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.

Cancer of the Stomach

Stomach cancer is diagnosed in approximately 25,000 individuals a year and is responsible for about 11,000 deaths per year. Although it is the second most common cancer in the world it is not so common in the U.S.

The great majority are called adenocarcinomas, about 95%. These are generally divided into two classes; gastric cardia cancer, which refers to the top one inch or so of the stomach where it meets the esophagus, the second being non cardia gastric cancer or distal gastric cancer. Gastric cancer has shown an overall decrease in incidence due to a diminution in the frequency of the latter. Adenocarcinomas develop in the innermost layer of the wall of the stomach, called mucosa. Precancerous lesions rarely cause symptoms and hence gastric cancer is commonly undetected at an early stage.

Helicobacter Pylori is a major cause of gastric cancer, specifically distal gastric cancer. It is also associated with gastric mucosa associated lymphoid tissue (MALT) lymphoma, another type of gastric cancer. Other risk factors include chronic gastritis, smoking, male sex, diet, blood group type, as well as, several inherited cancer syndromes.

The great majority of people with H Pylori never develop either of these neoplasia. Upper endoscopy (EGD) is the most important diagnostic test for the detection of gastric cancer, EGD as well as endoscopic ultrasonography (EUS) aid in the diagnosis and staging of gastric cancers and via these procedures biopsies can be obtained for analysis. The use of the aforementioned modalities as imaging studies such a CT scanning help us arrive at a clinical staging of the disease and determine whether surgery should be considered.

Survival rates strongly depend on the extent of spread at the time of surgery. Generally survival rates are reported to be around 30% at 5 years, a modest improvement over the last couple of decades with again initial staging remaining the most important factor.

Identification of individuals at increased risk and those with unexplained symptoms should be aggressively evaluated as early endoscopy may save their lives.