Gastric Cancer

Other name: stomach cancer

Gastric cancer is cancer arising in the stomach (see Your Digestive System).

The term 'tumour' refers to a growing lump and can mean either a benign (non-cancerous) or a malignant (cancerous) tumour. The term 'cancer' refers to a tumour in which the cells are multiplying and spreading beyond the tumour (invasion), eventually spreading to other areas of the body and interfering with the function of those organs.

Frequency in the Community

Gastric cancer is much less common than breast cancer, bowel cancer, and lung cancer. The incidence (number of new cases per year) and mortality (death rate) from gastric adenocarcinoma, the most common gastric cancer, are declining in Western countries, possibly related to improvements in diet and standard of living. Adenocarcinoma and lymphoma are the most common types of gastric cancers, followed by stromal tumours and carcinoids.

Cause of Gastric Cancer

The cause of gastric cancer is unknown. Environmental factors appear to be important, including diet and helicobacter pylori infection.

Certain gastric lesions are known to be precursors of gastric cancer: some types of gastric polyps (adenoma in particular); chronic atrophic gastritis; intestinal metaplasia (a term used by a pathologist to describe a change in the stomach lining), and some other rare conditions.

Symptoms

The symptoms of gastric cancer may be vague - discomfort in the upper abdomen, loss of appetite, nausea, tiredness and weight loss. Ulcerating lesions may bleed and cause anaemia. These symptoms can occur with many other gastrointestinal diseases, not necessarily tumours.

Types of Gastric Cancer: "Early gastric cancer: adenocarcinoma (various types), squamous cell carcinoma, carcinoid Adenocarcinoma and other malignant epithelial tumours 'Lymphoma' Stromal tumours of the stomach" Neuroendocrine tumours

Diagnosis

While the diagnosis may be suspected on barium meal x-ray, ultrasound and CT scan, the most accurate way of making the diagnosis is to perform a gastroscopy and take biopsies (samples of tissue) and brushings for examination of cells. These techniques are not always accurate since the cancer may be beneath the surface or the malignant change may be patchy. It may be necessary to repeat the biopsies or even to take a biopsy at laparotomy or laparoscopy.

Medical Treatment

The treatment depends on the type of cancer. A variety of treatments are used including surgery (to remove the cancer), chemotherapy, and radiotherapy. The surgery may involve removal of part of the stomach (partial gastrectomy) or all of the stomach (total gastrectomy).