Conditions | Gastric Cancer

What is Gastric Cancer?

Gastric cancer, which is also known as stomach cancer, is a type of cancer that begins in the stomach. The stomach is the organ where food is digested, located in the upper part of your belly. Normally, your stomach is lined with healthy cells. In gastric cancer, some of these cells can start to grow uncontrollably and form a tumour or mass. Cancer cells can travel to different areas of the body through the bloodstream, but one of the first places that gastric cancer spreads is to the lymph nodes around the tumour. If these lymph nodes contain cancer cells, it may indicate a higher risk of future cancer spread. This may also change the way in which your tumour is treated. It can also spread beyond the stomach to other places like the inner lining of the abdomen (peritoneum), or to other organs like the liver or lungs.

Symptoms

At first, gastric cancer may have symptoms. But as it grows, people may notice:

  • Stomach pain or discomfort
  • Feeling full after eating a small amount of food
  • Unexplained weight loss
  • Nausea or vomiting
  • Blood in the vomit, or in the stool
  • Heartburn (acid reflux) or indigestion
  • Unexplained iron deficiency anemia

Screening

Routine screening for gastric cancer for Ontarians is not recommended as the effectiveness of screening is uncertain and the incidence (or rate) of gastric cancer is low. However, certain people are at increased risk. You are at increased risk if you have:

  • symptoms described above
  • A family history of gastric cancer
  • Unexplained anemia
  • A history of gastric polyps
  • Been born in a country where the rate of gastric cancer is high, ex. Japan
  • Certain genetic conditions that may predispose you (for example, Familial adenomatous polyposis [FAP] or Hereditary nonpolyposis colorectal cancer [HNPCC or Lynch syndrome])

Stages of Gastric Cancer

Gastric cancer is diagnosed as either stage 0, stage I, stage II, stage III, or stage IV. The higher the number, the more the cancer has spread. Cancer can spread to other areas in the body through nearby tissue, the blood, and the lymph system.
Staging is the process used to see if cancer has spread from the stomach to other parts of the body. Cancer cells can travel to different areas of the body through the bloodstream, but one of the first places that stomach cancer spreads is to the lymph nodes around the tumour. If these lymph nodes contain cancer cells, it may indicate a higher risk of future cancer spread. This may also change the way in which your tumour is treated. It can also spread beyond the stomach to other places like the peritoneum, or to organs like the liver or lungs.

Knowing the stage of a cancer is very important because it determines the plan of treatment. This may include some or a combination of the following:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targeted therapy or immunotherapy (for advanced cancer).

The staging system commonly used for stomach cancer is the TNM system (Tumor, Node, Metastases), developed by the American Joint Committee on Cancer (AJCC).