Gastric/Stomach Cancer

Note: The information on cancer types on the ACRF website is not designed to provide medical or professional advice and is for information only. If you have any health problems or questions please consult your doctor.

Overview

Gastrointestinal cancer (also known as stomach cancer) can develop in any part of the stomach, a J-shaped organ in the upper abdomen where digestion commences before food passes to the intestines. It is thought to develop slowly over many years.

When muscles in the stomach break down food, gastric juices are released from glands in the mucosa, which is the inner stomach layer. They turn food into a thick fluid and nutrients from this are absorbed through the small bowel’s walls into the bloodstream.

Around 90 to 95 per cent of stomach cancers develop in cells lining the mucosa, called adenocarcinomas. Other types include squamous cell carcinoma, lymphoma, stromal tumours, and carcinoid tumours, however these are rare.

As stomach cancer often doesn’t cause symptoms until advanced, it is common not to detect it in its early stages. Precancerous changes in the stomach lining usually preface it.

Treatment

Treatment will depend on how large the tumour has grown, how deeply it has invaded the stomach’s layers and whether it has spread to nearby organs, lymph nodes, or other body parts.

The main treatment is gastrectomy surgery. A partial gastrectomy involves removal of part of the stomach, and the doctor connecting the part remaining to the oesophagus or small bowel, depending on whether the upper or lower stomach was removed. In a total gastrectomy, doctors remove all of the stomach, lymph nodes near the stomach, and other tissue. The oesophagus is then connected to the small bowel, so the patient can still eat and swallow. Occasionally the spleen, which filters blood and removes old blood cells, and part of the pancreas, need to be removed.

Recent studies indicate a combination of surgery, chemotherapy and radiation offers the best chance of survival for stomach cancer patients.

Chemotherapy can be given when cancers have invaded the layers of the stomach wall, nearby lymph nodes, and nearby organs. It can also be given before surgery to shrink a tumour.

Chemotherapy is also useful in some patients to relieve symptoms or delay recurrence and extend a patient’s life. Radiation is most commonly used combined with chemotherapy.