Definition of terms
The term stomach cancer refers to an uncontrolled proliferation of the cells of the gastric mucosa. There are different types of stomach cancer, with classification depending on both tumor location – entrance to the stomach (cardia), body (corpus) or the lower part of the stomach (antrum) – and histologic type. In addition to these more common types, there are other types of stomach cancer that affect the lower layers of the stomach wall (e.g. GIST, gastrointestinal stromal tumor) or specific tissues (gastric lymphoma) or types of cancers that originate in other organs (B-cell and T-cell lymphomas). Stomach cancers can be localized, can grow through all of the layers of the stomach wall, or can even grow into other organs
Potential causes of stomach cancer include chronic Helicobacter pylori infection (type B gastritis), chronic autoimmune atrophic gastritis, certain types of gastric polyps (adenomas) and a rare disorder called Ménétrier’s disease. Other contributory factors include dietary factors such as nitrates, the consumption of large quantities of salted or smoked foods, strong alcoholic beverages, and smoking. Age and genetic factors also play an important role.
Frequency of occurrence
Every year, 10 in every 100,000 people in Western industrialized countries are diagnosed with stomach cancer, with men twice as likely as women to develop the disease, and the highest incidence rates recorded in Asia (genetic and dietary factors). Although the disease is most commonly found in people over 50 years of age, stomach cancer is a disease that regularly affects younger people.
When it comes to diagnosing stomach cancer, gastroscopy is the method of choice, but tissue sample analysis (biopsy) is required to confirm diagnosis. A special type of endoscope with an ultrasound device installed in its tip can be used in order to evaluate the exact size and spread of the tumor and to visualize the lymph nodes in the vicinity of the tumor. The procedure also allows tissue sampling under ultrasound-guidance. Additional diagnostic screening methods include, in particular, external ultrasound, conventional x-ray imaging, CT and MRI scans and, in some cases, small surgical procedures to evaluate the exact size and spread of the tumor.
Endoscopic resection is possible in patients with early stage or small-sized tumors. In patients with more advanced disease, treatment options include surgery, drug-based treatment (chemotherapy) and, in increasingly rare cases, radiotherapy. Additional treatment options exist for a more targeted treatment approach. Treating stomach cancer is a complex process, with all decisions made on a case-by-case basis and after thorough evaluation.
Patients who have completed treatment for stomach cancer must be followed up on a regular basis using gastroscopy examinations with tissue sampling, abdominal ultrasound, as well as chest CT scans and, where appropriate, abdominal CT scans. Such screening tests must be complemented by an in-depth consultation to explore the presence or absence of symptoms and a thorough physical examination.