infection with H. pylori: An infection with this virus is a risk factor for stomach cancer.
• Treat Stomach conditions: Gastritis, GERD, ulcers and other common stomach conditions are risk factors for stomach cancer so should be treated promptly.

How is Stomach Cancer Diagnosed?

If you experience the symptoms of stomach cancer, your doctor will perform a thorough physical examination and take your medical history. Advances in technology have improved the accuracy and efficiency of many gastrointestinal cancer diagnostic tests, including the tests for stomach cancer. Diagnostic tests may include:

• Endoscopy: Advanced endoscopic techniques, using high-definition imaging are often used to diagnose stomach cancer. The procedure involves inserting a thin tube with a very small camera into the mouth and into the stomach. The doctor can pass very small surgical instruments through the endoscope into the stomach to allow the removal of a tissue sample (biopsy) for testing.
• Endoscopic ultrasound: A type of endoscopy that uses an ultrasound probe to take images of the stomach. It can show whether the cancer has spread from the stomach lining to the stomach wall.
• Radiologic tests: Tests such as CT scans, MRI, or barium swallow can identify tumors and cancer-related abnormalities. A barium swallow involves drinking a substance which makes the stomach lining visible on X-ray. A PET scan can also be used to show if cancer has spread.
• Blood tests: These can provide information on the function of other organs.
• Laparoscopy: This is a surgery that may be needed to determine if the cancer has spread (if other non-invasive methods haven’t given enough information).

What are the Treatment Options for Stomach Cancer?

Treatment for stomach cancer will depend on several factors, including the stage of the cancer and your overall health. A multidisciplinary team of experts will work with patients to discuss treatment options and preferences.

Thanks to advances in technology, doctors can now provide personalized treatment plans for patients diagnosed with stomach cancer.

At Cleveland Clinic Abu Dhabi, experts create a personalized treatment plan tailored to each patient. Treatment options include:

• Surgery: The type of surgery will depend on the stage of the cancer, but can involve removing a tumor, cancerous cells, a part of the stomach or all of it. Minimally invasive surgery options reduce the size of incisions, meaning faster recovery and fewer complications.
• Endoscopy: If the cancer is limited to the stomach lining’s upper layers only, then it can be removed via an endoscope. This is called endoscopic mucosal resection or endoscopic submucosal dissection.
• Gastrectomy: If the cancer has spread beyond the upper layers of the stomach lining, a part or all (a total gastrectomy) of the stomach will need to be removed. If all the stomach is removed, the esophagus can be connected to the small intestine so that eating is possible.
• Chemotherapy: Medications are used to destroy cancer cells or prevent their growth.
• Radiation therapy: High-energy X-rays or other types of radiation are used to target and destroy cancer cells. It can be used before surgery to shrink tumors or after surgery to kill any remaining cancer cells.
• Targeted therapy: This treatment option uses drugs that specifically target cancer cells, sparing healthy cells. Targeted therapies can be used in combination with chemotherapy.
• Immunotherapy: The patient’s own immune system is used to help fight cancer cells.

Stomach cancer is a serious condition, but survival rates are increased when it is diagnosed at an early stage. Talk to your doctor if you are experiencing any of the symptoms of stomach cancer.