Diagram of the stomachLow differentiated Adenocarcinoma of the stomach.
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Stomach cancer

In medicine, stomach cancer (also called gastric cancer) can develop in any part of the stomach and may spread throughout the stomach and to other organs. The cancer may grow along the stomach wall into the esophagus or small intestine. more...

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It also may extend through the stomach wall and spread to nearby lymph nodes and to organs such as the liver, pancreas, and colon. Stomach cancer also may spread to distant organs, such as the lungs, the lymph nodes above the collar bone, and the ovaries.

When cancer spreads to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if stomach cancer spreads to the liver, the cancer cells in the liver are stomach cancer cells and the disease is metastatic stomach cancer, not liver cancer.

A well known complication of stomach cancer is when it spreads to an ovary; the tumor in the ovary is called a Krukenberg tumor. This tumor, named for the doctor who first described it, is not a different disease; it is metastatic stomach cancer - the cancer cells in a Krukenberg tumor are stomach cancer cells, the same as the cancer cells in the primary tumor.

Epidemiology

Stomach cancer is more prevalent in China, Japan, Korea, and other countries in Asia and South America, than in the United States.

Infection with H. pylori is the main risk factor in about 80% or more of gastric cancers.

Symptoms

Stomach cancer can be hard to find early. Often there are no symptoms in the early stages and, in many cases, the cancer has spread before it is found. When symptoms do occur, they are often so vague that the person ignores them. Stomach cancer can cause the following:

  • Indigestion or a burning sensation (heartburn)
  • Discomfort or abdominal pain
  • Nausea and vomiting
  • Diarrhea or constipation
  • Bloating of the stomach after meals
  • Loss of appetite
  • Weight loss
  • Weakness and fatigue
  • Bleeding (vomiting blood or having blood in the stool)

Any of these symptoms may be caused by cancer or by other, less serious health problems, such as a stomach virus or an ulcer. Only a doctor can tell the cause. People who have any of these symptoms should see their doctor. They may be referred to a gastroenterologist, a doctor who specializes in diagnosing and treating digestive problems. These doctors are sometimes called gastrointestinal (or GI) specialists.

Diagnosis

To find the cause of symptoms, the doctor asks about the patient's medical history, does a physical exam, and may order laboratory studies. The patient may also have one or all of the following exams:

  • Fecal occult blood test
  • Upper GI series
  • Gastroscopic exam

Abnormal tissue seen in a gastroscope examination will be biopsied by the surgeon or gastroenterologist. This tissue is then sent to a pathologist for histological examination under a microscope to check for the presence of cancerous cells. A biopsy, with subsequent histological analysis, is the only sure way to confirm the presence of cancer cells.

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What should I know about stomach cancer? - Information: from your family doctor
From American Family Physician, 3/1/04

What is stomach cancer?

Stomach cancer, which is also called gastric cancer, is the growth of cells that are not normal in the lining and wall of the stomach. The stomach is the organ where food is digested.

Who might get stomach cancer?

You may have more risk for getting stomach cancer if you are old, if you are a man, if you smoke cigarettes, if you drink a lot of alcohol, or if you eat a lot of pickled or salty foods. Certain groups of people such as blacks, Native Americans, and Hispanics also may have an increased risk. Your chance of getting stomach cancer is higher if you have had an infection in your stomach caused by the bacteria Helicobacter pylori.

Can I prevent stomach cancer?

There is no way to prevent stomach cancer. However, you can help reduce your risk of getting stomach cancer by not drinking too much alcohol, by not smoking, and by eating a diet high in fresh fruits and vegetables, and vitamin C. Vitamin C is found in foods such as oranges and grapefruits.

How can my doctor tell if I have stomach cancer?

You won't know you have stomach cancer for sure until after your doctor examines your stomach. Sometimes cancer can be in the stomach for a long time and grow very large before it causes symptoms. In the early stages of stomach cancer, you may have these symptoms:

* Indigestion, stomach discomfort, or heartburn

* A bloated feeling after eating

* Nausea or loss of appetite

When the cancer is larger, you may have these symptoms:

* Blood in your stool

* Vomiting

* Weight loss

* Stomach pain

If you have any of these signs or symptoms, talk with your doctor.

How do doctors look for stomach cancer?

If you have signs, symptoms, or risk factors, your doctor may want you to get an x-ray test of your stomach. For this test, you will drink a liquid containing barium, which makes the stomach easier to see on the x-ray.

Your doctor also may look inside your stomach using a thin, lighted scope. For this test, the scope is inserted through your mouth and passed down to your stomach. Your doctor may give you medicine before the test so that you feel no pain.

If your doctor sees anything that is not normal during this test, he or she may cut out a small piece of the stomach so it can be looked at under a microscope to see if there are any cancer cells. This is called a biopsy.

How is stomach cancer treated?

The choice of treatment depends on whether the cancer is just in the stomach or if it has spread to other places in your body. It also depends on your health. The earlier stomach cancer is detected, the better the chances are that it can be cured.

Once cancer of the stomach is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This step is called staging. You might get a kind of x-ray called a CAT scan to see if your cancer has spread. An ultrasound test also can be done. Your doctor needs to know the stage of the cancer to plan your treatment, which could include surgery, chemotherapy, or radiation, or all three.

Where can I learn more about stomach cancer?

American Cancer Society, Inc.

1-800-ACS-2345 (1-800-227-2345)

http://www.cancer.org

AMC Cancer Research Center and Foundation

1-800-321-1557

http://www.amc.org

Cancer Information Service

1-800-4-CANCER (1-800-422-6237)

http://cis.nci.nih.gov

Notes:

COPYRIGHT 2004 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group

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