Stomach Cancer

What Is It?

Stomach cancer, also called gastric cancer, is the uncontrolled growth of abnormal cells in the lining of the stomach. The disease usually does not cause any symptoms until the later stages, and usually, by the time stomach cancer is diagnosed, the prognosis is poor. Most people who are diagnosed with stomach cancer are over the age of 60. The disease rarely occurs before age 50. The disease is more common in men than women.

Stomach cancer is a major cause of cancer deaths worldwide and is much more common outside the United States. The number of people who develop stomach cancer is particularly high in Japan, Chile, Costa Rica, Hungary and Poland. It is the leading cause of cancer death in many of these countries. In the United States, the number of cases of stomach cancer diagnosed every year has fallen 75 percent since 1930. The decline may be due in part to increased use of refrigeration for food storage and decreased use of salted and smoked foods.

Several factors increase the risk of stomach cancer:

• A diet high in smoked, salted or pickled foods
• Alcohol and tobacco use
• History of chronic stomach disorders such as gastritis
• Previous stomach surgery
• Having relatives who had been diagnosed with stomach cancer

A diet high in fruits and vegetables may reduce the risk of stomach cancer.

The American Cancer Society estimates that 22,400 people in the United States (13,400 men and 9,000 women) will be diagnosed with stomach cancer during 2003. More than 12,000 Americans die from the disease each year.

Symptoms

Many people with stomach cancer do not have symptoms. When symptoms occur, they can be so vague that they are ignored. The symptoms of stomach cancer are also common symptoms of stomach ulcers, viruses and other gastrointestinal disorders. The most common symptoms of stomach cancer are bloating after meals, nausea, loss of appetite, recurrent indigestion and diarrhea or constipation. Other symptoms include sudden weight loss, loss of appetite, blood in the stool or vomit, and black, tarry stools.

Diagnosis

If risk factors or symptoms indicate that stomach cancer is possible, your doctor may perform a fecal occult blood test to determine whether or not there is a microscopic bit of blood in the stool. However, blood does not always appear in the stool when stomach cancer is present. The next test usually will be an upper endoscopy or an upper gastrointestinal (GI) radiograph.

During an upper GI radiograph, the patient drinks a barium-containing solution that coats the stomach, and then a radiologist takes X-rays of the stomach. During endoscopy the patient is sedated while a lighted tube called an endoscope is threaded down the throat and into the stomach. The doctor uses this tool to examine the interior of the stomach. If either test indicates a possibility of cancer, doctors then will perform a biopsy, which involved removing a small bit of stomach tissue to be examined in a laboratory. This often can be done during the initial endoscopy. A biopsy is necessary to confirm the presence of stomach cancer.