The digestive system, also known as our gastrointestinal system, is the series of organs our bodies use to break down food, absorb nutrients, and excrete waste. Food proceeds from our mouth, down our esophagus, through the stomach, and from small intestine to large intestine before excretion. The word “gastric” refers to the stomach, the organ that participates in the chemical and physical digestion of food before passing it to the small intestine. Therefore, stomach cancer, also called “gastric cancer,” encompasses all cancers that originate in the stomach.

The wall of the stomach is made up of several layers of tissue. Stomach cancer typically starts when cells of the innermost layer, known as the “mucosa,” multiply uncontrollably and grow outward through the other layers. These other layers contain blood and lymphatic vessels. When cancer grows into these vessels, cancer may spread to other parts of the body.

Stomach cancer develops as a result of changes to the genetic material within the cells that make up the stomach. These changes result in the pattern of cell growth and division characteristic of stomach cancer. Although the increased likelihood of developing stomach cancer is associated with the following factors, in most cases, physicians and scientists are still trying to determine what causes stomach cancer to develop:

• Aging
• Chronic inflammation of the stomach
• Family history of certain cancers
• Family history of certain inherited cancer syndromes
• Exposure to aflatoxin
• Helicobacter pylori infection
• Immune system impairment
• Obesity
• Overconsumption of pickled, salty, and/or smoked foods
• Pernicious anemia
• Personal history of certain cancers
• Personal history of stomach polyp(s)
• Smoking
• Underconsumption of fruits and vegetables

Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner.

If stomach cancer is suspected, a doctor will likely order imaging to help arrive at a diagnosis. Imaging might include a CT scan, endoscopy, PET scan, PET-CT scan, ultrasound, or MRI. A CT (computed tomography) scan uses X-rays to generate a three-dimensional picture of the body whereas a PET (positron emission tomography) scan uses a small amount of radioactive tracer to locate any cancer cells by how readily they take up the radiotracer. A PET-CT combines the features of a CT scan with those of a PET scan. An endoscopy is a procedure whereby physicians insert a flexible tube with a small camera to peer inside the body. Lastly, an MRI (magnetic resonance imaging) uses magnetic fields to generate a detailed representation of the body.

If upon review of your results your doctor notices a mass suspicious for stomach cancer, he or she will likely order a biopsy in order to make a diagnosis and plan treatment, if necessary.

The following may be indicative of esophageal cancer but may also be indicative of other illnesses:

• Abdominal bloating, discomfort, and/or pain
• Abnormal, unexplainable weight loss
• Anemia
• Appearance of bloody or darkened stool
• Appearance of blood in vomit
• Enlarged lymph nodes
• Fatigue
• Heartburn and/or indigestion
• Loss of appetite
• Nausea and/or vomiting
• Sensation of fullness after only a small meal
• Sensation of fullness despite going a long time without eating

It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.

“Staging” occurs when a physician uses to test and scan results to determine which parts of the body are involved by cancer, in this case, stomach cancer. Staging is important because different stages of stomach cancer are better addressed with treatments that may differ in amount, combination, or type. According to the American Joint Committee on Cancer (AJCC), the stages for stomach cancer are as follows:

Stage 0

Cancer only involves the innermost layer of tissue that lines the interior of the stomach.

Stage I

Cancer has either penetrated through the stomach’s interior lining and spread to nearby lymph nodes OR grown to include part of the stomach muscular wall without involving lymph nodes surrounding the stomach.

Stage II

Cancer has either penetrated deeper into OR grown through the wall of the stomach, and may or may not involve regional lymph nodes. Cancer has not at this stage grown into the organs surrounding the stomach.

Stage III

Cancer now extends deeper into the stomach while involving the same number of nearby lymph nodes OR involves just as much stomach tissue as in previous stages but has progressed to include a greater number of regional lymph nodes. Cancer at this stage has not yet spread to distant areas of the body.

Stage IV

The primary tumor has spread beyond the stomach and nearby tissues to distant areas of the body, such as the liver.

Treatment of stomach cancer, depending on the stage and type, may include chemotherapy, radiation therapy, and/or surgery. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on a stomach cancer treatment plan include

• Your age, health, and lifestyle.
• The stage of your cancer.
• Any other serious health conditions you have.
• Your feelings about the need to treat cancer right away.
• Your doctor’s opinion about if you need to treat cancer right away.
• The likelihood that treatment will help fight or cure your cancer.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.