What is Stomach Cancer?

Cancer starts when cells in the body grow out of control and form lumps, which are called tumors. Tumors may either be benign (noncancerous) or malignant (cancerous). Cancer can spread from the origin to different parts of the body if not dealt with promptly. Stomach cancer, also known as gastric cancer, begins in the cells of the stomach.

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The stomach is an important part of the digestive system. It is a sac-like organ that digests food by secreting gastric juices. Chewed food enters the esophagus and passes through the gastroesophageal junction, where the esophagus and stomach meet, before being deposited in the stomach for digestion. After the food and gastric juices are mixed, they are emptied into the duodenum, which is the first part of the small intestine.

The belly area, which is generally referred to as the stomach, is called the 'abdomen'. Pain in the abdomen is usually referred to as a stomach ache, but it does not necessarily mean that the stomach is the one with problems because there are many organs in the abdominal area as well, such as the liver, colon, pancreas, and intestines.

The stomach has five parts. The first three, the cardia, fundus, and corpus, make up the proximal stomach. These parts make acid and digestive enzymes, as well as something called ‘intrinsic factor,’ a protein needed for absorbing vitamin B12.

The lower part of the stomach is composed of the antrum and pylorus, and they make up what is called the ‘distal stomach.’

The stomach is also made up of 5 layers. The innermost is called mucosa where digestive enzymes and stomach acids are produced. This layer is where most cancers begin. The next layer is the submucosa, followed by the muscularis propria, which is a thick muscle layer that helps mix the stomach contents. The two outer layers wrap around the stomach. They are the subserosa and serosa.

Stomach cancer develops slowly. It is often found in people aged 68 years old and above. Before cancer fully develops, 'pre-cancerous' changes often happen in the mucosa of the stomach. These changes do not often cause symptoms so they are usually left undetected.

However, cancers that start in the other layers of the stomach usually cause different symptoms and have different outcomes. The location of the cancer will affect treatment options. If a cancer is found in the GE junction, for example, it may be treated similarly to esophageal cancer.

Kinds of Stomach Cancer

Adenocarcinoma

Around 90 percent of stomach cancers are adenocarcinomas. They start developing in the mucosa which is the innermost layer. If you are diagnosed with stomach cancer, it will most likely be adenocarcinoma, which has two main types:

Intestinal Adenocarcinoma

Intestinal adenocarcinoma tends to have a better prognosis. This type of cancer is more likely to have gene changes that can be treated with targeted drug therapy.

Diffuse Adenocarcinoma

Diffuse adenocarcinoma has a worse prognosis because it tends to grow more quickly. It is less common, however.

Other Types Of Stomach Cancer

Gastrointestinal Stromal Tumors (GIST)

These cancers are uncommon and develop in very early forms of cells in the stomach wall called ‘interstitial cells of Cajal’. GISTS are more likely to metastasize or spread to other parts of the body, and they can also start anywhere in the digestive tract.

Neuroendocrine Tumors

Neuroendocrine Tumors (NETs) develop in the stomach cells that act like nerve cells or hormone-making cells. Most NETs do not often spread or grow quickly.

Lymphomas

Lymphomas are cancers that begin in the immune system cells called lymphocytes, but they can also begin in the stomach wall.

Stomach Cancer Symptoms

Stomach cancer is uncommon in the United States, and rates have declined, largely due to the advent of refrigeration which allowed for safe long-term food storage that prevents contamination. Because it is not common, there are no screening tests for stomach cancer that are recommended for the general population. When stomach cancer is found, it is usually when the cancer has grown large and spread outside the stomach. The following symptoms are indicators of stomach cancer:

  • Appetite loss
  • Unexplained weight loss
  • Abdominal pain
  • Vague, lingering abdominal discomfort
  • Feeling full after eating only a small meal
  • Heartburns and indigestion
  • Nausea
  • Vomiting
  • Abdominal swelling
  • Blood in the stool
  • Lethargy or anemia
  • Jaundice (when stomach cancer has already spread to the liver)

These are not exclusive to stomach cancer, but it is wise to immediately seek medical help if you experience any of these.

Stomach Cancer Risk Factors

Immutable Risk Factors

Men are more likely to have stomach cancer than women. Older people are also more likely to develop stomach cancer, with the risk going up significantly with age. Most stomach cancers are diagnosed in people well into their 60s in the United States. African Americans are more likely to develop stomach cancer or die from the disease than White Americans. But stomach cancer is less common in America than in the rest of the world. Rates are higher in East Asia, Eastern Europe, South America, and Central America.

Lifestyle Risk Factors

Obesity is associated with an increased risk of stomach cancer. A diet high in salt is also a risk factor. The reason for the drop in stomach cancer rates in the US due to the advent of refrigeration technology is likely due to the move away from heavily salt-preserved foods and the ability to store fresh food long-term without worries of spoilage. Working in the coal, metal, and rubber industries has also been shown to increase the risk of stomach cancer.

Helicobacter pylori Infection

Infection with Helicobacter pylori (H pylori) bacteria is a significant risk factor for stomach cancer, particularly in the lower (distal) part of the stomach, as long-term infection can lead to atrophic gastritis and other pre-cancerous changes in the stomach lining. People with stomach cancer have a higher rate of H pylori infection compared to those without, and the infection is also associated with certain types of stomach lymphoma, although most individuals carrying the bacteria do not develop cancer.

Heliobacter pylori is the most common cause of stomach ulcers. Infection does not necessarily mean you will get stomach cancer, but it is important to get immediate treatment once the infection is discovered.

Inherited Cancer Syndromes

Certain conditions called syndromes which may be genetic can lead to an increased risk of stomach cancer. The following inherited syndromes account for only a small percentage of stomach cancer worldwide, but if you are known to have them, your doctor should recommend constant monitoring:

  • Hereditary diffuse gastric cancer (HDGC)
  • Lynch syndrome
  • Familial adenomatous polyposis (FAP)
  • Gastric adenoma and proximal polyposis of the stomach (GAPPS)
  • Li-Fraumeni syndrome
  • Peutz-Jeghers syndrome (PJS)

A family history of stomach cancer is also an indicator that you may have increased risk. It is important to properly map out your family medical history with your doctor if you are experiencing any of the symptoms of stomach cancer.

Other Diseases and Conditions

Epstein-Barr Virus Infection

Epstein-Barr virus (EBV), the cause of infectious mononucleosis (mono), infects most people at some point in their lives, usually during childhood or adolescence, and has been associated with nasopharyngeal cancer and certain types of lymphoma; while EBV is found in the cancer cells of 5-10% of stomach cancer patients, its role in causing stomach cancer remains unclear, although EBV-linked stomach cancers tend to grow more slowly and have a lower tendency to metastasize.

Stomach Polyps

Polyps are non-cancerous growths that may be found in the stomach lining. They are often not harmful, but some types of polyps, like adenomatous polyps, can sometimes develop into cancer.

Pernicious Anemia

The intrinsic factor (IF) produced in the stomach is responsible for the absorption of Vitamin B12. If your stomach is damaged, you may have less or inadequate IF production and can develop anemia. This can increase your risk for stomach cancer.

Menetrier Disease

This disease is caused by excess growth of the stomach’s inner lining, which results in large folds that can lead to reduced stomach acid levels. This is a rare condition, but it can also increase stomach cancer risk.

If you or a loved one have suffered from a misdiagnosis or delayed diagnosis for your stomach cancer or from negligence during your treatment that caused you more harm, contact us at 833-PORTER9, or e-mail us at info@porterlawteam.com to discuss the details of our experience representing other clients and the results we were able to obtain in the past for clients who are suffering as you are. In many ways, our results speak for themselves, and we will stand ready to help you and your family in your time of greatest need.

Last Updated on March 8, 2024 by Michael S. Porter
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