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Gastric (Stomach) Cancer

Gastric Cancer

  • Gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach.
    The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) in foods that are eaten and helps pass waste material out of the body. Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.
  • The wall of the stomach is made up of 3 layers of tissue: the mucosal (innermost) layer, the muscularis (middle) layer, and the serosal (outermost) layer. Gastric cancer begins in the cells lining the mucosal layer and spreads through the outer layers as it grows.

Signs and symptoms

  • Possible signs of gastric cancer include indigestion and stomach discomfort or pain.
  • These and other symptoms may be caused by gastric cancer. Other conditions may cause the same symptoms.

    In the early stages of gastric cancer, the following symptoms may occur:

    > Indigestion and stomach discomfort.

    > A bloated feeling after eating.

    > Mild nausea.

    > Loss of appetite.

  • In more advanced stages of gastric cancer, the following symptoms may occur:

    > Blood in the stool.

    > Vomiting

    > Weight loss for no known reason.

    > Stomach pain.

    > Jaundice (yellowing of eyes and skin).

    > Ascites (build-up of fluid in the abdomen).

    > Trouble swallowing.

Staging

  • After gastric cancer has been diagnosed, tests are done to find out if cancer cells have spread within the stomach or to other parts of the body.
  • Stage 0 (Carcinoma in Situ)

    In stage 0, abnormal cells are found in the inside lining of the mucosal (innermost) layer of the stomach wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

  • Stage I

    In stage I, cancer has formed. Stage I is divided into stage IA and stage IB, depending on where the cancer has spread.

    > Stage IA: Cancer has spread completely through the mucosal (innermost) layer of the stomach wall.

    > Stage IB: Cancer has spread:
    -completely through the mucosal (innermost) layer of the stomach wall and is found in up to 6 lymph nodes near the tumor; or
    -to the muscularis (middle) layer of the stomach wall.
  • Stage II

    In stage II gastric cancer, cancer has spread:
    > completely through the mucosal (innermost) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor; or

    > to the muscularis (middle) layer of the stomach wall and is found in up to 6 lymph nodes near the tumor; or

    > to the serosal (outermost) layer of the stomach wall but not to lymph nodes or other organs.

  • Stage III

    Stage III gastric cancer is divided into stage IIIA and stage IIIB depending on where the cancer has spread.
    > Stage IIIA: Cancer has spread to:
    -the muscularis (middle) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor; or

    > the serosal (outermost) layer of the stomach wall and is found in 1 to 6 lymph nodes near the tumor; or

    > organs next to the stomach but not to lymph nodes or other parts of the body.

    > Stage IIIB: Cancer has spread to the serosal (outermost) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor.
  • Stage IV

    In stage IV, cancer has spread to:
    > organs next to the stomach and to at least one lymph node; or

    > more than 15 lymph nodes; or
  • Recurrent: Recurrent gastric cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the stomach or in other parts of the body such as the liver or lymph nodes.

Treatment

  • Surgery
    Surgery is a common treatment of all stages of gastric cancer. The following types of surgery may be used:
    > Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor. The spleen may be removed. The spleen is an organ in the upper abdomen that filters the blood and removes old blood cells.

    > Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen may be removed. The esophagus is connected to the small intestine so the patient can continue to eat and swallow.
  • Chemotherapy
    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
    Radiation therapy
  • Chemoradiation
    Chemoradiation combines chemotherapy and radiation therapy to increase the effects of both. Chemoradiation treatment given after surgery to increase the chances of a cure is called adjuvant therapy. If it is given before surgery, it is called neoadjuvant therapy.
    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.