Country singer Toby Keith recently posted on social media telling fans about his diagnosis and battle with stomach cancer over the last six months. In the U.S., we don’t hear about this type of cancer as frequently as we hear about other, more prevalent types. According to Amit Desai, M.D., a gastroenterologist at Texas Digestive Disease Consultants in Dallas, stomach cancer affects around 25,000-30,000 people each year in the U.S. So how does it differ from other types of cancer, and how does it affect those diagnosed with it?
What is stomach cancer?
The stomach functions by breaking down food before it enters the small and large intestines. There are five different sections of the stomach, and depending on which section the cancer develops in, symptoms and prognoses vary.
Changes to cells in the lining of the stomach often occur years before cancer starts to develop. Because these changes are typically symptom-free, they aren’t readily detected.
Desai notes that while stomach cancer isn’t as common as other types of cancer (it ranks number 15), it does have a high mortality rate — close to 50%.
The most common symptom of stomach cancer is weight loss, Desai states, and right behind that is abdominal pain. Some patients also experience nausea.
Other symptoms of stomach cancer include problems swallowing, black stool, feeling full after only eating a little bit, and pain that resembles a stomach ulcer.
Occasionally, some patients with stomach cancer have anemia or low blood counts which can cause fatigue.
“These are all non-specific symptoms and can also be associated with many different types of diseases,” says Desai. “It’s always best to get evaluated by a physician should you have new symptoms.”
Desai explains that doctors have found one significant risk factor for stomach cancer—infection with a bacteria called Helicobacter pylori (H. pylori).
“This bacteria can cause an infection in the stomach and it contributes to the development of H. pylori-associated gastritis and ulcers,” he says.
H. pylori-associated gastritis causes the stomach to become inflamed.
Many people have this infection with no symptoms and therefore it goes undetected. Over time, it may evolve into stomach cancer.
“This infection is likely acquired naturally in the foods we eat, so it can be hard to avoid getting it,” Desai continues. “However, it’s easily diagnosed with an endoscopy and is treatable with a course of antibiotics.”
Desai says another risk factor for stomach cancer is family history and that it’s important to be aware of this genetic component.
“There are certain forms of stomach cancer that can [occur] in your 20s and 30s if the genes are present,” notes Desai.
And while young people do get stomach cancer, the risk certainly increases with age.
Gender also seems to play a role in stomach cancer risk — men are more likely to be diagnosed than women.
Additionally, Desai mentions a high salt diet and eating lots of processed meats can increase your risk. Smoking, alcohol, and obesity are risk factors as well.
Detection & Diagnosis
“We diagnose stomach cancer primarily by endoscopy,” Desai explains. “In this procedure, a tiny camera is placed via the mouth into the stomach.”
It’s painless, non-invasive, and your provider will put you under anesthesia.
The camera can locate the cancer in your stomach and your doctor will take a biopsy to get a better idea of what type of cancer it is.
“Cancer doctors can use these biopsies to guide treatment,” says Desai.
Providers may also use other imaging tests, such as X-rays, CT and PET scans, MRIs, or ultrasounds to view the stomach and the cancer’s spread throughout the body.
There is no one-size-fits-all when it comes to stomach cancer treatment. The type of stomach cancer you have and its location will determine the type of treatment you receive.
“Once the type of cancer is known, the next step is to stage the cancer to see if it has spread anywhere,” Desai states. “Once the stage is known, then treatment can include
chemotherapy, radiation, and/or surgery. The earlier stage the cancer, the higher the rate of cure.”
Early-stage cancers haven’t spread beyond the stomach and haven’t grown deeply into the stomach wall. These cancers have the best prognosis as most of the time, they can be completely removed with surgery.
Potentially resectable (or removable) cancers have spread a little past the stomach and a little deeper into the stomach wall. Surgery may be able to remove most of the cancer, but chemotherapy after surgery can work to get rid of any lingering cancerous spots.
Unresectable local or regional cancers haven’t spread to other parts of the body, but aren’t able to be removed with surgery. Treatment for cancers in this stage might include a variety of things like chemo and immunotherapy, but the main goal is to prevent the cancer from growing and spreading.
Metastatic cancers have spread beyond the stomach to other parts of the body which makes them difficult to treat. Similar to unresectable local or regional cancers, metastatic cancer treatment focuses on preventing cancer growth and alleviating pain or any other uncomfortable symptoms the stomach cancer causes.
While stomach cancer cannot be completely prevented, there are ways to reduce your risk of developing it.
First, take care of your physical health.
Increase fruits, vegetables, and whole grains in your diet. Limit processed meats.
Get to a healthy weight and maintain it. Incorporate daily activity and exercise into your schedule.
Next, avoid smoking and alcohol as they both increase your risk for stomach cancer.
Last, if you know you have an H. pylori infection, even if you don’t have symptoms, talk to your provider about treating it with antibiotics.
Not only can these healthy changes help prevent stomach cancer, but they can help prevent a myriad of other cancers and diseases as well.