Here are some answers to frequently asked questions about stomach cancer:
Q: What is stomach cancer?
A: Stomach cancer is when cancer cells begin growing in the stomach. The cancer cells are found in the inner layer of the stomach's lining. Because stomach cancer is rare, doctors do not do routine screening in the United States.
Stomach cancer is often diagnosed in its later stages because there are often no symptoms early in the disease. This makes it harder to cure. Stomach cancer is becoming rare as methods of preparing and preserving food continue to improve. Stomach ulcers, which are very common, are not the same as stomach cancer.
Q: Who develops stomach cancer?
A: It is found mostly in people between their late 60s and 80s. Stomach cancer is more common in men than in women. The disease is more common in Hispanic Americans and African-Americans than in non-Hispanic whites. Stomach cancer is also more common in some parts of the world, such as Japan, China, parts of Southern and Eastern Europe, and South and Central America.
Q: What are the risk factors?
A: Certain factors may make one person more likely to get stomach cancer than another person. These are called risk factors. But just because a person has one or more risk factors does not mean that person will get stomach cancer. In fact, a person can have all of the risk factors and not get the disease. Or, a person can have no known risk factors and still get stomach cancer:
Diet. People who eat a lot of foods that are smoked or not properly refrigerated, fish and meats that are very salty, high-starch and low-fiber foods, and vegetables that are pickled are at increased risk of getting stomach cancer.
Tobacco and alcohol use. People who use tobacco and alcohol heavily (a pack or more of cigarettes a day and two or more alcoholic drinks a day) are at a higher risk for getting stomach cancer.
Weight. Obesity is linked to many cancers, including stomach cancer.
Stomach polyps. The risk for stomach cancer is higher in a person who has had small growths called polyps in the stomach.
Stomach surgery. Those who have already had surgery to remove part of their stomach for stomach ulcers or stomach cancer may be at greater risk for either a new or recurring stomach cancer in the remaining stomach.
Helicobacter pylori infection. These bacteria often cause stomach ulcers, which can damage and shrink the stomach's lining. This leads to a higher risk of stomach cancer.
Pernicious anemia or Menetrier's disease. People with pernicious anemia do not produce any hydrochloric acid, which may increase the risk for stomach cancer. It is a severe type of anemia that causes weakness and gastrointestinal symptoms, among other problems. Either of these conditions may increase the risk.
Gender. Stomach cancer is more common in men than in women.
Age. After the age of 50, there is increased risk for stomach cancer.
Family history. People who have several first-degree relatives (mother, father, sister, brother) who have had stomach cancer are more likely to get it.
Type A blood. People with type A blood are at a higher risk of getting stomach cancer. Researchers do not yet know why this is true.
Q: What are the symptoms of stomach cancer?
A: People with early stomach cancer, meaning it is small and has not spread, do not usually have symptoms or signs of the cancer. But, as the cancer grows, it can cause these symptoms:
Unexplained weight loss
Abdominal pain or vague pain just above the belly button area
Indigestion and vomiting
Loss of or decrease in appetite
Weakness or tiredness
Blood in the vomit or stool
A feeling of fullness after small meals
A person should see the doctor if they are having any of these symptoms. The symptoms are most often a sign of something other than stomach cancer, but it is important to make sure.
Q: How is stomach cancer diagnosed?
A: To find out the cause of any of the signs or symptoms, a doctor does a careful physical exam and asks about the personal and family medical history. The doctor may also order these tests to make a diagnosis:
Fecal occult blood test
Upper endoscopy (The doctor may take a biopsy during this test.)
Upper GI series
Endoscopic ultrasound (EUS)
Q: How is stomach cancer treated?
A: Treatment depends on the size and spread of the cancer. A person with stomach cancer may have one or more of these treatments:
Q: Should everyone get a second opinion for a diagnosis of stomach cancer?
A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion. Here are some of those reasons:
Not feeling comfortable with the treatment decision
Being diagnosed with a rare type of cancer
Having several options for how to treat the cancer
Having the diagnosis made by a doctor who is not a cancer expert
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion:
Ask a primary care doctor. Your doctor may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.
Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.
Seek other options. Check with a local medical society, a nearby hospital or medical school, or support group to get names of doctors who can give you a second opinion. Or ask other people who've had cancer for their recommendations.
Q: How much of the stomach is removed in people who have stomach cancer?
A: There are two kinds of surgeries to remove stomach cancer. One kind removes only the portion of the stomach that contains cancer. This is called a partial gastrectomy. The other removes the whole stomach, and is called total gastrectomy. Which type a person gets, or if they get surgery at all, depends on the stage and type of stomach cancer they have.
Q: How does a person eat after surgery for stomach cancer?
A: A person who has surgery for stomach cancer will likely meet with a registered dietitian to discuss what they can and cannot eat during and after treatment.
After a partial gastrectomy, where only part of the stomach is removed, most people will be able to eat much the same way they did before. Although they may have to make some changes to the way they eat.
A person who has had a total gastrectomy has had their whole stomach removed. They still swallow and eat in the same way because their surgeon connects the esophagus to the small intestine. The surgeon may place a small feeding tube, called a jejunostomy (J-tube), into the small intestine at the time of surgery. Nutrition is given through this tube for a while after surgery during recovery. Diet changes are also needed after total gastrectomy. Most people who have their stomachs removed find that they prefer to eat small meals more often, rather than large meals three times a day.
Q: What is new in stomach cancer research?
A: Cancer research should give you hope. Doctors and researchers around the world are learning more about what causes stomach cancer, and are looking for ways to prevent it. They are also finding better ways to detect and treat this disease.
Here's some recent research about prevention and causes of stomach cancer.
A diet with high amounts of chemical compounds called heterocyclic amines (found in red meat cooked at very high temperatures, such as over an open flame) may increase the risk of cancer in the upper part of the stomach.
Doctors are studying how certain drugs, such as aspirin, may prevent stomach cancer. This is known as chemoprevention.
Currently, researchers believe that antioxidants, such as vitamin A and vitamin C, and antibiotics for certain infections in the stomach may help prevent stomach cancer. Ongoing research is needed to know for sure.
Here are some ongoing studies about advances in the treatment of stomach cancer.
Evaluating a more extensive type of surgery used in Japan to see if it can offer better chances for cure
Checking to see if surgery combined with chemotherapy or radiation increases a person's chance of survival
Testing new drugs, such as Taxol (paclitaxel), UFT, a new form of 5-fluorouracil, and new drug combinations as well as new forms of intraperitoneal chemotherapy, which is given directly into the abdomen
Whether certain vaccines may help fight stomach cancer by boosting the immune system
Q: What are clinical trials?
A: Clinical trials are studies of new kinds of cancer treatments. Doctors run clinical trials to learn how well new treatments work and what their side effects are. Promising treatments are ones that work better or have fewer side effects than the current treatments. People who join these studies get to use treatments before the FDA approves them for the public. People in trials also help researchers learn more about cancer and help future cancer patients.