Stomach Cancer

The gastrointestinal cancer team at the UofL Brown Cancer Center brings together a team of experts to treat cancers of the stomach with cutting-edge techniques and therapies.

Overview

The Multidisciplinary Gastrointestinal Cancer Clinic at UofL Brown Cancer Center brings together a team of experts to treat cancers of the stomach with cutting-edge techniques and therapies.

Since treating stomach cancer often involves more than one type of therapy, your personalized course of treatment is planned by a group of experts. This team approach is the way UofL Brown Cancer Center provides you with the best possible treatment of your cancer.

Our expert team includes radiation oncologists, medical oncologists, surgeons and nutritionists. These specially trained experts customize your care, including the most advanced therapies with the least impact on your body. Our gastrointestinal cancer doctors don’t just specialize in cancer; they specialize specifically in treatment of stomach cancer.

At UofL Brown Cancer Center, your care for stomach cancer is personalized and will likely include surgery and possibly radiation, chemotherapy or other treatments, such as targeted therapies.

Stomach cancer and treatment can have profound effects on nutrition. Our nutritionists and cancer rehab physicians are involved in your care from the very beginning to minimize the long-term effects of treatment and promote strength and well-being during treatment.

Stomach cancer, also called gastric cancer, has become much less common in the United States and Europe over the past 60 years. While the rates of stomach cancer in general are declining, cancers in the area of the stomach near where it joins the esophagus are increasing.  This may be because of gastroesophageal reflux, a common cause of heartburn.

While stomach cancer is becoming less common in this country, it is the second leading cause of cancer death in much of the rest of the world, especially Japan, Eastern Europe, South America and parts of the Middle East. This may be due to differences in diet, the rate of infection with Helicobacter pylori (a type of bacteria) and the environment.

Stomach Cancer Types

Most stomach cancers are adenocarcinomas, which develop in the cells of the mucosa. However, stomach cancer can develop anywhere in the organ and spread to other parts of the body by growing beyond the stomach wall, entering the bloodstream or reaching the lymphatic system.

The other types of cancer found in the stomach are considered rare. They include:

  • Lymphoma, which affects a body’s immune system
  • Gastrointestinal stromal tumors, often called GIST or gastric sarcomas
  • Carcinoid tumors, which affect the hormone-producing cells of the stomach

Risk Factors

Although the exact cause of stomach cancer is not known, certain factors seem to increase your risk of developing the disease. These include:

  • Eating foods preserved through pickling, salting and drying or that contain nitrates
  • Eating foods that have not been stored or prepared correctly
  • Obesity: Men who are obese have a higher risk of cancer in the part of the stomach nearest the esophagus.
  • Infection with Helicobacter pylori: This type of bacteria, or germ, is a common cause of ulcers and may cause chronic inflammation in the stomach lining. This sometimes develops into pre-cancerous changes and cancer.
  • Tobacco and alcohol abuse: Smoking and drinking excessive amounts of alcohol appear to increase the likelihood of cancer in the upper part of the stomach. Some studies have shown that smoking doubles the risk of stomach cancer.
  • Family history. If close relatives have stomach cancer or one of the following conditions, you may be at a higher risk of stomach cancer.  Our cancer genetic counselors will help you decide whether genetic testing would be appropriate for you or your family.
  • Hereditary non-polyposis colon cancer (HNPCC)
  • Li-Fraumeni syndrome

Not everyone with risk factors gets stomach cancer. However, if you have risk factors, you should discuss them with your doctor.

In rare cases, stomach cancer can be passed down from one generation to the next.  Our genetic counselors can provide you with additional information and help you decide whether genetic testing is for you.

Most cancers have the same symptoms as other, less serious conditions.  Still, it’s important to know the signs. Stomach cancer often does not have symptoms in the early stages. When signs do appear, they may be mistaken for less serious problems such as indigestion or heartburn. This means stomach cancer often is not found until it spreads.

Stomach cancer symptoms may include:

  • Abdominal pain or discomfort
  • Loss of appetite
  • Heartburn, indigestion or ulcer-type symptoms
  • Nausea and vomiting
  • Bloating or swelling in the abdomen
  • Diarrhea or constipation
  • Feeling of fullness after eating small amounts of food
  • Bloody or black stools
  • Fatigue
  • Unintentional weight loss

These symptoms do not always mean you have stomach cancer. However, if you notice any of them for more than two weeks, talk to your doctor. Even if they are not signs of cancer, they may signal other health problems.

Because stomach cancer has symptoms that are mistaken for other conditions, it can be challenging to diagnose.

If you have symptoms that may signal stomach cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family medical history.

If stomach cancer is suspected, your doctor may recommend endoscopy.  An endoscope is inserted through the mouth, nose or an incision into the esophagus and stomach. The endoscope has a tool to remove tissue samples for examination.

A biopsy is the removal of tissue to examine under a microscope. Different methods are available to obtain the tissue, depending on where it is located. In stomach cancer, biopsies usually are performed by endoscopy.

If you are diagnosed with stomach cancer, your doctor may order some of the following tests to see if your cancer has spread and to determine its stage.

Imaging tests, which may include:

  • CT or CAT (computed axial tomography) scans
  • PET (positron emission tomography) scans
  • MRI (Magnetic resonance imaging)

Endoscopic ultrasound: Using specialized equipment, doctors insert an endoscope equipped with a small ultrasound device into the stomach. It produces sound waves that produce an image on a video screen.

Stomach Cancer Staging

If you are diagnosed with stomach cancer, your doctor will determine the stage of the disease.

Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer.

Common cancer treatments include chemotherapy, radiation treatment, and surgery.  Doctors select a treatment plan based on your diagnosis and disease.

Since treating stomach cancer often involves more than one type of therapy, your personalized course of treatment is planned by a group of experts that may include oncologists, radiation oncologists and surgeons. This team approach is the way UofL Brown Cancer Center provides you with the best possible treatment of your cancer.

If you are diagnosed with stomach cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer, the location of the tumor and your general health.

One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.

Surgery

Surgery is the most common treatment for stomach cancer.   Chemotherapy and radiation may also be recommended to decrease the risk of the cancer returning after surgery.  Types of surgery include:

Endoscopic mucosal resection: An endoscope is inserted down the throat and into the stomach, allowing doctors to remove certain types of early, non-invasive stomach cancers.

Subtotal (partial) gastrectomy: The cancerous part of the stomach, nearby lymph nodes (tissues that filter infection and disease) and parts of other organs near the tumor are surgically removed.

Total gastrectomy: The entire stomach, nearby lymph nodes and sometimes the spleen, parts of the esophagus, intestines, pancreas and other organs where the cancer has spread, are removed. The esophagus is reconnected to the small intestine you can continue to eat and swallow.

During the surgery, the surgeon forms a new “stomach” from part of the intestine. After surgery, you may:

  • Have a feeding tube that goes directly into your small intestine to be sure you receive needed nutrients
  • Need to eat smaller, more frequent meals and avoid sugar
  • Need to take vitamin supplements as pills or shots (injections)

If a stomach cancer tumor is blocking the stomach but cannot be removed completely, a stent may be placed to keep the passageway open. 

Chemotherapy

Chemotherapy may be used to shrink the cancer before surgery or it may be used after surgery to decrease the chance of the cancer returning.  It may be combined with radiation to increase the effectiveness of both treatments. It also may be used to shrink tumors that cannot be surgically removed.

Radiation Therapy

We use the most precise methods of radiation therapy, targeting the stomach cancer while limiting damage to surrounding areas.

Clinical Trials

Ask your doctor about any clinical trials for which you may be eligible.

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in stomach cancer treatment, visit the UofL Physicians website here.