Gastric cancer (stomach cancer) is a cancer that starts in the stomach. The stomach has 5 parts: cardia; fundus; body (corpus); antrum; pylorus. Cancers starting in different sections of the stomach tend to have different symptoms, outcomes and treatment options. Most gastric cancers start in the top mucosal layer and as the cancer grows into the deeper layers, the stage is more advanced and the prognosis is not as good.
This summary focuses on the most common type called gastric adenocarcinoma. Gastric adenocarcinomas are classified histologically into intestinal or diffuse sub-types.
Poor appetite; weight loss; abdominal pain or vague discomfort above navel; sense of fullness in upper abdomen after eating a small meal; heartburn or indigestion; nausea; vomiting (+/- blood); swelling or fluid build-up in abdomen.
In the U.S., there is no standard or routine screening test for gastric cancer; the effectiveness of current screening techniques for the early diagnosis of gastric cancer is not proven. For those at elevated or high risk, screening may include upper endoscopy and/or capsule endoscopy at regular intervals, with random and targeted biopsies as indicated.
Surgery is typically used to remove the part of the stomach with cancer (gastrectomy) and nearby lymph nodes.
Surgery removing a part or the entire stomach (gastrectomy) as well as surrounding tissues, organs, and lymph nodes may be used plus adjuvant and/or neoadjuvant chemotherapy and/or radiation therapy.
Often treated with chemotherapy. Targeted therapy in combination with chemotherapy may be used to treat HER2-positive metastatic gastric cancers. Palliative surgeries may be performed for unresectable cancers to control growth or to prevent or relieve symptoms and/or complications.
Demographics: Older age; male gender; ethnicity - Hispanic/Latino, African, Asian
Lifestyle: Diet high in salt and smoked food; tobacco use; low intake of fruits & vegetables; obesity; occupational exposures
Medical History: H. pylori; chronic gastritis; stomach polyps; previous stomach surgery; stomach lymphoma; pernicious anemia; common immune deficiency syndrome
Risk reduction options: Prophylactic gastrectomy (typically only considered for high risk individuals); healthy diet; physical activity; nonsteroidal anti-inflammatory drugs (NSAIDS)
Inherited: Type A blood; family history of disease; inherited genetic syndromes
Associated Myriad MyRisk™ Genes: MLH1, MSH2, MSH6, PMS2, EPCAM, APC, TP53, STK11, CDH1, BMPR1A, SMAD4