Stomach cancer is sometimes called gastric cancer. Worldwide it is one of the most common cancers. It is common in Japan and China but is less common in the UK. About 5,000 people develop stomach cancer each year in the UK. Stomach cancer is more common in men than in women and tends to occur mainly in older people. Most people who develop stomach cancer are over the age of 55.
people with stomach cancer rarely show symptoms in the early stages, therefore the disease is often not diagnosed until it’s more advanced.
How is stomach cancer diagnosed?
To make a diagnosis, your doctor will first perform a physical exam to check for any abnormalities. They may also order a blood test, including a test for the presence of H. pyloribacteria.
In addition to taking a complete history and performing a physical exam, your doctor may do one or more of the following tests:
Upper GI series- The patient is asked to drink a barium solution. Subsequently x-rays of the stomach are taken. The barium outlines the inside of the stomach helping to reveal any abnormal areas that may be involved with cancer. This test is used less often than it used to be, and patients now often undergo endoscopy (see below) first.
Endoscopy- A lighted, flexible tube with a camera, called an endoscope, is inserted through the mouth into the esophagus and then into the stomach. Sedation is given prior to insertion of the endoscope. If an abnormal area is found, biopsies (tissue samples) can be taken and examined under a microscope to look for cancer cells.
If cancer is found, the doctor may schedule additional staging tests to determine if the cancer has spread. A CT scan may be used to determine if cancer has spread to the liver, pancreas, lungs or other organs near the stomach.
Staging of gastric cancer may also be performed by using endoscopic ultrasound. Endoscopic ultrasound can help to determine the depth of spread of the tumor into the wall of the stomach and involvement of adjacent structures as well as assess for any enlarged lymph nodes that may be invaded with cancer cells.
Stages of stomach cancer
The stages of adenocarcinoma of the stomach or esophagus include:
Stage I. At this stage, the tumor is limited to the top layer of tissue that lines the inside of the esophagus or stomach. Cancer cells also may have spread to a limited number of nearby lymph nodes.
Stage II. The cancer at this stage has spread deeper, growing into a deeper muscle layer of the esophagus or stomach wall. Cancer may also have spread to more of the lymph nodes.
Stage III. At this stage, the cancer may have grown through all the layers of the esophagus or stomach and spread to nearby structures. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.
Stage IV. This stage indicates that the cancer has spread to distant areas of the body.
How is Stomach Cancer Treated?
Your treatment options for gastric cancer or stomach cancer depend on the stage of your cancer, your overall health and your preferences.
Treatment plans may vary depending on the size, location, extent of tumor and the patient’s overall health. Treatments include surgery, chemotherapy and /or radiation therapy.
Surgery is the most common treatment. The surgeon can remove part of the stomach (gastrectomy) or the entire stomach. Lymph nodes near the tumor are generally removed during surgery so that they can be checked for cancer cells.
Researchers are exploring the use of chemotherapy before surgery to help shrink the tumor and after surgery to help kill residual tumor cells. Chemotherapy is given in cycles with intervals of several weeks depending on the drugs used.
Radiation therapy is the use of high-energy rays to damage cancer cells and stop them from growing. Radiation destroys the cancer cells only in the treated area.
Doctors are looking at the combination of surgery, chemotherapy and radiation therapy to see what combination would have the most beneficial effect.