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Stomach (Gastric) Cancer

Gastric cancer occurs in the stomach — the muscular sac located in the upper abdomen, just below your ribs. The stomach is responsible for breakdown of the food that we eat, in addition to producing acid and other substances that aid with digestion. Adenocarcinoma is the most common type of stomach cancer and arises from the glands of the inner lining or mucosa. Gastric adenocarcinoma has a tendency to spread to the liver and peritoneum (surface lining of the abdomen). Rarely, sarcomas, gastrointestinal stromal tumors (GIST), neuroendocrine tumors (carcinoids), or lymphoma arise in the stomach.

Diagnosis

Signs and symptoms of stomach cancer may include but are not limited to:

  • Fatigue
  • Feeling full or bloated after eating little
  • Heartburn or indigestion
  • Nausea
  • Abdominal pain
  • Vomiting
  • Weight loss

Risk Factors

Risk factors for gastric cancer include but are not limited to:

  • A diet high in salty and smoked foods
  • A diet low in fruits and vegetables
  • Family history of stomach cancer
  • Infection with Helicobacter pylori
  • Long-term stomach inflammation (chronic gastritis)
  • Pernicious anemia
  • Smoking
  • Stomach polyps

Treatment

When detected early, removal of a portion or all of the stomach may represent adequate treatment. This procedure is called a partial or total gastrectomy. Your surgical oncologist will perform a reconstruction using the small intestine after removing the stomach and surrounding lymph nodes. If the tumor is advanced, a combination of therapies including surgery, chemotherapy, and/or radiation therapy may be recommended. In some cases, we advise patients to receive chemotherapy before surgery to maximize the chance of killing microscopic tumor cells that may have spread beyond the stomach.

Your staging evaluation prior to surgery, which often includes CT scans and endoscopic procedures, will guide your cancer team in determining the most appropriate course or treatment. Our gastroenterologists have expertise in performing endoscopic ultrasonography (EUS), which allows us to determine the degree to which the tumor has penetrated the stomach wall. The recommendation to use surgery in combination with chemotherapy and/or radiation will be made after discussion of your case in a conference attended by surgeons, medical oncologists, and radiation oncologists.