Cancer of the Stomach

Affecting 25,000  individuals a year and the cause of approximately  11,000 annual deaths, stomach cancer, also known as gastric cancer, is relatively new in the United States.

95% of these cancerous tumors, or adenocarcinomas, are the second most common cause of cancer- related deaths worldwide. They can be divided into two classes, the first being gastric cardia cancer which occurs in the top portion of the stomach near the junction of the esophagus, and the second type is non-cardia gastric cancer which may be found in all other areas of the stomach.

Adenocarcinomas develop in the cells lining the innermost (or mucosal) layer of the stomach making precancerous lesions rarely detected since symptoms are difficult to detect at early stages. Yet, overall gastric cancer has shown a decrease in occurrence, specifically non-cardia gastric cancer because of better diet, better food refrigeration and the use of antibiotics for treatment.

One major cause of gastric cancer is the Helicobacter pylori bacteria infection, specifically distal gastric cancer. It is also associated with gastric mucosa and with lymphoid tissue (MALT) lymphoma, another type of gastric cancer. Men have a higher risk of developing this type of cancer and other risk factors include chronic gastritis, smoking, diet, blood group type, as well as inherited cancer syndromes.

The great majority of people infected with Helicobacter pylori never develop neoplasia, the formation of such tumors. Upper endoscopy (EGO) is the most important diagnostic test for the detection of gastric cancer, as well as endoscopic ultrasonography (EUS) which aids in the diagnosis and staging of gastric cancers. Via these procedures biopsies can be obtained for analysis. The use of the aforementioned modalities such as imaging studies and CT scanning help arrive at a clinical staging of the disease and determination of whether surgery should be considered or not.

Survival rates strongly depend on the extent of how far the cancer has spread at the time of surgery.

Generally, survival rates are reported to be around 30% within the first five years, a modest improvement  over the last couple of decades with initial staging remaining the key factor for such increase. Identification   of   individuals at increased risk, or those with unexplained symptoms should be aggressively evaluated as early endoscopy saves lives.