Digestive Disorders

The American Cancer Society estimates that 21,600 Americanswill be newly diagnosed with stomach cancer during 2002. Most people diagnosed with stomach cancer are in their 60s and 70s.

What is a Risk Factor? A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors. Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors. But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What causes stomach cancer?

The exact cause of stomach cancer is not known, although there are many risk factors believed to contribute to cells in the stomach becoming cancerous.

What are the risk factors for stomach cancer?

The following are suggested as risk factors for stomach cancer:

• Helicobacter pylori infection
• diet that includes the following:
  
  
  • large amounts of smoked foods
  • salted fish and meat
  • foods high in starch and low in fiber
  • pickled vegetables
  • foods and beverages that contain nitrates and nitrites
    
    
• tobacco abuse
• alcohol abuse
• previous stomach surgery
• megaloblastic (pernicious) anemia (caused by vitamin B12 deficiency)
• Menetrier's disease
• age 55 or older (most patients are in their 60s or 70s)
• male gender (more men are diagnosed with the disease than women)
• having blood type A
• family history of the following:
  
  
  • nonpolyposis colon cancer
  • familial adenomatous polyposis
  • stomach cancer
    
    
• history of stomach polyps
• exposure to environmental factors such as dusts and fumes in the workplace

What are the symptoms of stomach cancer?

The following are the most common symptoms of stomach cancer. However, each individual may experience symptoms differently. Symptoms may include:

• indigestion or heartburn (burning sensation)
• discomfort or pain in the abdomen
• nausea and vomiting
• diarrhea or constipation
• bloating after meals
• loss of appetite
• weakness and fatigue
• vomiting blood or blood in the stool

The symptoms of stomach cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is stomach cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for stomach cancer may include the following:

• fecal occult blood test - checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then tested in the physician's office or sent to a laboratory.

• upper GI (gastrointestinal) series (Also called barium swallow.) - a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.

• esophagogastroduodenoscopy (Also called EGD or upper endoscopy.)
  An EGD (upper endoscopy) is a procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).

• endoscopic ultrasound - this imaging technique uses sound waves to create a computer image of the inside of the esophagus and stomach. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the physician to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).

Treatment for stomach cancer:

Specific treatment for stomach cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment for stomach cancer may include:

• surgery
  Surgery may be necessary to remove cancerous tissue, as well as nearby non-cancerous tissue. The most common operation is called gastrectomy. If part of the stomach is removed, it is called a subtotal or partial gastrectomy. If the entire stomach is removed, it is called a total gastrectomy.
  
  
• radiation therapy
  Radiation therapy uses high-energy rays to kill or shrink cancer cells.
  
  
• chemotherapy
  Chemotherapy uses anticancer drugs to kill cancer cells.