Some of the factors that may increase the
risk for development of gastric cancer include: Age over
55, male gender, ethnicity, smoking, family history of
stomach cancer, eating smoked, salted, or pickled foods,
and the bacterial infection Helicobacter pylori. H.
pylori is a common, treatable infection which leads to
stomach inflammation and may increase the risk of
developing gastric cancer. In the United States, gastric
cancer is more common in Asians or Pacific Islanders,
Hispanic Americans, and African Americans than in
non-Hispanic whites. Learn more about Prevention & Risk
Reducing Facts.
Incidence/Prevalence
In the United States, 21,000 new cases
of gastric cancer were estimated for 2010, with over
10,000 estimated deaths from gastric cancer. Although
the incidence has declined over time in the U.S.,
gastric cancer still remains the second leading cause of
cancer deaths worldwide. The lifetime risk of developing
gastric cancer is approximately 1 in 112, with a
slightly higher risk in men than women.
Signs/Symptoms
Stomach cancer may or may not present
with vague gastrointestinal symptoms, including
indigestion, abdominal pain or discomfort, nausea and
vomiting, bloating, or the feeling of fullness when
eating a meal (also called early satiety). These
symptoms can also be associated with other
gastrointestinal illnesses, however, and should be
discussed with a doctor who can perform tests to
determine the cause of the symptoms.
Workup/Diagnosis
Lab tests may be normal with gastric
cancer, or there may be signs of anemia (low red blood
cells). The best way to diagnose gastric cancer is by
taking a sample of stomach tissue (biopsy). To do this,
a gastroenterologist uses a small camera called an
endoscope to look inside the stomach and take biopsy
samples. The samples are then sent to a pathologist, who
can look at them under a microscope to determine if the
cells are cancerous. Other tests that may be performed
to look for cancer include endoscopic ultrasound, barium
swallow, CT scan, MRI, or PET scan.
Gastric adenocarcinoma can be staged based on the TNM
system. This system takes into account the extent of the
primary tumor, lymph node involvement, and metastasis,
or spread of the cancer to other parts of the body. The
five stages range from Stage 0 to Stage IV based on each
of the three categories, with stage IV being cancer that
has spread to distant parts of the body.
Treatment
Gastric cancer is treated with
surgery, chemotherapy, radiation, or a combination of
these. Surgical options depend on the extent of the
cancer within the stomach, and include partial or total
gastrectomy (removal of the stomach). Radiation and
chemotherapy may be used before or after surgery to
target the growing cancer cells in the stomach. Two
medications commonly used for chemotherapy in gastric
cancer patients include Fluorouracil (5-FU) and
cisplatin (Platinol). In advanced cases of gastric
cancer, surgery or chemotherapy may be used to alleviate
symptoms. This is known as supportive care or palliative
care.
Outcome
The 5-year survival rate for people
diagnosed with gastric cancer has been estimated at 26%
to 28% overall. This number is low because most cases
are detected at a late stage, when the cancer has
already spread outside the stomach. However, cases that
are detected at earlier stages have a better prognosis.
Research
Although the National Cancer Institute spends approximately 11 million to 12 million dollars annually on gastric cancer research, this is less than 0.5% of the total NCI budget. However, many medical centers develop clinical trials to learn more about prevention and treatment of gastric cancer.