Stomach Cancer

What is the Stomach?

The stomach is a large sac in the upper abdomen. It produces a strong acid that breaks down food so it can be absorbed.


What is Stomach Cancer?

Stomach cancer, also known as gastric cancer, is a type of cancer that develops in the lining of the stomach. It is a serious and potentially fatal disease that requires early detection and treatment. Stomach cancer typically starts in the mucus-producing cells that line the stomach, and over time, it can spread to the deeper layers of the stomach. 


In Australia, stomach cancer is the fifth most commonly diagnosed cancer and the fourth leading cause of cancer death.


Impact of Stomach Cancer on Anatomy and Health

Some of the most common ways that stomach cancer can impact your anatomy and health include:

  • Digestive Problems: Stomach cancer can cause digestive issues such as indigestion, heartburn, nausea, vomiting, and abdominal pain. As the tumour grows, it may also prevent food from passing through the stomach, resulting in a sense of fullness after eating small amounts.
  • Weight Loss: Unexplained weight loss is a common symptom of stomach cancer. This can occur for several reasons, including a loss of appetite, difficulty swallowing, or malnutrition due to the cancer's impact on the digestive process.
  • Anaemia: Stomach cancer can cause bleeding in the stomach, leading to a condition called anaemia. Anaemia occurs when the body does not have enough red blood cells to carry oxygen to the body's tissues. Symptoms of anaemia can include fatigue, weakness, dizziness, and shortness of breath.
  • Perforation: In advanced cases of stomach cancer, the tumour can penetrate the stomach wall, leading to a hole or perforation. This can cause abdominal pain, nausea, vomiting, and fever. Perforation is a medical emergency that requires immediate treatment.
  • Spread to other Organs: If stomach cancer is not treated, it can spread to other organs, such as the liver, lungs, or bones. This can lead to serious health complications and a reduced chance of survival.


In addition to the physical impact, stomach cancer can significantly impact a person's emotional well-being. The uncertainty and fear associated with a cancer diagnosis can cause anxiety, depression, and other mental health issues.


Risk Factors for Stomach Cancer

Stomach cancer is more common in people over the age of 50. Other risk factors for stomach cancer include:

  • Family history of stomach cancer
  • Previous stomach surgery
  • Helicobacter pylori infection (a type of bacteria that can cause stomach ulcers)
  • Smoking
  • Obesity
  • A diet high in smoked, salted, or pickled foods
  • Exposure to certain chemicals, such as asbestos or coal dust


Causes of Stomach Cancer

The exact cause of stomach cancer is unknown, but certain factors can increase the risk of developing the disease. One of the main risk factors for stomach cancer is an infection with Helicobacter pylori (H. pylori), a type of bacteria that can cause inflammation in the stomach lining. Other factors that can increase the risk of stomach cancer include smoking, a diet high in salt and preservatives, and a family history of the disease.


Symptoms of Stomach Cancer

The symptoms of stomach cancer can be vague and nonspecific, making it difficult to diagnose the disease in its early stages. Some common symptoms of stomach cancer include:

  • Indigestion or heartburn
  • Loss of appetite
  • Abdominal pain or discomfort
  • Nausea and vomiting
  • Difficulty swallowing
  • Fatigue
  • Unexplained weight loss
  • Feeling full after eating small amounts of food
  • Blood in the stool or vomit


Note that other medical conditions can also cause these symptoms. It is important to consult your doctor if you experience any of these symptoms.


Preventing Stomach Cancer

While some risk factors for stomach cancer, such as age and family history, cannot be changed, there are several steps you can take to reduce your risk of developing the disease.

  • Eat a Healthy Diet
  • Avoid Tobacco and Alcohol
  • Get Screened for H. pylori
  • Maintain a Healthy Weight
  • Practise Good Food Safety
  • Consider Genetic Testing


Types of Stomach Cancer

The type of stomach cancer you have is based on the type of cell where your cancer began. These include:

  • Adenocarcinoma: The most common type of stomach cancer, accounting for around 95% of cases. It starts in the glandular cells that line the stomach.
  • Lymphoma: This type of stomach cancer starts in the immune system cells in the stomach lining.
  • Gastrointestinal stromal tumour (GIST): This is a rare type of stomach cancer that develops in the cells that control the muscles in the stomach.
  • Carcinoid tumour: This is a rare type of stomach cancer that develops in the hormone-producing cells in the stomach lining.


Stages of Stomach Cancer

Stomach cancer is staged based on how far the cancer has spread. The stages of stomach cancer are:

  • Stage 0: The cancer is only present in the stomach's inner lining.
  • Stage I: Cancer has spread beyond the stomach's inner lining and into the muscle layer.
  • Stage II: Cancer has spread into the stomach's outer layer and nearby lymph nodes.
  • Stage III: Cancer has spread to nearby organs or lymph nodes but not to distant sites.
  • Stage IV: Cancer has spread to distant organs like the liver or lungs.


What is Stomach Cancer Staging?

Staging is the process of determining how advanced a cancer is and how far it has spread. In the case of stomach cancer, staging involves determining the size and location of the tumour and whether it has spread to nearby lymph nodes or other organs.


The most commonly used system for staging stomach cancer is the TNM system, which stands for Tumour, Node, and Metastasis. The TNM system uses three key factors to determine the stage of the cancer:

  • Tumour (T): This factor describes the size and location of the primary tumour. The T stage ranges from 0 to 4, with higher numbers indicating a larger or more invasive tumour.
  • Node (N): This factor describes whether the cancer has spread to nearby lymph nodes. The N stage ranges from 0 to 3, with higher numbers indicating more lymph node involvement.
  • Metastasis (M): This factor describes whether the cancer has spread to other parts of the body, such as the liver or lungs. The M stage is either 0 (no metastasis) or 1 (metastasis present).


Diagnosis of Stomach Cancer

There are several methods used to diagnose stomach cancer. These include:

  • Endoscopy: A procedure in which a thin, flexible tube with a camera is inserted into the stomach through the mouth to examine the stomach's lining.
  • Biopsy: During an endoscopy, a small tissue sample can be examined under a microscope to confirm the presence of cancer cells.
  • Imaging tests: These tests, such as CT scans, PET scans, and MRIs, can determine the extent of the cancer and whether it has spread to other parts of the body.


Treatment for Stomach Cancer

The treatment options for stomach cancer depend on the stage and extent of the cancer and the person's overall health. The main treatments for stomach cancer are:

  • Surgery: Removing part or all of the stomach. If the cancer has spread to other organs, such as the liver or lymph nodes, those may also need to be removed.
  • Chemotherapy: Use of drugs to kill cancer cells. Chemotherapy may be given before or after surgery to shrink the tumour or destroy any remaining cancer cells.
  • Radiation therapy: Using high-energy X-rays or other types of radiation to kill cancer cells.


For small cancers that have not spread, stomach surgery (Gastrectomy) to remove the affected part of the stomach is the most effective treatment. For larger cancers that have not spread, outcomes of stomach surgery are improved if chemotherapy can be given before and after a stomach operation. When stomach cancer has spread, these treatments aim to prolong life and control symptoms:

  • Chemotherapy
  • Radiotherapy
  • Stomach surgery (Gastrectomy)
  • Endoscopic stenting


What if Stomach Cancer is Untreated?

If left untreated, stomach cancer can spread to other parts of the body, such as the liver, lungs, and bones. This can lead to serious health complications, such as:

  • Malnutrition: As cancer grows, it can make it difficult for the stomach to digest food, leading to malnutrition and weight loss.
  • Perforation: If cancer penetrates the wall of the stomach, it can cause a hole to form, leading to an infection in the abdominal cavity
  • Obstruction: Cancer can block the stomach or intestines, preventing food and fluids from passing through.
  • Bleeding: Cancer can cause bleeding in the stomach or intestines, leading to anaemia or haemorrhage.


What Other Illnesses Can Mimic Stomach Cancer?

  • Non-cancerous tumours
  • Ulcers that bleed or burst
  • Polyps
  • Prominent or abnormal blood vessels
  • Scaring that occurs after an ulcer heals
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