The gastric cancer experts at Memorial Sloan Kettering offer comprehensive care for people with all types of stomach cancer, and see more people with this illness than any other cancer center in the United States. Thanks to improvements in the accuracy of staging the illness and advances in surgical techniques , significant progress has been made in the diagnosis and treatment of this illness.
Most people up to 95 percent develop a stomach cancer called adenocarcinoma, which starts in the tissues that make up the stomach lining. This type of stomach cancer may be related to long periods of inflammation and irritation in the lower part of the stomach. This type of stomach cancer starts in the first proximal part of the stomach and may extend into the gastroesophageal junction where the esophagus joins the stomach. This cancer is more common in the United States than in other parts of the world, and tends to start in people who are obese or have gastro-esophageal reflux disease.
This aggressive cancer grows rapidly in the cells of the stomach wall. If you have a recurrence, we will perform comprehensive testing and develop a treatment plan tailored to your needs. The staging process is a basis for selecting treatment options and helping doctors communicate potential outcomes prognosis. The TNM system considers three important factors:.
T tumor : This describes the size and growth of the primary stomach tumor. N node : This provides information about stomach cancer found in regional lymph nodes. M metastasis : This indicates whether the cancer has metastasized , or spread to other areas. Each of these categories are rated on a numbered scale, with the higher numbers indicating increased severity. These categories are then grouped into stomach cancer stages from Stage 0: Early stage stomach cancer may also be referred to as carcinoma in situ , because the cancer has not spread into any nearby tissue.
In this stage, the cancer has not yet spread to the inner layer of cells that line the stomach. Stage 1 stomach cancer: This stage of stomach cancer is divided into two categories:.
Stage 2 stomach cancer : This stage of stomach cancer is divided into two categories:. Stage 3 stomach cancer : This stage of stomach cancer is divided into three categories:. Stage 4 stomach cancer : This is the most advanced form of the disease. In stage 4, the cancer has metastasized , or spread, beyond the stomach into other areas of the body.
About four out of five stomach cancers in the United States are diagnosed after the cancer has spread to other areas of the body. The five-year survival rate for those diagnosed with stage 4 stomach cancer is 4 percent. Next topic: How is stomach cancer diagnosed? Make a difference in the fight against cancer by donating to cancer research. Call us anytime. This page was updated on September 21, Stomach cancer stages. Surgery to remove some or all of the stomach is known as a gastrectomy.
It will still be possible to eat normally after a gastrectomy, but you'll probably have to adjust the size of your portions. Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer returning. Read more about treating stomach cancer. Living with stomach cancer and the effects of surgery can be tough, but there are a range of services that can provide social, psychological and financial support. Read more about living with stomach cancer.
The outlook for stomach cancer depends on several factors, including your age, your general health, and how far the cancer has spread the stage of the condition.
Unfortunately, as stomach cancer isn't often picked up until the later stages, the outlook isn't as good as for some other cancers. Of all those with stomach cancer, about:. Many symptoms of stomach cancer are similar to less serious conditions, so it can be difficult to recognise in the early stages.
Stomach cancer is usually easier to treat if it's diagnosed early. It's therefore important for your GP to refer you to a specialist as soon as possible if stomach cancer is suspected. Stomach cancer is much more common in older people, with 90 out of cases occurring in people who are over 55 years of age. Indigestion is a very common symptom in the general population. However, it's unlikely that someone with indigestion who's under the age of 55 will have stomach cancer.
However, see your GP if you have indigestion and weight loss, anaemia or persistent vomiting. They should refer you to a specialist for further testing. Also see your GP if you have difficulty swallowing. This isn't a common symptom among the general population and the cause should always be investigated.
You can also read more about being referred to a stomach cancer specialist on Cancer Research UK. Stomach cancer is caused by changes in the cells of the stomach, although it's unclear exactly why these changes occur.
Cancer begins with a change mutation in the structure of the DNA in cells, which can affect how they grow.
This means cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour. Left untreated, cancer can spread to other parts of the body, usually through the lymphatic system a network of vessels and glands called lymph nodes located throughout the body. Once the cancer reaches your lymphatic system, it's capable of spreading to other parts of your body, including your blood, bones and organs. It's not known what triggers the changes in DNA that lead to stomach cancer and why only a small number of people develop the condition.
However, evidence suggests that a number of different factors can affect your chances of developing stomach cancer. These are discussed below. Your risk of developing stomach cancer increases with age. Most cases occur in people aged 55 or over. People who smoke are about twice as likely to develop stomach cancer compared with non-smokers. This is because you swallow some cigarette smoke when you inhale and it ends up in your stomach. Cigarettes contain harmful chemicals which can damage the cells in your stomach.
The more you smoke and the longer you've been smoking, the bigger the risk. Helicobacter pylori H. In most people, these bacteria are harmless, but in some people an H. Research has found people with severe chronic atrophic gastritis have an increased risk of developing stomach cancer, although this risk is still small. A diet rich in pickled vegetables, such as pickled onions or piccalilli, salted fish, salt in general and smoked meats, such as pastrami or smoked beef, increases your risk of stomach cancer.
Countries where this type of diet is popular, such as Japan, tend to have much higher rates of stomach cancer than the UK. A high fibre diet with five portions of fruit and vegetables a day will help protect against stomach cancer, and a diet high in fats and processed food and red meat will increase your risk of getting stomach cancer. You're more likely to develop stomach cancer if you have a close relative with the condition, such as one of your parents or a sibling brother or sister.
In such cases, it may be appropriate for your doctor to arrange genetic counselling. It's not fully understood why stomach cancer seems to run in families. It may be because of shared risk factors, such as having similar diets or having an H. In around one in 50 cases of stomach cancer, testing has found that people share a mutation in a gene known as E-cadherin. Research into stomach cancer has also shown that you may be more at risk of getting the condition if you have the blood type A.
Your blood type is passed on from your parents, so this could be another way in which family history may increase your risk of developing stomach cancer. There's also a condition that runs in families called familial adenomatous polyposis FAP , which may increase your risk of developing stomach cancer. FAP causes small growths, called polyps, to form in your digestive system, and is known to increase your risk of developing bowel cancer.
Your risk of developing stomach cancer is increased if you've had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma cancer that develops in your white blood cells. For men, the risk of getting stomach cancer is increased after having prostate cancer , bladder cancer , breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer , breast cancer or cervical cancer.
Having certain medical conditions can also increase your risk of developing stomach cancer, such as pernicious anaemia a vitamin B12 deficiency, which occurs when your body can't absorb it properly , and peptic stomach ulcers an ulcer in your stomach lining, often caused by H.
If you've had stomach surgery, or surgery to a part of your body that affects your stomach, you may be more likely to develop stomach cancer.
This can include surgery to remove part of your stomach known as a partial gastrectomy , surgery to remove part of your vagus nerve the nerve that carries information from your brain to organs such as your heart, lungs and digestive system , or surgery to repair a stomach ulcer. See your GP as soon as possible if you have stomach cancer symptoms such as indigestion, unexpected weight loss, anaemia and persistent vomiting. Your GP will ask about your symptoms and examine your stomach for any lumpiness or tenderness.
If they think that stomach cancer may be a possibility they'll refer you to a specialist for further investigation. Find out who should be referred for further tests for suspected stomach cancer.
These may include a blood test and chest X-ray , which will assess your overall health. A sample of your stools may also be tested for blood. Because of the potentially serious nature of stomach cancer, you should be referred to the specialist within two weeks. Read more about waiting times. An endoscopy is a procedure where the inside of your body is examined using a piece of equipment called an endoscope a long, thin flexible tube with a light and a video camera at the end.
If you need to have an endoscopy, you won't be able to eat or drink for four to eight hours before the procedure. This is to ensure your stomach and duodenum top of the small intestine are empty.
You'll be awake during the endoscopy, but may be given a sedative by injection to make you feel drowsy and relaxed. A local anaesthetic may also be sprayed onto the back of your throat, so the area is numbed.
The endoscope will be passed down your gullet food pipe and into your stomach so the specialist can look for any stomach ulcers or signs of cancer. If tissue is found that may be cancerous, a sample will be taken for testing. This procedure is known as a biopsy.
The sample will be examined under a microscope in a laboratory. The results will show whether the cells are cancerous malignant or non-cancerous benign and will usually take 7 to 10 days to come back. The endoscopy itself usually takes about 15 minutes, although you should allow about 2 hours in total for your visit.
If your specialist thinks you may have cancer in the top part of your stomach, you may have an ultrasound scan at the same time as an endoscopy. This is known as an endoscopic ultrasound and uses high-frequency sound waves to produce an image of your stomach this method is commonly used to view an unborn baby in the womb.
If you have an endoscopic ultrasound, an ultrasound probe will be attached to the end of the endoscope before it's passed down your throat. The scan will help determine the stage of any cancer in the top part of your stomach. After an endoscopy, or an endoscopic ultrasound, you won't be able to drive for several hours because of the sedative. You may also have a sore throat , although this should pass within a few days. A barium meal X-ray or barium swallow involves drinking a chalky liquid containing a substance called barium, which makes your stomach show up on an X-ray.
Nowadays, however, it's less commonly used to diagnose stomach cancers. Organs such as your stomach don't usually show up on an X-ray because they're made of soft tissue that isn't dense enough to stop the X-rays passing through. However, when these organs are filled with barium, it blocks the X-rays and shows up white on an X-ray screen.
You won't able to eat or drink for at least 6 hours before the procedure because your stomach and duodenum need to be empty. You may be given an injection to relax the muscles in your digestive system. A barium swallow usually takes about 15 minutes. Afterwards, you'll be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system.
You may feel slightly sick, and the barium may cause constipation. Your stools may be white for a few days afterwards as the barium passes through your system. If you're diagnosed with stomach cancer, further tests may be needed to help determine how far it's spread and how quickly it's likely to spread known as the stage and grade.
Your cancer specialist oncologist will discuss this with you. However, it may not always be possible to identify the exact stage of your condition until your treatment starts. Your specialist may need to examine your stomach in more detail to see if the cancer has spread, particularly to the lining of the abdominal cavity peritoneum. If it has, you may need to have a small operation called a laparoscopy. This procedure is carried out under a general anaesthetic , so you'll be unconscious during it.
During the procedure, a thin viewing tube with a camera at the end a laparoscope will be inserted into your stomach through a small incision in the lower part of your tummy. In some cases, your specialist may need to examine more than one area of your stomach and make more than one incision. A computer is then used to put the images together and create a detailed picture of the inside of your body. These scans will help your doctor assess how advanced your cancer is.
It allows them to see whether the cancerous cells have formed tumours anywhere else in the body. The scans can also help your doctors work out which type of treatment will be most effective and appropriate for you.
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