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Stomach Cancer: Overview

Stomach cancer is a disease in which cancer cells grow in the stomach. It is also called gastric cancer. There are different types of stomach cancer. They each grow in different parts of the stomach. The different types of cancer cells also look different.

Types of stomach cancer

The most common type of stomach cancer is called adenocarcinoma. This type forms in the inner layer of the stomach. The inner layer of the stomach is called the mucosa.

Other types of stomach cancer are less common:

  • Lymphomas. These are cancers of immune system tissue.

  • Gastrointestinal stromal tumors. These form from a type of cell in the stomach wall called interstitial cells of Cajal. In some cases, these tumors are not cancer.

  • Carcinoid tumors. These come from cells in the stomach that make hormones. These do not typically spread to other organs.

What causes stomach cancer?

The exact cause of stomach cancer is not known. Risk factors may make it more likely that stomach cancer will happen. These include:

  • Family history of cancer

  • Personal medical history, such as smoking

  • Exposure to certain toxic chemicals

What are the symptoms of stomach cancer?

The most common symptoms of stomach cancer are:

  • Indigestion or heartburn

  • Pain in the belly (abdomen)

  • Feeling of fullness or bloating in the abdomen

  • Nausea and vomiting

  • Vomiting blood

  • Diarrhea or constipation

  • Blood in the stool

  • Loss of appetite

  • Unexplained weight loss

  • Weakness and feeling tired

How is stomach cancer diagnosed?

A health care provider will start with your medical history. He or she may also give a physical exam. Tests may then be done. The tests may include:

  • Fecal occult blood test. This test checks for hidden (occult) blood in the stool. A small amount of stool is tested for the blood.

  • Upper GI (gastrointestinal) series. This is also called a barium swallow. For the test, you swallow a special liquid with barium. The barium coats the upper GI system. This includes the esophagus, stomach, and the first part of the small intestine (duodenum). These areas then show up on an X-ray.

  • Esophagogastroduodenoscopy (EGD). This is also called an upper endoscopy.  The test uses a thin, flexible tube called an endoscope. The tube is put into your mouth and throat. It is then guided down into the esophagus, stomach, and duodenum. The special small tools may be used to take small pieces of tissue in these areas. This is called a biopsy.

How is stomach cancer treated?

Doctors can treat stomach cancer in several ways. Treatment for stomach cancer may include:

  • Surgery. This is done to remove cancer tissue. It also removes nearby tissue that does is not cancer. The most common surgery is a gastrectomy. This is a surgery that removes part or all of the stomach. If part of the stomach is removed, it is called a subtotal or partial gastrectomy. If the entire stomach is removed, it is called a total gastrectomy. Nearby lymph nodes are often removed as well.

  • External radiation (external beam therapy). This uses high levels of radiation to kill the cancer cells. Radiation may be used after surgery to try to kill any cancer cells that may remain. Or it may be used as in more advanced stomach cancer to ease symptoms, such as pain or a blockage. This is known as palliative treatment.

  • Chemotherapy. These are drugs that change how cancer cells grow or reproduce. Many different kinds of drugs are available for chemotherapy. Each one works in a different way.

  • Targeted therapy. This uses drugs that target certain parts of specific types of cancer cells. Your cancer cells must be tested before the therapy is done. This is so the right drug can be used. For example, some people have HER2-positive stomach cancer. This means the cancer cells have too much HER2 protein. The drug to treat this type of cancer cell may be different from the drug to treat another type of cancer cell.

You may have more than one type of treatment. For example, you may have surgery and then radiation. Or, targeted therapy may be used with chemotherapy. 

You will work closely with your health care providers to find the best treatment for you. Be sure to talk with your health care provider about any questions or concerns.