Gastric Cancer

Stomach cancer, or gastric cancer, originates in the stomach. Although its occurrence has declined significantly over the past two decades, stomach cancer is still among the most prevalent cancers worldwide. The most common type is adenocarcinoma, one that starts from the stomach’s inner lining. There are other types that start from middle or outer parts of the stomach, but they are relatively rare.

What causes gastric cancer?

Though the actual cause of stomach cancer is not yet known, there are some factors associated with it, particularly diet and lifestyle.For example, a diet high in smoked or salted foods and processed meat and low in vegetables is a risk factor for stomach cancer, as is drinking alcohol and smoking. Helicobacter pylori, a microorganism that infects the inner lining of stomach, also contributes to cancer development. 

Some non-cancerous conditions in the stomach, such as sores or overgrowth of cells of the inner lining can precede cancer. Finally, some hereditary conditions can make people more likely to get stomach cancer. 

However, sometimes there is not a clear risk factor: Stomach cancer can still occur in the absence of any of these factors or conditions.  

What are symptoms of gastric cancer?

Stomach cancer may not cause any symptoms in its earlier stages. Some symptoms of stomach cancer, such as early satiety (sense of fullness), mild belly pain and fatigue are common, and similar tosymptoms of other, less serious conditions.

However, some symptoms are more suggestive of stomach cancer. If you experience any of the following symptoms for more than two weeks, you should see a gastroenterologist:

  • Unexplained weight loss
  • Severe abdominal pain
  • Nausea and vomiting
  • Loss of appetite
  • Vomiting blood
  • Tarry (dark, sticky) stool
  • Difficulty or painful swallowing

Stomach Cancer Diagnosis

When you go to your gastroenterology appointment, the doctor will ask about your health  and perform a thorough physical examination and request blood and stool samples. These will provide your doctor with many important details and guide the clinical decision. Your doctor may request imaging tests including:

  • CT or CAT (computed axial tomography) scans
  • PET (positron emission tomography) scans
  • MRI (magnetic resonance imaging)
  • Upper gastrointestinal endoscopy (also known as an EGD)

Other diagnostic procedures include endoscopy with biopsy and endoscopic ultrasound.

Endoscopy with Biopsy

Endoscopy is the most reliable and accurate test for gastrointestinal conditions, especially ones in the inner lining of the stomach and small intestines. Advanced endoscopic techniques lead to earlier detection of gastric cancer, which means the cancer is easier to treat.

An endoscope is a thin, lighted tube with a tiny camera at its tip. Your doctor can see the back of your mouth and throat, esophagus, stomach and parts of the small intestine on a screen. During an endoscopy:

  • You lie on your left side.
  • You receive anesthesia so you will be very relaxed or asleep throughout the procedure.
  • The practitioner guides the endoscope through your mouth, down your throat and into your stomach.
  • The endoscope shows the inner lining of your stomach, as well as your mouth, pharynx (voice box) and esophagus.
  • Your doctor performs a biopsy, which is removing a small part of tissue and sending it to a lab for tests. Biopsy results help the doctor make a diagnosis.

You may have another endoscopy after your diagnosis to establish the extent of the cancer, which helps your doctor decide on which treatments and follow-ups are appropriate for you.

Endoscopic Ultrasound

This test combines the endoscope with ultrasound, a soundwave generating imaging probe that provides detailed images and information about your digestive tract. It is especially useful in seeing the middle and outer layers beyond the inner lining. This test helps your doctor see the depth of the tumor and whether it has spread (metastasized).