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.

Read more at Wikipedia.org


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Gene variants implicated in stomach cancer - Predisposed to Trouble
From Science News, 11/30/02 by Nathan Seppa

Over the past 20 years, as scientists have established that the bacterium Helicobacter pylori causes ulcers, they've also linked the microbe to stomach cancer. A new study suggests that a person's risk of this malignancy can depend on the genetics of both the individual and the bacterium.

Scientists in Portugal report that among people with an H. pylori infection, those who carry certain variants of genes in the microbe and in their own cells face a substantially higher risk of stomach cancer than do people without these variants. The study appears in the Nov. 22 Journal of the National Cancer Institute.

The human and microbial variants occur in genes known to orchestrate inflammation, says Martin J. Blaser of the New York University School of Medicine. The Portuguese findings "suggest that inflammation is really driving this [cancer] process," he says. Although the new study needs to be confirmed by larger trials and studies of other gene variants, he says, the work points to a synergy between microbial and human genetic variants.

The researchers analyzed genes found in H. pylori and blood samples taken from 221 people who had chronic stomach inflammation and 222 others who had undergone surgery for stomach cancer. The scientists examined variations in two H. pylori genes that influence inflammation--vacA and cagA. People carrying microbes with certain variant forms of at least one of these genes had a cancer risk up to 17 times as great as that of people without those variant forms.

The scientists then looked for variants in human genes dubbed Il-1B and Il-1RN. A person with both a high-risk microbial variant and one of certain human-gene variants was 7 to 87 times as likely to have stomach cancer as was someone without any of these variants, says study coauthor Ceu Figueiredo of the University of Porto.

Earlier studies had identified high-risk H. pylori and human gene variants. The new study is the first to measure stomach cancer risk in light of both, Figueiredo says.

An infection with H. pylori often goes unnoticed. Some scientists estimate that this microbe lives in the stomachs of up to half the world's people, though no country does widespread screening for the infection. Doctors test for the microbe mainly in people who complain of ulcer symptoms.

People infected with H. pylori have a lifetime risk of stomach cancer three to six times that of uninfected people (SN: 10/9/99, p. 234). However, diet, chemical exposure, and other microbes probably also contribute to stomach cancer.

"If H. pylori eradication could be targeted to individuals who are infected by a more virulent H. pylori strain ... such treatment could result in substantially reduced gastric cancer risk," says study coauthor Jose Carlos Machado, also of the University of Porto.

The work represents "a good first step" toward finding human gene variations that predispose people to stomach cancer, says Karen M. Ottemann of the University of California, Santa Cruz. Further research could eventually lead to procedures with which doctors could screen people to judge this cancer risk, she says.

COPYRIGHT 2002 Science Service, Inc.
COPYRIGHT 2002 Gale Group

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