There are a number of types of stomach cancer. Adenocarcinoma is the most common type of stomach cancer representing 95% of the cases. Once the leading cause of cancer death in the United States, the disease is much less common, and is now the 16th US cancer in occurrence. In California, about 3000 new cases are expected each year, and over half of these will occur in Southern California (Los Angeles, Orange, Riverside, Ventura and Kern counties combined). In fact, almost one-third of the cases that occur in California are found in Los Angeles county.
More cases occur in males than females, and in the past, commonly in people over age 60 years. However, recently, an increasing number of cases in younger patients age less than 40 years has been observed. The incidence has doubled from 1973 to 2015.
Everyone should be aware of some of the risk factors for developing gastric adenocarcinoma.
The exact cause is now known, however there are a number of conditions which are known to increase the risk of developing adenocarcinoma:
Gastric adenocarcinoma begins as a small focus of cancer in the lining of the stomach. Early on, there may be no symptoms, or non-specific symptoms that could be mistaken for harmless, common conditions:
First, do see your physician and discuss your symptoms and of your concerns regarding stomach cancer and any risk factors that you may have.
The most expeditious test for gastric cancer is an upper endoscopy or EGD. This is a small diameter tube (about the thickness of your baby finger) that is inserted into the mouth and passed into the stomach. It allows the doctor to actually see the inside of the stomach, looking for any unusual findings. If something is found, then a small piece of tissue can be removed (biopsy) and sent for analysis.
If stomach cancer is found, then a number of different tests and procedures may take place to “stage” or assess the extent of the tumor to help decide what treatments will take place and in what order.
Most patients being treated for stomach cancer will include either a partial or complete removal of the stomach (gastrectomy). The goal of surgery is complete (microscopic) removal of the tumor and any lymph nodes in the immediate vicinity that may also be involved with the cancer. The amount of stomach removed is a decision ultimately made by the surgeon based upon the location, size and cell type of the tumor. The overall health of the patient, may also be a factor in the decision. In cases of early stomach cancer, surgery may be the first treatment to take place.
The long-term side effects of a partial or total removal of the stomach are primarily:
These are medicines that could be given either by mouth or by intravenous infusion. These medicines are designed to destroy cancer cells. For more advanced cases of stomach cancer, your oncologist may decide to offer chemotherapy before surgery. Because chemotherapy circulates through the body, it can reach a much greater area in the body and make contact with cancer cells that may have gone beyond the stomach. Given before surgery, it may also reduce the size of the tumor as well.
If surgery is performed first, then most patients who are found to have large or deep tumors, or to have tumor found in the lymph nodes, will also receive chemotherapy after they have recovered from surgery.
In some cases, focused doses of radiation may be given in addition to other treatments. Some types of stomach cancer, usually those in the very upper stomach may be treated with both chemotherapy and radiation therapy before surgery is performed. In other situations, radiation therapy may be given after surgery to try to destroy cancer cells that may remain in the area where the stomach had been.
General Surgery: Darryl Hiyama, MD
Medical Oncology: J. Randolph Hecht, MD Zev Wainberg, MD Saeed Sadeghi, MD
Gastroenterology: Raman Muthusamy, MD Rabindra Watson, MD Daniel Cho, MD Rome Jutabha, MD
Radiation Oncology: Steve Lee, MD
Pathology: Galen Cortina, MD
Telephone number 310-829-5471
Learn more about myUCLAhealth