Your stomach is part of your digestive system, located in the upper left part of your abdomen. This pouchlike muscular organ takes in food from your esophagus and breaks it down using gastric juices it secretes from tiny glands in its inner mucous membrane. The broken-down food then passes to your small intestine.
Stomach cancer, also called gastric cancer, happens when abnormal cells begin to grow in the inner lining.
Types of Stomach Cancer
More than 90% of stomach cancers are adenocarcinomas. These abnormal growths in the inner lining of the stomach wall often have distinct properties based on the tumor’s location.
Proximal Stomach Cancer
Proximal stomach cancer affects the first part of your stomach. It may extend into the part that meets your esophagus, called the GE Junction. Risk factors for this type of cancer include obesity and gastroesophageal reflux, or GERD.
Non-Cardia Stomach Cancer
Non-cardia stomach cancer affects any other part of the stomach. It may develop if you have long periods of inflammation and irritation, often caused by chronic infection with Heliobacter pylori bacteria (H. pylori).
Diffuse Stomach Cancer
Diffuse stomach cancer grows inside your stomach wall as scattered cells without actually forming a distinct tumor. Genetics often causes this type of stomach cancer.
Other cancers of the stomach include:
- Gastrointestinal stomal tumors (GISTS), abnormal growths in the connective tissues of the stomach wall.
- Lymphoma, an uncontrolled growth of immune cells of the stomach.
- Carcinoid tumors, cancers of the hormone-producing cells of the stomach. These often stimulate production of gastric acid, a substance that helps the body digest food.
About 27,000 people in the US are diagnosed with stomach cancer every year--about 17,000 men and 10,000 women. Stomach cancer is more common in older people, around 68 years old on average. It’s the 14th most common cancer in the US.
Many of the risk factors for stomach cancer are in your control, including poor diet, smoking, and using tobacco products. But some risks are out of your control. Regardless of your risk, getting stomach cancer is not your fault. Here are some risk factors.
Gender and Age
Stomach cancer is more common in men than in women. Most people who develop stomach cancer are 65 or older.
Heliobacter Pylori (H. pylori) Infection
This bacterial infection can lead to chronic inflammation in the inner layer of your stomach. Sometimes, the infection becomes precancerous lesions, which then may become cancer.
When you eat lots of highly preserved foods like smoked fish, salted meats, and pickled vegetables, you can increase the chance that you’ll develop stomach cancer.
Smoking and Alcohol Use
Both smoking tobacco and excessive alcohol consumption have been linked to increased risk of developing stomach cancer.
You’re at higher risk of stomach cancer if you’ve had stomach polyps or part of your stomach removed to treat ulcers.
Impaired uptake of Vitamin B12 due to lack of a substance called intrinsic factor in the stomach lining.
Persistent Abdominal Symptoms
Persistent abdominal symptoms for the past three months.
Family cancer syndromes
Hereditary nonpolyposis colorectal cancer (HNPCC), Li Fraumeni syndrome, and hereditary diffuse gastric cancer.
You're at higher risk if you have a family history of stomach cancer.
Family History of Breast Cancer
People carrying mutations of the inherited genes BRCA1 and BRCA2 may have a higher rate of stomach cancer. Mutations in a gene called E-cadherin can be associated with both gastric cancers and lobular breast cancers.
Signs of Stomach Cancer
Symptoms of earlier-stage gastric cancers are usually vague and may include minor stomach aches and indigestion. Other warning signs include:
- Dark stools
- Difficulty swallowing, which becomes worse over time
- Excessive burping
- General decline in health
- Loss of appetite or feeling full early after starting to eat
- Vomiting blood
- Weakness or fatigue
- Unexplained weight loss
Screening and Diagnosis
If you or your doctor are concerned that you might have stomach cancer, the Columbia Stomach Cancer Screening Center is a national leader in screening for stomach cancer.
Your appointment will include a detailed assessment of your medical history and symptoms and a physical exam. If you’re at high risk or we suspect that you have stomach cancer, you will likely have an upper endoscopy, a procedure that allows your doctor to use a flexible tube with a camera and light in it to thoroughly examine the inside of your stomach for lesions that indicate cancer. They’ll take tissue samples, which a pathologist will examine for abnormalities. You’re under sedation for this test.
We sometimes do an endoscopic ultrasound, too, to determine how deep an ulceration or tumor is. This test uses sound waves to create images of your stomach.
If you do have stomach cancer, you’ll likely have more tests, including:
This X-ray test creates a series of pictures of the body from many angles. It can detect enlarged lymph nodes, which may signal more advanced stomach cancer, infection, or a benign mass.
PET (Positron Emission Tomography) Scan
A PET scan uses a small amount of radioactive glucose injected into your vein to show where glucose is being used in your body. A scanner rotates around your body to create an overall picture. Cancer cells use more glucose than normal cells do.