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					        STOMACH (GASTRIC) CANCER: The Facts


What is it?

         Stomach Cancer, which is also called
Gastric Cancer, is the term used for cancer
that originates in the lining of the stomach.
The stomach is the J-shaped organ in the
upper abdomen, and is part of the digestive
system. It is connected to the esophagus
(food-pipe) and the small intestine. Food
travels down the esophagus and into the
stomach. There it is mixed with digestive
juices from the lining of the stomach and
broken down. Two or three hours later, the
partially digested food moves into the small
intestine, and then to the large intestine
(colon).
         Stomach Cancer usually begins in the lining of the stomach. The stomach has four layers of
lining. The innermost lining, the mucosa, contains the glands that produce the digestive juices.
Ninety to ninety-five percent of Stomach Cancers begin in the mucosa layer. The second layer, the
submucosa, contains blood vessels that feed blood and oxygen to the glands of the mucosa. The
third layer, the muscularis, contains muscles, which contract to make a rippling motion. This motion
moves the food through the stomach and mixes it with the digestive juices. The fourth and
outermost layer, the serosa, protects the other layers and keeps the acidic digestive juices confined
to the stomach.
         The different types of Stomach Cancer are usually identified by how they grow and spread.
If left untreated, Stomach Cancer can eventually spread to many other organs. Stomach Cancer is
normally associated with four typical growth patterns:

   o   Superficial Spread: The Cancer forms only a thin layer over the mucosa. This is the least
       aggressive type of Stomach cancer.
   o   Ulcer Forming: The Cancer creates an ulcer in the stomach wall. A biopsy can tell whether
       or not an ulcer is cancerous.
   o   Polypoid: The Cancer forms tumors that resemble a cauliflower.
   o   Infiltrating: This type of Cancer is the most common and the most aggressive.

        Stomach Cancer is also classified using a staging system. This system is based on the
extent that the cancer has spread and to what areas of the body. This classification system ranges
from “stage 0” (cancer that is localized in the stomach) through “stage IV” (cancer that has spread
to lymph nodes and distant organs).
Who gets it?

        Annually in the United States, approximately 21,500 people will be diagnosed with Stomach
Cancer. Most Stomach Cancer patients are in their 60’s and 70’s. Men are twice as likely to get
Stomach Cancer as women. The disease is also more common in African-Americans than in
Caucasians.
        Near the beginning of the 20 th century, Stomach Cancer was a leading cause of death in the
United States. With improvements in food production, preservation, and preparation, Stomach
Cancer has become relatively uncommon in the United States. It is most common in Japan,
Eastern Europe, and Latin America. Rhode Island has a 25% higher rate of Stomach Cancer
cases than the national average.
        The exact cause of Stomach Cancer is still unknown, but certain factors can place you at a
higher risk:

          Helicobacter Pylori Infection: A bacterial infection that can injure and shrink the
           stomach lining.
          Diet: A diet high in smoked or salted meat and fish, high starch/low fiber foods, pickled
           vegetables, and nitrate preservatives
          Smoking and Alcohol: Smoking and excess alcohol use have been linked to Stomach
           Cancer
          Prior Stomach Surgeries
          Pernicious Anemia: A condition in which no acidic digestive juices are produced.
          Sex: Males are at higher risk
          Family History: People with 3 or more first degree relatives (parents, sisters and
           brothers) who have had stomach cancer are at a higher risk.
          Blood Type: People with type A blood are at higher risk. Researchers have no idea
           why this is so.
          Occupational Hazards: Exposure to substances of coal mining and industrial
           processing of nickel, rubber, and timber.

How is it detected?

         There is no officially accepted screening test for Stomach Cancer. If a physician suspects
Stomach Cancer, he or she will usually perform a physical exam, a chest X-ray, and one or more of
the following diagnostic tests:

   o   Upper GI Series: The patient swallows a barium mixture and a series of x-rays of the
       digestive tract are taken. The barium makes abnormal tissues, ulcers, and tumors more
       visible on the screen.
   o   Upper Endoscopy: The patient is sedated. A lighted probe is sent down through the
       esophagus and into the stomach. The doctor can examine the stomach and its lining for
       abnormal tissue. A sample of stomach tissue is usually taken and sent to a lab, where it is
       examined under a microscope by a pathologist for the presence of Cancer cells. This is
       called a biopsy.
   o   CT Scan: A computer image of the abdomen, pelvis, or chest that can be used to determine
       if Cancer has spread to other organs.
   o   Endoscopic Ultrasound (EUS): The patient is sedated. A probe is inserted through the
       esophagus that uses sound waves to make a screen image of the stomach that can be used
       to detect tumors or abnormal tissues. The EUS, unlike the CT scan or Upper GI Series,
       allows the doctor to see how deep the tumor is and how many layers of the stomach it has
       invaded.
   o   Laparoscopic Ultrasound (LUS): The patient is given a local anesthetic. A small incision is
       made near the belly button, and a probe is inserted directly into the abdomen. An ultrasound
       is done from inside the body to create a screen image, which can then be used to locate
       tumors and abnormal tissue.
   o   Fecal Occult Blood Test: A stool sample is analyzed to determine if there are microscopic
       amounts of blood present.

Symptoms

        Early stages of Stomach Cancer usually show no symptoms, making it difficult to diagnose
and treat. All of the following symptoms have been associated with Stomach Cancer, but none
definitely indicate that Cancer is present:

         Unexplained weight loss
         Abdominal pain or vague pain above the belly button
         Indigestion/vomiting
         Weakness/fatigue
         Blood in vomit or stool
         Feelings of fullness
If the cancer has spread to the liver:
         Jaundice: Yellowing of the skin
         Ascites: Enlarged belly from fluid

        Symptoms normally do not appear until Stomach Cancer has begun to develop into later
stages. Report any symptoms to your doctor immediately! The earlier the cancer is detected,
the better the chances of survival.


Is it curable?

        Stomach Cancer is a very difficult disease to treat. Since the early cancer stages show few
symptoms, Stomach Cancer is usually diagnosed in advanced stages. It is relatively uncommon in
the U.S., so there are not routine screenings of the population for Stomach Cancer. RI has a 50%
higher death rate from stomach cancer than the national average.
        If detected early, Stomach Cancer can be successfully treated with no serious lasting
effects. Advanced stages involve more extensive treatments, but can sometimes still be cured if the
cancer hasn’t spread too much. In cases in which the cancer has spread to multiple organs,
treatment of these other areas must be considered as well. The more the cancer has spread, the
more difficult it is to treat successfully.
        When detected in a late stage, the 5-year survival rate for Stomach Cancer is low. However,
every case is different so patients with Stomach Cancer should not base their chances of survival
on statistics alone. The seriousness of this disease must be kept in mind, but there are always new
treatments that may offer hope.
It is easier to prevent cancer than to cure it…

        Certain lifestyle changes can help decrease your risk of developing Stomach Cancer (as
well as other types of cancer):

         A well balanced diet that avoids salted or smoked foods, avoids excess starch, and
          includes sufficient daily fiber.
         Prepare and refrigerate food properly
         Not smoking
         Use alcohol in moderation
         Avoid exposure to coal, nickel, or rubber processing

				
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posted:11/4/2009
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