Gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach. The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) in foods that are eaten and helps pass waste material out of the body. Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.
The wall of the stomach is made up of 3 layers of tissue: the mucosal (innermost) layer, the muscularis (middle) layer, and the serosal (outermost) layer. Gastric cancer begins in the cells lining the mucosal layer and spreads through the outer layers as it grows. Stromal tumors of the stomach begin in supporting connective tissue and are treated differently from gastric cancer.
Signs & Symptoms
These and other signs and symptoms may be caused by gastric cancer or by other conditions. In the early stages of gastric cancer, the following symptoms may occur:
- Indigestion and stomach discomfort
- A bloated feeling after eating
- Mild nausea
- Loss of appetite
- Heartburn
In more advanced stages of gastric cancer, the following signs and symptoms may occur:
- Blood in the stool
- Vomiting
- Weight loss for no known reason
- Stomach pain
- Jaundice (yellowing of eyes and skin)
- Ascites (build-up of fluid in the abdomen)
- Trouble swallowing
Treatment
There are different types of treatment for patients with gastric cancer. Your OHC doctor will help you determine the best care plan for you.
Surgery is a common treatment of all stages of gastric cancer. The following types of surgery may be used:
- Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor. The spleen may be removed. The spleen is an organ in the upper abdomen that filters the blood and removes old blood cells.
- Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen may be removed. The esophagus is connected to the small intestine so the patient can continue to eat and swallow.
If the tumor is blocking the stomach but the cancer cannot be completely removed by standard surgery, the following procedures may be used:
- Endoluminal stent placement: A procedure to insert a stent (a thin, expandable tube) in order to keep a passage (such as arteries or the esophagus) open. For tumors blocking the passage into or out of the stomach, surgery may be done to place a stent from the esophagus to the stomach or from the stomach to the small intestine to allow the patient to eat normally.
- Endoluminal laser therapy: A procedure in which an endoscope (a thin, lighted tube) with a laser attached is inserted into the body. A laser is an intense beam of light that can be used as a knife.
- Gastrojejunostomy: Surgery to remove the part of the stomach with cancer that is blocking the opening into the small intestine. The stomach is connected to the jejunum (a part of the small intestine) to allow food and medicine to pass from the stomach into the small intestine.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both. Chemoradiation given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Chemoradiation given before surgery, to shrink the tumor (neoadjuvant therapy), is being studied.
Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy used in the treatment of gastric cancer.
