Stomach cancer, also called gastric cancer, is the uncontrolled growth of abnormal cells in the lining of the stomach. The disease usually does not cause any symptoms until the later stages, and usually, by the time stomach cancer is diagnosed, the prognosis is poor. Most people who are diagnosed with stomach cancer are over the age of 60. The disease rarely occurs before age 50, and it is more common in men than women.

Stomach cancer is a major cause of cancer deaths worldwide and is much more common outside the United States. The number of people who develop stomach cancer is particularly high in Japan, Chile, Costa Rica, Hungary and Poland. It is the leading cause of cancer death in many of these countries. In the United States, the number of cases of stomach cancer diagnosed every year has fallen 75% since 1930. The decline may be due in part to increased use of refrigeration for food storage and decreased use of salted and smoked foods.

Several factors increase the risk of stomach cancer:

• A diet high in smoked, salted or pickled foods
• Alcohol and tobacco use
• History of chronic stomach disorders such as gastritis
• Previous stomach surgery
• Having relatives who have been diagnosed with stomach cancer

A diet high in fruits and vegetables may reduce the risk of stomach cancer.

The American Cancer Society estimates that 21,860 people in the United States (13,510 men and 8,350 women) will be diagnosed with stomach cancer during 2005. More than 11,000 Americans die from the disease each year.

Many people with stomach cancer do not have any symptoms. When symptoms occur, they can be so vague that they are ignored. The symptoms of stomach cancer are also common symptoms of stomach ulcers, viruses and other gastrointestinal disorders. The most common symptoms of stomach cancer are bloating after meals, nausea, loss of appetite, recurrent indigestion and diarrhea or constipation. Other symptoms include sudden weight loss, loss of appetite, blood in the stool or vomit, and black, tarry stools.

If risk factors or symptoms indicate that stomach cancer is possible, your doctor may do a fecal occult blood test to determine whether or not there is a microscopic bit of blood in the stool. However, blood does not always appear in the stool when stomach cancer is present. The next test usually will be an upper endoscopy or an upper gastrointestinal (GI) radiograph.

During an upper GI radiograph, the patient drinks a barium-containing solution that coats the stomach, and then a radiologist takes X-rays of the stomach. During endoscopy the patient is sedated while a lighted tube called an endoscope is threaded down the throat and into the stomach. The doctor uses this tool to examine the interior of the stomach.

If either test indicates a possibility of cancer, doctors will then do a biopsy which involves removing a small bit of stomach tissue to be examined in a laboratory. This often can be done during the endoscopy. A biopsy is necessary to confirm the presence of stomach cancer.

Stomach cancer will continue to worsen unless it is treated. Doctors believe that stomach cancer develops very slowly, and may take years before it produces symptoms.

The causes of stomach cancer aren't completely understood, but some evidence indicates that a certain diet can help to prevent stomach cancer. Eat a diet high in fresh food, particularly fresh fruits and vegetables. Do not smoke. Drink alcohol in moderation. Most experts recommend that women have no more than one drink a day and that men have no more than two drinks a day. Avoid smoked, cured, fermented, and pickled foods, as well as foods, such as bacon, that have been cured with nitrates.

The three most common treatments for stomach cancer are surgery, chemotherapy and radiation therapy. Surgery currently is the only cure for the disease. Chemotherapy and radiation therapy are used to relieve symptoms and slow the progress of the disease, and sometimes can prolong survival.

• Stomach cancer surgery, called gastrectomy, involves the removal of part or all of the stomach. Nearby lymph glands also may have to be removed.
• Chemotherapy involves anticancer drugs, given by mouth or injected into a vein.
• Radiation therapy involves high-energy radiation, which is used to attack cancer cells.

Chemotherapy and radiation therapy can be used alone or in combination, and either can effectively destroy cancer cells. However, both therapies destroy healthy tissue as well, which can cause a number of side effects. For this reason, chemotherapy or radiation therapy generally is accompanied by treatments for side effects, which may include fatigue, nausea, decreased blood counts and hair loss. Treatment of stomach cancer also may require steps to ensure that the patient continues to receive proper nutrition.

You should see your doctor is you have any of the symptoms of stomach cancer. When gastrointestinal symptoms don't respond to simple treatments, such as antacids, or when symptoms last for more than a week or two, it's time to see a doctor. People who use tobacco or alcohol, have a family history of stomach cancer, or have a diet that is either low in fruits and vegetables or high in cured, smoked or salted meats should be particularly wary of gastrointestinal symptoms.

Much depends on how far stomach cancer has developed by the time it is diagnosed. When the disease is found early, before it has penetrated the lining of the stomach or spread outside the stomach, the chance for a full recovery is much greater. It is important to remember that no two cancer patients are alike, and responses to treatment vary from person to person.

As many as 50% of people who have been diagnosed with stomach cancer in the early stages of the disease will live five years or more. However, only 10% to 20% of stomach cancers are diagnosed in the early stages. The overall five-year survival rate is around 21%.

American Cancer Society (ACS)
1599 Clifton Road, NE
Atlanta, GA 30329-4251
Toll-Free: 1-800-227-2345
http://www.cancer.org/

National Cancer Institute (NCI)
U.S. National Institutes of Health
Public Inquiries Office
Building 31, Room 10A03
31 Center Drive, MSC 8322
Bethesda, MD 20892-2580
Phone: 301-435-3848
Toll-Free: 1-800-422-6237
TTY: 1-800-332-8615
E-Mail: cancergovstaff@mail.nih.gov
http://www.nci.nih.gov/

American College of Gastroenterology (ACG)
P.O. Box 342260
Bethesda, MD 20827-2260
Phone: 301-263-9000
http://www.acg.gi.org/

American Gastroenterological Association
4930 Del Ray Ave.
Bethesda, MD 20814
Phone: 301-654-2055
Fax: 301-654-5920
http://www.gastro.org/