Information factsheet on cancer of the stomach

Cancer of the

Stomach

The information in this factsheet will help you understand cancer of the stomach. It is an agreed view on this cancer by medical experts. We hope that it will answer some questions and concerns you might have. The information in this factsheet is brief but more details are given in a booklet called Understanding Cancer of the Stomach from the Irish Cancer Society. It is available free of charge by calling the helpline on 1800 200 700.

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Information factsheet on cancer of the stomach

What is cancer?

The body is made up of tiny building blocks called cells which form the organs and tissues of the body. Cancer can affect cell growth and can cause them to grow and divide without control or order.These groups of abnormal cells can form a tumour. Tumours can be benign or malignant. A benign tumour is not cancer and can usuallybe removed. Benign tumours do not spread to other parts of the body. A malignant tumour is cancer. Cancer cells can spread by breaking away and entering the bloodstream or lymphatic system. The lymphatic system drains away excess fluids (called lymph) from the tissues. Cancer cells can then invade other tissues and organs.

Each year, about 450 people in Ireland learn that they have cancer of the stomach.

What is the stomach?

The stomach is a hollow muscular organ, located between the lower end of the oesophagus (gullet) and the beginning of the intestine. It is part of the digestive system. Once food has been swallowed, it passes down the gullet and into the stomach.

The stomach stores the food. Muscles in the stomach wall release acid and chemicals that break down the food eaten. Food then travels to the small intestine where it is absorbed, giving the body the fuel it needs.

Risk factors for cancer of the stomach

A risk factor is anything that increases a person’s chance of getting a disease such as cancer. Having a risk factor or a number of risk factors does not mean that a person will get the disease. The exact cause of cancer of the stomach is unknown, but there are certain factors that can increase the risk.

Age: Risk increases with age. There is a sharp increase in stomach cancer after the age of 50.

Gender: Stomach cancer is more common in men than in women.

Family history: You may have a higher risk of stomach cancer if there is a family history of the condition.

Tobacco: Cigarettes, cigars, pipes and other tobacco products are a major risk factor for stomach cancer.

Alcohol: Alcohol use can increase the risk of cancers in the upper part of the stomach closest to the oesophagus.

DietFood: Diets Diets that have a lot ofcontaining large amounts of smoked, salted and pickled foods are associated with an can increased the risk of stomach cancer.

Medical conditions: Some medical conditions carry a higher risk of stomach cancer.

  • Chronic gastritis – Bacteriuma called Helicobacter pylori are linked to the development of gastritis. Infection with these bacteriaum may lead to inflammatory changes in to part of the lining of the stomach. It can cause indigestion. If the infection is not treated properly, it can spread and develop into chronic gastritis. This can increase the risk of getting. Chronic gastritis poses an increased risk of developing stomach cancer.
  • Pernicious anaemia – There is an increased risk of developing stomach cancer in people with this condition. pernicious anaemia.

How can I reduce my risk of developing cancer of the stomach?

Nobody knows what causes stomach cancer. But there are steps you can take to reduce your risk of getting it.

  1. If you smoke, set a date to stop. Do not smoke in the presence of others. If you would like advice or support on quitting, you can call the National Smokers Quitline at Callsave 1850 201 203.
  1. Alcohol use is not recommended but if you do drink alcohol, cut down on the amount you take. Men should not drink any more than 2 standard drinks per day. Women should not drink any more than 1 standard drink per day. One standard drink is equal to a ½ pint of beer, or 1 small glass of wine, or 1 pub measure of spirits. Aim to have some alcohol-free days in the week.
  1. Eat foods that are low in fat and high in fibre. Smoked or pickled foods should be avoided as well as salted meats and fish. Eating wholegrain products such as wholegrain bread, oatmeal, brown rice and some breakfast cereals seem to lower the risk of stomach cancer.

Fresh fruit and vegetables with vitamin A and C help lower the risk also. These include green vegetables such as broccoli/cabbage, carrots, tomatoes and fruits such as kiwi and oranges. It is recommended that you eat five or more portions of fruit and vegetables every day.

Cancer of the stomach

When cancer occurs, the cells in the lining of the stomach change to form a tumour. The tumour may cause very few symptoms at first but as it grows it can begin to affect the digestion of food. This can cause certain symptoms.

What are the warning signs/symptoms?
  • Unexplained loss of appetite
  • Weight loss
  • Difficulty in swallowing
  • Frequent bloated feeling after eating
  • Unexplained tiredness – may be due to anaemia from bleeding
  • Blood in the bowel motion or black stools
  • Nagging stomach pain or feeling sick or vomiting over time
  • Indigestion or heartburn that does not go away.

Note: These symptoms do not always mean cancer. But if you have any of them, especially for some weeks and for no good reason, get your doctor to check them to be certain.

Screening for stomach cancer

There are no early detection methods to screen the general population for stomach cancerAttention to warning signs and symptoms is the best way to detect stomach cancer early. The earlier this cancer is caught the better the chance of cure.

People who have a higher risksuch as those with with medical conditions such as chronic gastritis and pernicious anaemia shouldmust be followed look outcarefully to detect for any the warning signs. Contact your doctor if you have any unusual changes that may be signs of cancer development.

How is cancer of the stomach diagnosed?

Most people begun by visiting their family doctor or GP. Your GP will send you to a hospital doctor for tests. After checking your general health, some special tests can be done in hospital.

These include endoscopy, where a flexible tube is passed down your throat, through the oesopahgusand into your stomach. Small pieces of the lining of your stomach can be removed for an examination called a biopsy. The doctor can look through the tube and check for anything unusual.

Blood tests and a chest X-ray are also done.

Barium meal is a special X-ray of your oesophagus and stomach. Awhitedrink called barium is swallowed and about six hours later X-rays are taken.

Staging and further tests

Staging means doing tests to find out the exact size of the tumour and whether it has spread to other parts of the body. Sometimes further tests are needed and can include the following:

Ultrasound scan: This test is carried out in the X-ray department of the hospital.Once you are lying comfortably on your back, a gel is spread onto your abdomen. A small probe like a flat microphone, which produces sound waves, is then passed over the area. Sound waves are used to give a picture of your stomach and liver.

Endoscopic ultrasound:This test is similar to an endoscopy. A small ultrasound probe is connected to the scope (tube) while in your stomach. Sound waves are used to build up a picture of the parts of your body from inside your stomach.

CT scan (CAT scan): This is a special type of X-ray, which gives a detailed picture of the inside of your body. It can take up to 30 minutes. Sometimes you are given a drink or an injection to help show a particular part of your body.

Laparoscopy: This is where the surgeon looks inside the abdomen. A small cut is made in your abdomen using a tube with a light on it to see the organs around your stomach.Biopsies can be taken at this time. You will be put to sleep for a laparoscopy.

MRI scan: This scan uses magnetic fields and may need to be done before treatment begins. It is painless and very noisy. Some people find it claustrophobic, but it is possible to bring someone in with you while having it done. If you have a pacemaker or any type of metal device placed in your body, it is important to tell the person doing the scan.

When cancer of the stomach is diagnosed

After cancer is diagnosed, shock, disbelief and anxiety are natural reactions. This can result in confusion. You may find it hard to think of what you want to ask the doctor. Sometimes there is a lot of information to take in, which might be difficult to remember later. It helps to make a list of questions and write down what the doctor says. It is a good idea to take a family member or friend along when meeting the doctor.

Treatment for cancerof the stomach

It is important to find out from your doctor or nurse how the different treatments work, how long they will last and what are the side-effects?

Sometimes there may be a choice between treatments. When talking about treatments, find out about taking part in a type of research study called clinical trials.

Surgery is the main treatment for cancer of the stomach.The type of surgery you have will depend on:

  • The type of tumour
  • Its location in the stomach
  • The size of the tumour
  • If it has spread to other parts of the body.

Surgery will involve taking away part of the stomach, known as partial gastrectomy, or removal of the entire stomach known as total gastrectomy. If it is not possible to remove the cancer completely, surgery can still be used to relieve pain, vomiting or blockage if caused by the tumour.

After surgery there can be problems digesting some foods. These problems can be temporary or permanent. A change in diet may be needed and require a special diet. You may have to take this diet for a few weeks or months, or permanently. It will all depend on the extent of the surgery.

Cramps, nausea, diarrhoea and dizziness after eating can occur. This happens because food and liquid enter the small intestine too quickly. This group of symptoms is called the dumping syndrome. The best way to control this problem is to eat small meals throughout the day.The doctor or a dietitian (a nutrition specialist) can explain if any changes to your diet are needed.

Eating well means getting enough calories and protein to prevent weight loss, to build up strength and rebuild normal tissues. This is important for people with a diagnosis of stomach cancer. The Irish Cancer Society has more information about eating well in a free booklet called Diet and the Cancer Patient.

Chemotherapy is used to treat stomach cancer. This type of treatment involves theuse of drugs to kill cancer cells and can often be given after surgery in an effort to prevent the cancer coming back. This is called adjuvant chemotherapy. Usually this type of treatment is given in cycles for about six months. Chemotherapy is also given to treat stomach cancer when surgery is not possible or when the cancer has spread.

There are side-effects from chemotherapy and these will depend on the drugs that are used. Nowadays there are many ways to relieve side-effects and give you help and support. So do talk to your doctor or nurse about side-effects. More information on chemotherapy and its side-effects is available from the Irish Cancer Society in a booklet called Chemotherapy. You can also call the National Cancer Helpline on 1800 200 700.

Radiotherapy is the use of powerful X-rays to treat cancer. It is not usually used to treat stomach cancer, but can help to relieve distressing symptoms like pain caused by cancer. It may also be used in conjunction with chemotherapy after surgery to try to prevent a recurrence of the cancer.

Radiotherapy can cause side-effects that occur during or after treatment. The side-effects depend on the dose given and can vary from person to person. Nowadays there are more ways to relieve side-effects. So it is important to find out from your doctor or nurse about any side-effects that could occur during or after treatment.

More information on radiotherapy and its side-effects is available from the Irish Cancer Society in a booklet called Radiotherapy. You can also call the National Cancer Helpline on 1800 200 700.

Further information

If you or someone you know is diagnosed with stomach cancer, more detailed information about its symptoms, diagnosis and treatment is available in a booklet called Understanding Cancer of the Stomach. This booklet can help you understand the feelings and distress that can arise with a cancer diagnosis. It is available free of charge by calling the Irish Cancer Society’s Helpline on 1800 200 700.

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