From Kurt P. Leuenberger, MD, medical oncologist and hematologist at OHC
December 5, 2022
Worldwide, stomach (gastric) cancer is one of the most common cancers. Fortunately, in the U.S. it is rather uncommon, and the incidence has been steadily declining. As a result, there are no standardized screening recommendations for the general population which means that the cancer is often discovered in late stages when it is more difficult to treat. November was Stomach Cancer Awareness Month, so it is a good time to increase awareness about the signs and symptoms of the disease and highlight recent promising treatment advances.
Understanding Signs and Symptoms and Risk Factors
Unfortunately, when someone begins experiencing the signs or symptoms of stomach cancer, they usually attribute them to more benign conditions like irritable bowel syndrome or acid reflux. While stomach cancer is curable when it is localized to the stomach, a delayed diagnosis results in advanced disease that is not curative. Following are signs and symptoms of stomach cancer to be aware of:
- Abdominal swelling or pain
- Difficulty eating
- Weight loss
- Nausea and/or appetite loss
- Indigestion
- Bloating or feeling full after eating
- Cramping, diarrhea, and/or constipation
- Exhaustion or weakness
- Jaundice
Those who are at high risk for stomach cancer should discuss a screening regimen with their healthcare providers. Stomach cancer risk factors include:
- An infection with Helicobacter pylori (H. pylori), a bacteria infection that occurs in the stomach and commonly causes stomach ulcers
- Obesity
- Poor diet and/or a diet high in salt and/or smoked foods
- Smoking
- Alcohol consumption
- Family history of stomach cancer
- Gastritis
- Previous surgery for ulcers
- Previous infection with the Epstein Barr virus
- Pernicious anemia
- Stomach polyps
Diagnosis
The most common test used to diagnose stomach cancer is the upper endoscopy. During this test, a doctor will pass an endoscope, which is a thin tube with a small camera, through the patient’s mouth and down the throat and esophagus to look inside the stomach and upper portion of the small intestine. The procedure enables the doctor to take samples of suspicious-looking tissue to send to a lab for further evaluation.
Research and New Therapies Offer Hope
Although advanced stomach cancers are not curable with surgery, patients should have hope as we now have more treatment options for stomach cancer than ever before. Increasing knowledge about the microenvironment of cancer has led to the development of more therapies for stomach cancer. In other words, we have learned more about the interaction between a cancerous tumor and the cells, proteins, and other factors that surround it and promote its growth. Following are some promising new therapies:
- Enhertu– Last January, the FDA approved this anti-body drug conjugate for patients with previously treated HER2-positive (HER2+ or human epidermal growth factor receptor 2-positive) advanced stomach cancer. HER2 is a protein that causes cells to grow. Cancers with large amounts of the HER2 protein are HER2+. About one in five stomach cancers are HER2+.
As an antibody-drug conjugate, Enhertu targets cancer cells and delivers chemotherapy more precisely than traditional chemotherapy resulting in fewer side effects. - Opdivo plus chemotherapy– Last April, the FDA approved Opdivo in combination with chemotherapy for patients with advanced stomach cancer. This was the first immunotherapy approved for the initial treatment of stomach cancer. Immunotherapies use the power of the patient’s own immune system to fight their cancer.
- Keytruda used with Herceptin and chemotherapy– Last May, the FDA approved this combination for patients with HER2-positive stomach cancer. Approval was based on the results of the phase 3 KEYNOTE-811 trial that showed the combination significantly reduced tumor size and induced a complete response in some patients.
Clinical trials are providing hope to advanced stomach cancer patients who oftentimes have limited treatment options. For more information on stomach cancer and the latest therapies available or to request a second opinion with an OHC cancer expert, call 1-888-649-4800 or visit ohcare.com.
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