Stomach cancer is one of the most common cancers in Victoria with about 530 people diagnosed every year. However, the number of people with stomach cancer is falling in Australia. Stomach cancer is rare in people under 50 years of age and affects more men than women.
Risks and causes
The exact cause of stomach cancer is unknown. However, some risk factors make it more likely that a person will develop this disease. These risk factors include:
- Smoking
- Age – most cases are diagnosed in people over 50
- Gender – it is twice as likely in men than women
- Infection with the bacteria Helicobacter pylori
- A diet high in smoked, pickled and salted foods and low in fresh fruit and vegetables
- A family history of stomach cancer
- Partial gastrectomy for ulcer disease (after about 20 years)
- Inheriting a genetic change that causes the bowel disorders familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC).
The symptoms of stomach cancer are usually vague and can be common to other medical conditions. This means it is usually diagnosed in the advanced stages of the disease.
Some of the symptoms of stomach cancer include:
- Indigestion (such as heartburn, bloating or burping)
- Feeling full, even after a small meal
- Nausea or vomiting (or both)
- Pain and difficulty swallowing
- Unexplained tiredness or weakness
- Blood in vomit
- Black-coloured faeces, which means old blood
- Weight loss or loss of appetite – more likely in a very advanced cancer.
Stomach cancer is usually diagnosed using a number of tests, including:
- Gastroscopy a thin flexible tube is passed down your throat so the doctor can see into your stomach, oesophagus and upper part of your bowel.
- Biopsy a small sample of the stomach is removed during the endoscopy and looked at under a microscope.
- Barium x-ray liquid barium is swallowed and shows up on an x-ray screen as it passes through the stomach and digestive system. It can show up abnormalities in the stomach.
- Ultrasound sound waves create a picture of your stomach.
- Blood tests – including a carcinoembryonic antigen (CEA) test. CEA is produced in high quantities by some cancer cells including about half of the people diagnosed with stomach cancer.
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- If stomach cancer is diagnosed, further tests may be needed to see if the cancer has spread. These may include a CT, MRI or PET scan:
- CT scan – a special x-ray taken from many different angles to build a three-dimensional picture of your body. A dye may be injected to further highlight internal organs.
- Magnetic resonance imaging (MRI) – similar to a CT scan but uses magnetism instead of x-rays to build three-dimensional pictures of your body.
- Positron emission tomography (PET) scan – an injection with a glucose solution containing a very small amount of radioactive material is given. The scanner can ‘see’ the radioactive substance. Cancerous cells show up as ‘hot spots’ – areas where the glucose is being taken up.
Treatment depends on the type and size of the cancer, your age and health and whether the cancer has spread. Treatments include:
- Surgery the main treatment in the early stages. All or part of the stomach is removed along with any cancerous lymph nodes. This is major surgery and you will need to be fit enough to have it.
- Chemotherapy the use of anti-cancer drugs, which can stop cancer cells from multiplying. You may have this before or after surgery.
- Radiotherapy the use of radiation to kill cancer cells. Radiotherapy is not often used to treat stomach cancer but you may have it after surgery to destroy any remaining cancer cells or – if the cancer is very advanced – to help relieve pain.
- Symptom control – even if your stomach cancer cannot be cured, you may have treatment to help control your symptoms. This may include surgery to relieve a blockage at the entry or exit of your stomach.
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