What is Stomach Cancer ?

Stomach cancer is characterized by abnormal growth of cells lining the stomach. There exist different kinds of stomach cancer, which is based on the type of cells and part of the stomach involved.

Symptoms of Stomach Cancer

Typically there are no early signs or symptoms of stomach cancer. Only in the advanced stages the symptoms come at the forefront. Here are the most common some symptoms of stomach cancer:

  • Weight loss
  • Frequent heartburns
  • Belly pain, especially in the upper belly
  • Trouble swallowing
  • Having no appetite, or feeling full after eating a small amount of food
  • Nausea and vomiting
  • Feeling tired or short of breath
  • Excessive fatigue

Causes of Stomach Cancer

The cause of stomach cancer isn’t exactly known. But there are some factors or conditions which can lead to development of cancer, which are:

  • GERD (Gastrointestinal Reflux Disease) in which there is backflow of stomach acid into the esophagus.
  • Infection by H.Pylori which causes ulcers in stomach
  • Inflammation of Gut also called as Gastritis
  • Pernicious Anaemia
  • Polyps in Stomach

Stages of Stomach Cancer

The most common system used for staging lung cancer is the TNM system.

T stands for Tumour. It is used to describe the size of the tumour. It also helps to determine whether the tumour has grown into other parts of the organ or tissues around the organ. It is represented by a range of 1 to 4. The higher the number means the larger the tumour.

N stands for Lymph Nodes. It helps determine if cancer has spread to the lymph nodes around the organ. NX means the impact on lymph nodes cannot be determined. N0 means cancer hasn’t spread to nearby lymph nodes while N1, N2, and N3 means cancer has spread to lymph nodes. N1 to N3 also shows the range that how many lymph nodes are affected.

M stands for Metastasis. It is used to determine if cancer has spread to other parts of the body through blood or lymphatic system. MX means the metastasis cannot be determined; M0 means cancer has not spread to other body parts while M1 indicates that it has spread to other body parts.

Sometimes lowercase letters like a, b and c are used to divide the tumour, lymph nodes, and metastasis into subcategories. Also lowercase “is” is used to denote carcinoma in situ. E.g. Tis

For the convenience of grading the extent of spread of cancer, the cancer is classified into 5 broad stages.

Stage 0

In this stage cancer cells are present only in the top layer of cells of the mucosa (innermost layer of the stomach) and have not grown into deeper layers of tissue such as the lamina propria. This stage is called as carcinoma in situ (Tis). Cancer has not spread to any nearby lymph nodes (N0) or any distant sites (M0).

Stage I

In this stage the cancer has grown no further than the lining of the stomach. There is no cancer in the lymph nodes or the cancer is still within the stomach lining.

Stage II

Stage II tumor is characterized by following conditions:

The cancer has grown into the inner layer of the wall of the stomach. It has spread to 3 to 6 lymph nodes but not present elsewhere (T1, N2, and M0) or the cancer has grown into the inner layers of the wall of the stomach. It has spread to around 7 to 15 lymph nodes and is not present at any other place.

Stage III

In this stage, the cancer is characterized by following features:

The cancer can be seen growing into the outer muscular layers of the stomach wall. It has spread to 7 to 15 lymph nodes but not to any other organs (T2, N3a, M0) or the cancer has grown into the inner layer of the wall of the stomach or to the outer muscular layers present in the stomach wall. It has spread to 16 or more lymph nodes but not in any distant parts of the body (T1 or T2, N3b, M0).

Stage IV

It is the most advanced stage of stomach cancer. Stage IV stomach cancer describes a cancer of any size that has spread to any distant parts of the body in addition to the area around the stomach (any T, any N, M1).

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Stomach Cancer

Risk Factors

Certain factors increase the chances of developing stomach cancer. These are as follows:

H.pylori infections
Polyps in stomach
Diet high in salty and smoked foods
Family history of stomach cancer
Pernicious anaemia
Long term stomach inflammation

Types of Stomach Cancer

Following are the types of cancers that develop in the stomach:

  • Adenocarcinomas: This type of cancer develops in the cells of the innermost lining of the stomach. It is also the most common type of stomach cancer.
  • Lymphoma: It is a cancer of the immune system tissue that may start where lymph tissues are found, including the stomach. Lymphomas in the stomach are rare and about 4% cases of such cancer can be seen.
  • Gastrointestinal stromal tumors: GISTs are a rare type of stomach cancer that develops in a special cell found in the lining of the stomach called interstitial cells of Cajal (ICCs). Under a microscope, GIST cells look very similar to muscle or nerve cells.
  • Carcinoid tumors: This type of cancer typically starts in the hormone-producing cells of the stomach. The tumours usually do not spread to different organs and make about 3% of all the stomach cancer cases worldwide.

Diagnosis of Stomach Cancer

Stomach cancer is diagnosed by the following methods:

  • Doctors use an endoscope to check the abnormalities in the stomach, esophagus
  • Tissue Biopsy: A sample of tissue is collected for by fine-needle aspiration technique to check the sample for cancer growth.
  • Imaging tests: These tests include MRI, CT, and PET that help determine the extent of spread of cancer in stomach and beyond stomach.

Treatment of Stomach Cancer

Stomach cancer can be treated by one or a combination of the following treatments:

  • Surgical removal of the affected part
  • Radiation therapy to kill cancer cells in the affected area.
  • Chemotherapy to kill or restrict the growth of cancer cells.
  • Immunotherapy, also called as biologic therapy, is designed to boost the body’s natural defences to fight against the cancer. It uses materials made either by the body or prepared in a laboratory to improve, target, or restore normal immune system function.

Prevention of Stomach Cancer

There is no definite way by which stomach cancer can be prevented. But following these steps can help to a large extent:

  • Exercise regularly
  • Reduce intake of salty and smoked foods
  • Quit smoking
  • Eat fresh fruits and vegetables