Guide to Gastric (Stomach) Cancer

It’s when healthy cells in your stomach change and start to grow out of control. It tends to slowly get worse over many years. It can start in any part of your stomach and can spread to other areas of your body, including your liver, lungs, and bones.

This is the most common type of gastric cancer, making up as many as 95% of all cases. It starts in the tissues of your stomach lining, in the cells that make mucus and other fluids.

Less common kinds of gastric cancer include ones that start in the cells of your digestive tract -- carcinoid tumors and gastric sarcoma -- and lymphomas, which are linked to part of your immune system called lymph nodes.

Around 28,000 people get it each year in the U.S. -- about 60% of people diagnosed with it are over 65. Men are more likely to get it than women. It was the leading cause of cancer death in the U.S. until the 1930s, but now it’s the 14th most common type of cancer. Researchers think it may have become less common after refrigerators made it easier to store fruits and vegetables, and people began eating fewer salted and smoked foods.

This is a kind of bacteria that causes ulcers and inflammation in your stomach, and it’s one of the main causes of gastric cancer. There are different strains, some of which have a higher risk of cancer. Your doctor can test to see if you have this bacteria. H. Pylori can be treated with antibiotics, which may be another reason this kind of cancer is less common now than in the 1930s. The only way to know you have this bacteria is with a test. If you have a parent, sibling, or child who’s been diagnosed with gastric cancer, you should get tested.

You have a higher chance of getting gastric cancer if someone in your family has had it or you’ve had stomach surgery. A few medical conditions also can raise your chances: pernicious anemia (when you’re very low on red blood cells because you need more B12), familial adenomatous polyposis (when you have polyps in areas like your stomach and colon), and achlorhydria (when you don’t have enough of a certain acid in your digestive fluid).

Things you do every day can affect your chances of getting gastric cancer. Eating a lot of smoked foods, salted fish and meat, and pickled vegetables can boost your risk, along with not getting enough fruit and vegetables. You also might be more likely to get it if you smoke, drink a lot of alcohol, or are very overweight.

You may not notice any symptoms -- sometimes it’s not found until it’s spread to another part of your body. But here's what to look for:

• Tiredness
• Feeling bloated or full after you eat even a little
• Painful heartburn and indigestion
• Nausea and vomiting
• Diarrhea or constipation
• Stomach pain
• Weight loss for no reason
• Not being hungry
• Bloody or black stools

Your doctor will ask about any symptoms you have and do a physical exam. They’ll ask about your medical history and lifestyle. If they think you might have gastric cancer, they’re likely to recommend that you see a doctor who specializes in digestive issues (a gastroenterologist) for tests.

Your doctor probably will start with this test. They’ll send a tiny camera through a tube down your throat to look into your stomach. If anything doesn’t look right, they’ll take a tiny piece of tissue -- called a biopsy -- and send it to a lab, where they’ll look for cancer cells in the sample under a microscope.

Your doctor might suggest other ways to get a closer look at any tumor. This could be a CT (computerized tomography) scan, when several X-rays are taken from different angles and put together to make a more complete picture. Or you might have an MRI (magnetic resonance imaging) scan, which uses powerful magnets and radio waves to make detailed images.

Your treatment depends on where your cancer is, how far it’s advanced, and your overall health. In most cases, surgery to take out the tumor is the first step. Your doctor also might remove part or all of your stomach or take lymph nodes from other parts of your body to look for signs that the cancer has spread.

You also may have radiation therapy (high-powered X-rays) or chemotherapy (powerful drugs) to shrink the tumor before surgery -- and possibly afterward as well to kill any leftover cancer cells. These two kinds of therapy are often used together.

Your doctor may suggest targeted therapy -- special drugs that find and attack cancer cells without harming the healthy cells around them. They also might talk with you about immunotherapy, which helps your body use its natural defenses to fight the cancer.

Ask your doctor if there are any stomach cancer research trials that might be right for you. These studies look at new drugs and procedures, so you might get to try the latest treatments.