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Reviewed by Alastair J Munro, professor of radiation oncology
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What is stomach cancer?
Each year, about 8,000 people in the UK develop stomach
cancer.
Stomach cancer, also known as gastric cancer, is the result of
cell changes in the lining of the stomach. In the UK, stomach cancer is much
less common than it used to be - the number of new patients each year has
halved over the past 30 years.
The location of the tumours within the stomach has also changed.
It used to be that most of the tumours were located near where the stomach
joins the small bowel; now the most common site is close to the junction with
the oesophagus (gullet).
Stomach cancer is very common in Japan and the Japanese have
developed an intensive and effective approach to screening for stomach
cancer.
What causes stomach cancer?
The causes of stomach cancer continue to be debated. A
combination of heredity (the genes inherited from your parents) and
environmental (diet,
smoking, etc) factors are all thought
to play a part.
Milk, fresh vegetables, vitamin C and frozen food all appear to
reduce the risk of stomach cancer. Any kind of food that has been smoked,
pickled or salted appears to increase the risk.
Other risk factors that have been suggested include being blood
group A and having the bacteria Helicobacter pylori in the stomach.
Stomach cancer is more common in men than women, and has its
peak age range between 40 and 60 years old.
What are the symptoms of stomach cancer?
Unexplained weight loss can be a symptom of stomach cancer and
feeling “full-up” or bloated after eating only a small amount of food may also
be a problem associated with a tumour in the stomach.
Stomach cancers can cause
heartburn, but it’s a
rare cause of this very common symptom.
If the tumour obstructs the food passage then vomiting may
occur. Sometimes tumours can cause obstruction to the outlet of the stomach,
and bringing up large volumes of undigested food long after eating is a
characteristic symptom of this state of affairs.
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Good advice
If you have the slightest suspicion of any of the symptoms
mentioned, you should contact your doctor at once for an assessment.
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Excessive belching can be an early, and embarrassing, symptom.
This can progress to a sensation of vague discomfort followed by pain if the
tumour grows through the stomach wall.
Slim patients may become aware of a lump in the upper part of
the abdomen just below the lower end of the breastbone.
Stomach cancer can grow slowly and imperceptibly. Sometimes
symptoms will only develop once the disease has spread beyond the stomach, for
example to involve the liver. In this case, the symptoms would be those of
cancer involving the
liver.
There may be internal bleeding appearing as blood in the vomit,
or black, tar-like, faeces, or the bleeding may be so slight as to pass
undetected, If this is the case the patient goes to the doctor because they are
tired and pale and are then found to have
iron-deficiency anaemia.
As with
cancer of the oesophagus, it may take
a long time, often many months, from the time that symptoms first appear to the
patient seeking medical advice. This delay may allow time for the tumour to
spread and to progress from being potentially curable to being
inoperable.
How is stomach cancer diagnosed?
There are two main investigations for cancer of the stomach.
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X-ray examination, in this case a
barium meal. This involves swallowing a white, chalky liquid and having a
series of X-ray pictures taken of the stomach area.
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A
gastroscopy. During a gastroscopy,
the doctor examines the inside of the stomach using a camera attached to a
flexible tube and is able to take a sample from the tumour for
biopsy and
microscopy.
How is stomach cancer treated?
The most effective treatment is surgery and the sooner the
disease is discovered, the better the chances of a complete recovery. The cure
rate after surgery is about 30 per cent.
In Japan, where stomach cancers are detected much earlier in the
course of the disease, survival rates are higher than in the UK. This shows the
importance of early diagnosis.
Unfortunately, in the UK many patients do not realise the
significance of their symptoms until the later stages of the disease and this
significantly reduces the chances of cure.
Chemotherapy,
sometimes combined with radiotherapy, has recently been shown to be highly
effective against some forms of stomach cancer and may help convert an
inoperable tumour into an operable one. The regime used is toxic and
complicated and, unfortunately, only a minority of patients are fit enough to
be treated in this way.
Reference
http://info.cancerresearchuk.org/cancerstats/types/stomach/?a=5441
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Based on a text by Dr Per Grinsted, GP
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Last updated 05.09.2008
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