Gastric cancer

If you or a loved one is facing a gastric cancer diagnosis, you’re not alone. At Atrium Health Floyd and Harbin Clinic, our team of gastroenterologists and cancer specialists is dedicated to providing expert care at every step.

What is gastric cancer?

Gastric cancer is cancer that starts in the stomach. The most common type, adenocarcinoma, starts in the stomach’s inner lining and spreads outward as it grows. Treatment may include chemotherapy, radiation therapy, immunotherapy or surgery.

Causes of gastric cancer

Stomach cancer occurs when cells in your stomach lining grow and spread too quickly. Experts don’t know exactly why these cell changes occur.

Gastric cancer symptoms

Early-stage stomach cancer often does not cause symptoms. As the cancer progresses, it may cause:

• Abdominal pain
• Ascites (fluid or swelling in your abdomen)
• Dark or black stool
• Fatigue or weakness
• Feeling full after eating small portions
• Heartburn or indigestion
• Loss of appetite
• Nausea or vomiting
• Weight loss without an obvious cause

Gastric cancer types

The terms “stomach cancer” and “gastric cancer” usually refer to adenocarcinoma. This type makes up 90 to 95% of gastric cancers. But other, less common types of cancer may also start in the stomach, such as:

• Gastrointestinal stromal tumors (GISTs), which begin in interstitial cells (early forms of cells in the digestive tract)
• Neuroendocrine tumors, which may act like nerve cells or produce hormones
• Lymphomas, which start in lymphocytes, a type of immune system cell
• Squamous cell and small cell carcinomas, which affect the stomach only in rare cases

Gastric cancer diagnosis

Diagnosing stomach cancer usually starts with a physical exam and discussion of your symptoms and family history. Your doctor may also recommend tests, including:

• Barium swallow test: Also known as an upper GI series, this test involves drinking a liquid that makes your digestive tract visible on X-rays.
• Blood tests: These testsprovide information about your overall health.
• Endoscopic ultrasound: This test combines endoscopy with ultrasound imaging to create images of your stomach wall and nearby structures.
• Endoscopy with biopsy: In an endoscopy, your doctor guides a thin, lighted tube with a camera into your stomach. They also may take a small sample of tissue to look at in the lab, called a biopsy.
• Imaging tests: Your doctor may order a CT scan, MRI or X-rays.

Gastric cancer risk factors

Helicobacter pylori (H. pylori) infection is the most significant risk factor for stomach cancer. This bacteria can cause stomach ulcers and gastritis.

Other risk factors for gastric cancer include:

• Diet high in salted or smoked food, and low in fruits and vegetables
• Exposure to high levels of radiation
• Family history of stomach cancer
• Heavy alcohol use (more than three drinks per day)
• Obesity
• Smoking or other tobacco use
• Working in the coal, metal or rubber industries

Certain health conditions may also increase your risk of stomach cancer, including:

• Certain types of gastritis, including chronic atrophic gastritis or atrophic gastritis with intestinal metaplasia
• Epstein-Barr virus infection
• Gastroesophageal reflux disease (GERD)
• Pernicious anemia

Gastric cancer prevention

Not all cases of stomach cancer can be prevented. But you may be able to lower your risk of developing stomach cancer by:

• Avoiding or limiting alcohol
• Eating a healthy diet rich in fruits and vegetables, and low in processed foods and red meat
• Not smoking, or quitting if you currently smoke
• Getting regular physical activity
• Treating H. pylori infection if you have it