Stomach cancer (gastric cancer) forms in the tissues of the stomach. Cancerous cells can develop in any of the five layers of the stomach, from the innermost layer, the mucosa, to the outermost layer, the serosa. Most cases begin in the mucosa, which produces stomach acid and digestive enzymes. Symptoms, treatments, and survival rates vary depending on the cancer’s point of origin in the stomach and the stage of the cancer. Cancers that begin in the mucosa, the innermost layer, are the most treatable, as they slowly grow out into the outer stomach layers. Cancers starting in the outer layers of the stomach are more likely to spread to nearby organs or lymph nodes. Stomach cancer that spreads into the lymph system is less treatable. Once a leading cause of cancer-related deaths in the United States, the disease has become less common.
Statistics
- In 2023, an estimated 26,500 people in the United States will be diagnosed with stomach cancer.
- An estimated 11,130 Americans will die from the disease in 2023.
- In Texas, 2,110 new diagnoses are expected and 990 deaths from stomach cancer are anticipated in 2023.
- Approximately six out of ten people diagnosed with stomach cancer are over 65.
Risk Factors
- Bacterial Infection: A specific bacteria called Helicobacter pylori has been linked to stomach cancer as a major cause of the disease. However, most people with this treatable bacterium do not develop stomach cancer.
- Demographics: More men than women are diagnosed with the disease. The average age of those diagnosed is 68, and risk continues to increase with age. People with family history of the disease are also at a higher risk. Hispanics, African Americans, Native Americans, and Asian/Pacific Islanders are more likely to develop stomach cancer.
- Blood Type: People with Type A blood have a higher risk.
- Diet: Smoked foods, salted fish and meats, pickled vegetables, as well as eating few or no fruits, have been linked to an increased risk.
- Smoking: Smokers face twice the risk of developing stomach cancer than nonsmokers.
- Environmental Factors: Exposure to radiation and work exposure in the rubber, coal, and metal industries leads to higher risk.
- CVID: People with common variable immune deficiency have an increased risk.
- Stomach Health Issues: People with stomach lymphoma, previous stomach surgery, pernicious anemia, Menetrier disease, certain types of stomach polyps, intestinal metaplasia, chronic atrophic gastritis, and those with inherited cancer syndromes (BRCA-1, BRCA-2, familial adenomatous polyposis syndrome, hereditary diffuse gastric cancer, Li-Fraumeni syndrome, Lynch syndrome, and Peutz-Jeghers syndrome) have a higher risk.
- Weight: Being overweight or obese may increase the risk of certain types of stomach cancer.
- Viral Infection: The Epstein-Barr virus (EBV) is associated with some stomach cancers.
Symptoms
Stomach cancer in its early stages does not trigger immediate symptoms. However, symptoms that may appear in later stages of development include:
- Stomach area pain, discomfort, or swelling
- Vomiting and nausea
- Unexplained weight loss
- Full feeling after a small meal
- Jaundice
- Heartburn or indigestion
- Feeling of food sticking in throat when eating
- Loss of appetite
- Diarrhea or constipation
- Anemia
- Weakness or fatigue
- Blood in vomit or the stool
- Dark, tarry, or foul-smelling stools
Linitis Plastica
Linitis plastica is a very rare type of stomach cancer that spreads to the muscles of the stomach wall, forming a thick and immovable layer. It develops a flat, thickened area of the mucosa and is sometimes called leather bottle stomach. When this happens, the stomach is unable to hold much food and does not stretch out as food digests. Linitis plastica is a rapidly growing cancer. Although the survival outlook is poor and it is difficult to treat, treatment options are available in some cases. Treatment options for linitis plastica are surgery and chemotherapy, and radiotherapy may be used to relieve symptoms. A total gastrectomy (surgical removal of the stomach) may be recommended.
Treatment Options
Treatment options vary, depending on the size, location, stage, type of cancer, and the patient’s health. Most treatment options include a combination of surgery, chemotherapy, radiation therapy, targeted therapy, proton therapy, immunotherapy, and palliative medicine. Patients with stomach cancer may also consider participation in clinical trials.