How Is Stomach Cancer Diagnosed
Several different tests can be used to help diagnose stomach cancer.
- Radiologic tests like a CT scan, barium swallow and MRI can help identify a problem in the stomach if the tumor is large enough.
- An upper endoscopy is used to take a biopsy of the lesion to make the diagnosis or to detect early cancer before a mass is large enough to be seen on radiologic tests. An upper endoscopy is performed by inserting a thin tube with a tiny camera through the mouth and into the stomach, where biopsies are obtained from the tumor.
- To find out how much of the stomach wall a tumor involves and to help assess the stage of the cancer, a doctor will order an endoscopic ultrasound, which uses a special type of endoscope that has an ultrasound probe. The endoscope is placed in the stomach through the mouth. The ultrasound probe is able to look through the surface of the stomach lining to the stomach wall beyond and see how much of the stomach is involved by the tumor.
Changes In Genes In Stomach Cancer Cells
Recent research has provided clues on how some stomach cancers form. For instance, H pylori bacteria, particularly certain subtypes, can convert substances in some foods into chemicals that cause mutations in the DNA of the cells in the stomach lining. This may help explain why certain foods such as preserved meats increase a persons risk for stomach cancer. On the other hand, some of the foods that might lower stomach cancer risk, such as fruits and vegetables, contain antioxidants that can block substances that damage a cells DNA.
Stomach cancers, like other cancers, are caused by changes in the DNA inside cells. DNA is the chemical that carries our genes, which control how our cells function. We look like our parents because they are the source of our DNA. But DNA affects more than how we look.
Some genes control when cells grow, divide into new cells, and die:
- Genes that normally help cells grow, divide, and stay alive can sometimes change to become oncogenes.
- Genes that help keep cell division under control, repair mistakes in DNA, or cause cells to die at the right time are called tumor suppressor genes.
Cancers can be caused by DNA changes that keep oncogenes turned on, or that turn off tumor suppressor genes.
Thinking About Taking Part In A Clinical Trial
Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they’re not right for everyone.
If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials.
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How Stomach Cancer Is Treated
Treatment options which may be considered include surgery, chemotherapy . The treatment advised for each case depends on various factors, such as:
- How large the cancer is.
- Whether it has spread .
- Your general health.
It is important to make sure you get enough nutrition from your food and you will probably be asked to see a dietician to make sure you are on the best possible diet.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the various possible treatment options for your type of cancer.
You should also discuss with your specialist the aims of treatment. For example:
- Treatment may aim to cure the cancer. Some stomach cancers can be cured, particularly if they are treated in the early stages of the disease.
- Treatment may aim to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
- Treatment may aim to ease symptoms. If a cure is not possible, treatments may be used to reduce the size of a cancer, which may ease symptoms such as pain. If a cancer is advanced, you may require treatments such as:
- Food supplements.
- Other techniques to help keep you free of pain or other symptoms.
Does Stomach Cancer Affect Men And Women Differently
It is important to look for signs of stomach cancer in adults over the age of 55. However, it most commonly affects those in their 60s or 70s. While it is crucial to be aware of the signs of stomach cancer in females, men are more likely to develop stomach cancer. In 2020, 16,980 men and 10,620 women are projected to be diagnosed with the disease. Men have a lifetime risk of 1 in 95 of developing stomach cancer, while women have a 1 in 154 risk. The signs of stomach cancer in men are typically no different than in women.
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Sexuality And Stomach Cancer
Having stomach cancer and treatment can change the way you feel about yourself, other people, relationships and sex. These changes can be very upsetting and hard to talk about. Doctors and nurses are very understanding and can give you support. You can ask for a referral to a counsellor or therapist who specialises in body image, sex and relationships.
Symptoms Of Stomach Cancer
Sometimes cancer can grow in the stomach for a long time before it causes symptoms. In the early stages, stomach cancer can cause the following symptoms:
- Indigestion, stomach discomfort, or heartburn
- Nausea
When the cancer is larger, it can cause these symptoms:
- Blood in your stool or stools that are black in color
- A bloated feeling after eating, even when eating a small amount
- Vomiting after meals
- Stomach pain, especially after meals
- Weakness and fatigue
Many of these symptoms may be caused by conditions other than cancer. However, if you have any of these problems and they dont go away, talk to your doctor. The earlier stomach cancer is found, the better the chances for effective treatment.
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Diagnosis Of Stomach Cancer In Cats
When a cat develops gastrointestinal signs, your veterinarian will first perform a comprehensive physical exam.
Your cats overall health will be assessed, including body weight, hydration, mucous membrane color, and your cats mental attitude . Next, your veterinarian will focus on your cats abdomen.
If an obvious cause for your cats gastrointestinal signs is not found on physical exam, your veterinarian will recommend a further workup.
A complete blood panel, including a complete blood cell count and serum biochemistry panel, will often be performed first.
In a cat with stomach cancer, this bloodwork may show signs of anemia , increased white blood cells , and decreased blood protein . If your cats liver is also affected, your veterinarian may also notice increases in one or more of your cats liver values.
Next, your veterinarian will recommend imaging.
Radiographs and ultrasound can both be used to provide a view of what is going on in your cats abdomen. Radiographs are less expensive than ultrasound, but they also show less abdominal detail than an ultrasound.
Ultrasound is more informative, providing a three-dimensional view of all structures in the abdomen, including the lymph nodes, and provides the ability to detect small metastases. However, ultrasound often requires referral to a veterinary specialist, as well as sedation.
In order to definitively diagnose stomach cancer, a cellular diagnosis is needed.
How Long Can Cats Live With Stomach Cancer
The prognosis for a cat with stomach cancer depends on the type of cancer and how advanced the cancer is at the time of diagnosis. A cat with gastric lymphoma can be expected to survive an average of six months with chemotherapy, although a cat that initially responds favorably to chemotherapy can be expected to survive for over a year, on average.
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Which Chemo Drugs Are Used For Stomach Cancer
Many different chemo drugs can be used to treat stomach cancer, including:
- 5-FU , often given along with leucovorin
- Capecitabine
- Paclitaxel
- Trifluridine and tipiracil , a combination drug in pill form
Most often, 2 or 3 of these drugs are combined . But this depends on factors such as the stage of the cancer, the persons overall health, and whether chemo is combined with radiation therapy. Three-drug combinations can have more side effects, so they are usually reserved for people who are in very good health and who can be followed closely by their doctor.
For earlier stage cancers, some common drug combinations used before and/or after surgery include:
- Oxaliplatin plus 5-FU/leucovorin , or oxaliplatin plus capecitabine
- FLOT
- Docetaxel or paclitaxel plus either 5-FU or capecitabine
- Cisplatin plus either 5-FU or capecitabine
- Paclitaxel and carboplatin
When chemo is given with radiation after surgery, a single drug such as 5-FU or capecitabine may be used.
For advanced stomach cancer, many of the same combinations of drugs can be used, although doctors often prefer combinations of 2 drugs rather than 3 to try to reduce side effects. Some of the most commonly used combinations include:
- Oxaliplatin plus 5-FU/leucovorin , or oxaliplatin plus capecitabine
- Cisplatin plus either 5-FU or capecitabine
- Irinotecan plus 5-FU/leucovorin
- Epirubicin, either cisplatin or oxaliplatin, and either 5-FU or capecitabine
- Docetaxel, 5-FU, and either cisplatin, carboplatin, or oxaliplatin
Adenocarcinoma Of The Stomach
In most cases, stomach cancer begins from a cell which is on the inside lining of the stomach . This type of stomach cancer is called adenocarcinoma of the stomach. As the cancer cells multiply:
- The tumour may invade deeper into the wall of the stomach. In time, it may pass through the wall of the stomach and invade nearby organs such as the pancreas or liver.
- The tumour may spread up or down the stomach into the gullet or small intestine.
- Some cells may break off into the lymph channels or bloodstream. The cancer may then spread to nearby lymph nodes or spread to other areas of the body .
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Survival For All Stages Of Stomach Cancer
For people with stomach cancer in England:
- more than 45 out of 100 people will survive their cancer for 1 year or more
- more than 20 out of 100 people will survive their cancer for 5 years or more
- more than 15 out of 100 people will survive their cancer for 10 years or more
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.
When Is Chemo Used For Stomach Cancer
Chemo might be used at different times to help treat stomach cancer:
- Chemo can be given before surgery for stomach cancer. This is known as neoadjuvant treatment. Neoadjuvant treatment can often shrink the tumor and possibly make surgery easier. It may also help keep the cancer from coming back and help patients live longer. For some stages of stomach cancer, neoadjuvant chemo is one of the standard treatment options. Often, chemo is then given again after surgery.
- Chemo may be given after surgery has been done to remove the cancer. This is called adjuvant treatment. The goal of adjuvant chemo is to kill any areas of cancer that may have been left behind but are too small to see. This can help keep the cancer from coming back. Often, for stomach cancer, chemo is given with radiation therapy after surgery. This may be especially helpful for cancers that could not be removed completely by surgery.
- Chemo may be given as the primary treatment if the cancer has spread to distant parts of the body, or if it can’t be removed for some other reason. Chemo may help shrink the cancer or slow its growth, which can relieve symptoms and help people live longer.
Doctors give chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks.
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Treatment Of Gastric Cancer
Correspondence to: Michele Orditura, MD, PhD, Division of Medical Oncology, Dipartimento di Medicina, Clinica e Sperimentale F. Magrassi-A. Lanzara, Seconda Università degli Studi di Napoli, c/o II Policlinico, via S. Pansini 5, 80131 Naples, Italy.
Telephone: +39-815-666723 Fax: +39-815-666723-6732
Can You Treat Stomach Cancer By Changing Your Diet
Using a healthy diet to treat stomach cancer is not enough to cure cancer, but you can talk to your doctor about using it as part of a medical plan to improve your overall health. Those who eat a diet rich in produce like fresh fruits and vegetables and whole grains may decrease their risk for stomach cancer. However, some studies show that increasing plant-based foods reduces the risk of fatal stomach cancer in men, but not women. Talk with your healthcare provider about your dietary options.
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How Is Stomach Cancer Treated
There are several approaches to treating stomach cancer. In many cases, surgery can be avoided.
In the early stages when the cancer is limited to the superficial layers of the stomach, the cancer can be removed through an upper endoscopy performed by a gastroenterologist. In this procedure , the tumor is dissected from the rest of the gastric wall and removed through the mouth.
Once the tumor invades beyond the superficial layers of the stomach, surgery will be required to remove the stomach and connect the esophagus to the small intestines to allow for digestion.
Radiation therapy uses high-powered beams of energy to kill cancer cells. Chemotherapy uses chemicals to kill the cancer cells. These treatments are generally combined.
There are also several drugs to treat stomach cancer. Treatment depends on how severe the cancer is and is decided upon by a doctor after diagnosis.
Radiation In Perioperative Therapy
The use of radiation alone as preoperative treatment remains unclear, due to limited numbers of randomized clinical trials evaluating the efficacy of radiotherapy alone.
Zhang et al randomized a large sample size of gastric adenocarcinomas of cardia to surgery alone or radiotherapy for a total dose of 40 Gy and surgery. Tumor resectability and T2 cancer were more frequently observed in the radiation arm with a 11.0% decrease in T4 tumors. Five- and 10-year survival rates for radiation plus surgery and surgery alone groups were 30.1%, 19.7%, and 20.2%, 13.3%, respectively, while no significant differences were observed between the two groups in terms of surgical complications.
In another randomized trial with a longer follow-up , 51 patients per arm were randomly assigned to 20 Gy in 5 daily fractions followed by surgery or surgery alone. The 5-year and 10-year survival rates were 39.0% and 32.0%, and 30.0% and 18.0%, for preoperative radiotherapy and surgery alone groups, respectively however, after 20 years, the study failed to demonstrate a survival benefit for preoperative radiotherapy.
Of note, these two studies were started in the 1970s, when radiation used to be delivered by telecobalt or 8-MV photon, now rarely used.
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Having Another Type Of Cancer
Your risk of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma .
For men, the risk of getting stomach cancer is increased after having prostate cancer, bladder cancer, breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer, breast cancer or cervical cancer.
Inherited Versus Acquired Gene Mutations
Inherited mutations in some genes can increase a persons stomach cancer risk. But these are thought to cause only a small percentage of stomach cancers.
Most of the gene changes that lead to stomach cancer occur after birth. Some of these acquired mutations might be caused by risk factors such as H pylori infection or tobacco use. But other gene changes may just be random events that sometimes happen inside cells, without having an outside cause.
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What Are The Symptoms Of Stomach Cancer
Early-stage stomach cancer often doesnt cause noticeable symptoms. As the disease progresses, though, patients may experience the following symptoms:
- Bloating: Feeling that the stomach is bloated or very full, even after a small meal, may be a sign that a tumor is obstructing part of the stomach.
- Abdominal pain: General pain in the stomach region with no known cause is a common sign of stomach cancer.
- Unintended weight loss: Trouble eating, loss of appetite, and nausea are symptoms that can lead to unintentional weight loss and should be brought to a doctor’s attention.
- Nausea and vomiting: A more dramatic presentation of abdominal pain, bloating, and discomfort may include vomiting, potentially even vomiting blood.
An important point to remember is that these symptoms are also relatively common signs of noncancerous conditions, such as an ulcer or infection. On their own, or even in combination, they do not necessarily mean someone has stomach cancer. But anyone with such symptoms should see a doctor, so that a proper diagnosis can be made and, when needed, treatment can start as soon as possible.