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Stomach Cancer

Stomach cancer is the fourth most common cancer wordwide. Early symptoms of indigestion with acid reflux and loss of appetite are often ignored. By the time the later symptoms of severe stomach pain, marked weight loss, nausea, vomiting and fatigue are experienced, the cancer may have spread and therefore is more difficult to treat. 

As with oesophageal cancer, most stomach cancers are found in the over 50s and more commonly in men. Other risk factors include:

  • diet - eating a diet high in preserved foods such as those pickled, salted, smoked or cured
  • smoking
  • stomach infections by a bacterium Helicobacter pylori which is a major cause of stomach ulcers
  • family history - accounts for a small number of cases

Diagnosis is normally by gastroscopy. Under sedation, a thin flexible tube (endoscope) with a light and camera is passed down the oesophagus into the stomach. Any growths can easily be spotted and a tissue sample (biopsy) taken for further analysis.  If cancerous cells are found, further tests are needed to determine the extent of the spread:

  • CT scan of the abdomen in which two or three-dimensional x-ray pictures are taken to highlight any abnormal tissue growth 
  • PET scan in which a very small amount of radioactive tracer drug is injected and a scan of the body carried out over a period of about an hour
  • endoscopic ultrasound which combines endoscopy and ultrasound (sound waves) to build up a picture of the stomach wall

Treatment is usually by surgery to remove part or all of the stomach. Some surrounding normal tissue will also be taken to ensure no cancerous tissue is left behind. Depending on the spread, part of the pancreas and small intestine may also be removed. 

Chemotherapy may be given to try and shrink the cancer before surgery, and later to destroy any cancer cells remaining after the operation. Radiotherapy is often used in addition to chemotherapy, particularly if the patient is unable to undergo surgery or the cancer is too advanced.

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