Stomach cancer, also referred to as gastric cancer, is an abnormal cell
growth that starts in the stomach. While it can infect any area of the
stomach, the main part of the stomach is where most stomach cancers
form.
Typically, stomach cancers develop gradually over the years.
Pre-cancerous changes occur in the stomach's inner lining (mucosa) prior
to the development of a true cancer.
What are the types of stomach cancer?
There are four types of stomach cancer:
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Adenocarcinoma: The majority of stomach cancers
(90-95%) are adenocarcinomas, which begins in the cells of the stomach
lining. The intestinal type has a better prognosis, while the diffuse
type spreads faster and is more challenging to treat.
-
Lymphoma: Lymphoma refers to a tumour that starts in
lymphocytes (immune system cells). Some of it may begin in the stomach
wall, though it typically begins in other places of the body.
-
Gastrointestinal stromal tumour (GIST): GIST is rare
and typically starts in the stomach. However, it can develop anywhere
in the digestive system.
-
Neuroendocrine tumour: Neuroendocrine tumour develops
from the cells of the neuroendocrine system. The majority of these
tumours develop gradually and remain in the stomach, but some may
spread quickly.
What are the risk factors for developing stomach cancer?
The exact cause of stomach cancer is unclear, but the following risk
factors put you at a higher risk of developing it:
- Male gender
- Age 65 and above
-
Infection with Helicobacter pylori (H. pylori), a type of bacteria
- Heavy smoking, excessive alcohol consumption
- Diet rich in pickled, smoked, or salted food
- Diet low in vegetables, fresh fruits, vitamin C and A
- Stomach polyps (unusual growth of tissue)
- Long-term severe gastritis or acid-reflux
-
Family history of stomach cancer: If you have a parent or sibling who
has been diagnosed with lung cancer, you have an increased risk of
developing lung cancer
- Genetic mutations such as HDC-1 mutations
What are the signs and symptoms of stomach cancer?
Given that symptoms of stomach cancer are rarely present, early
detection may be challenging. Patients with advanced stomach cancer may
experience the following symptoms:
- Nausea
- Vomiting
- Blood in the stool
- Heartburn
- Indigestion
- Loss of appetite
- Unexplained weight loss
- Pain in the upper part of your abdomen
- Lump at the upper part of your abdomen
- Dysphagia – inability to swallow
- Feeling full after consuming a small amount of food
- Tiredness or lethargy
You may have similar symptoms frequently if you have gastro-oesophageal
reflux disease or other conditions, and you may become accustomed to
them. However, you must visit a doctor if your symptoms change or
worsen.
How do doctors diagnose stomach cancer?
Stomach cancer is diagnosed after performing several tests. Your doctor
would initially ask about your general health and symptoms. Other tests
may include:
-
Blood tests
-
Blood tests will be performed to test for anaemia due to stomach
cancer bleeding and blood in the stool (faeces) that is not
visible to the naked eye.
-
Upper endoscopy
-
Upper endoscopy is done to examine the oesophagus, stomach, and
duodenum for abnormal areas. It is most commonly done by the
doctor if a diagnosis of stomach cancer is suspected.
-
A thin, lit tube called an endoscope is put into the oesophagus
through the mouth and down the throat. During the procedure, a
biopsy may be done whereby a small sample of tissue may be removed
and sent to the laboratory to be examined. This procedure takes
approximately 10 to 15 minutes.
-
Computed tomography (CT) scan
-
CT scan is useful to determine the location and extent of the
spread of cancer. This procedure involves the use of X-rays to
provide detailed, cross-sectional images of the soft tissues of
the body.
-
Endoscopic ultrasound
-
This procedure is conducted to determine if cancer from the
stomach lining has spread to the stomach wall, nearby lymph nodes
or other nearby areas.
-
Positron emission tomography (PET) scan
-
PET scan aids in determining the extent of cancer spread to other
parts of the body at once.
-
Barium swallow
-
This procedure is done to test for any abnormalities in the
stomach and oesophagus. The procedure involves drinking a barium
liquid on empty stomach to make the stomach lining more visible on
the X-ray. This procedure takes approximately 20 minutes.
-
Laparoscopy
-
A laparoscopy is a minor surgery that might be done if stomach
cancer has been found and has not metastasised to other parts of
the body.
-
This can confirm that the cancer is still limited to the stomach,
implying that surgery to remove it is still an option.
Learn more about the different types of screening and diagnostic
procedures performed to diagnose stomach cancer.
How is stomach cancer treated?
The course of treatment for stomach cancer is determined by the
location, size, stage, and type of cancer. The treatments typically used
include radiotherapy, chemotherapy, and targeted therapy.
-
Surgery is typically used in treating stomach cancer,
especially if it is detected early, has not spread, or has not spread
significantly. Surgery may be performed to remove the cancer, a part
of the stomach and adjacent tissues that are also affected. Surgery
may also be done to relieve an obstruction in the stomach to allow
food to pass through easily.
-
Chemotherapy utilises strong cancer-killing drugs to
reduce the size of the tumour before surgery or to eradicate any
leftover cancer cells after surgery. It is used to slow the spread of
cancer and may be used alongside radiotherapy or targeted drug
therapy.
-
Radiotherapy employs high-energy radiation to reduce
the size of tumours and kill cancer cells. This procedure is used to
alleviate the symptoms of advanced cancer.
-
Targeted therapy uses medications aimed at inhibiting
the progression of advanced stomach cancer. Trastuzumab can be used
for patients that have a high level of HER2 (a type of protein).
-
Palliative care is an option in situations where
treatment is not recommended, or cancer cannot be treated completely,
the goal is to maximise the quality of life by minimising signs and
symptoms of cancer.
Learn more about the different types of
treatment technologies to treat stomach cancer.
What can I do to reduce the risk of developing stomach cancer?
While stomach cancer is not always preventable, there are steps you can
take to help lower your risk of developing this condition, such as:
- Treat for H.pylori infection if you are tested positive
- Staying away from tobacco, including second-hand smoke
- Reduce the intake of alcohol
- Exercising regularly and maintaining an active lifestyle
- Minimise the intake of fried and salty food
- Consume more vegetables and fruits
Do I need to get screened for stomach cancer?
There are currently no available routine screening tests for individuals
at average risk. Therefore, it is important to check on symptoms and
warning signs for early detection of stomach cancer. Maintaining a
healthy lifestyle and getting regular health screenings is recommended.
Consult your doctor to determine if you would benefit from a stomach
cancer screening.
Make an appointment at Pantai Hospitals
Early detection of stomach cancer makes it easier to treat the disease
with effective and appropriate treatment. A dedicated multidisciplinary
team of specialists and oncologists at Pantai Hospitals is available for
consultation to provide the best care and assistance to patients through
screening, diagnosis, and treatment.
Get in touch with us to book an appointment
today if you have any concerns or questions about stomach cancer
treatment options.
Pantai Hospitals have been accredited by the Malaysian Society for
Quality in Health (MSQH) for its commitment to patient safety and
service quality.