Stomach cancer is a common cancer in Australia, however the number of people diagnosed has been falling. It is rare in people under 50 years of age and affects more men than women.
Incidence and mortality
There are nearly 1900 new cases of stomach cancer diagnosed each year in Australia. Stomach cancer affects nearly twice as many men as women. The risk of being diagnosed by age 85 is 1 in 62 for men and 1 in 137 for women.
In 2007, there were 1129 deaths from stomach cancer.
Screening
There is no routine screening test for stomach cancer.
Symptoms and diagnosis
In the early stages, stomach cancers often do not cause any symptoms.
Signs of early stomach cancer include:
- a painful or burning sensation in the abdomen
- heartburn or indigestion (dyspepsia).
Other symptoms that can occur later include:
- a sense of fullness, even after a small meal
- nausea and/or vomiting
- loss of appetite and/or weight loss
- swelling of the abdomen
- unexplained tiredness or weakness
- blood in vomit
- black-coloured faeces.
The most common tests to diagnose stomach cancer are an endoscopy or gastroscopy (possibly with biopsy). Other tests, used less often, are barium swallow/upper gastrointestinal x-ray or endoscopic ultrasound.
Staging
After stomach cancer is diagnosed, one or more of the following tests are used to determine the extent of the cancer (its stage):
- CT scan
- ultrasound scan
- PET scan
- laparoscopy
- bone scan.
The staging system used for stomach cancer is the TNM system , which describes the stage of the cancer from stage I to stage IV.
Causes
The causes of stomach cancer are not known, but factors that put some people at higher risk are:
- smoking
- age over 50
- being male - stomach cancers are more common in men than in 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 or hereditary nonpolyposis colorectal cancer.
Prevention
Not smoking or quitting smoking. A diet that is high in fresh vegetables and fruit, and low in smoked, pickled and salted foods, may be protective. Treatment of H pylori infection may also be protective.
Treatment
The main treatment for stomach cancer is surgery – a total or partial gastrectomy (removing all or part of the stomach). Chemotherapy may be given before and/or after surgery, usually:
1. Three cycles of pre-operative chemotherapy (epirubicin/cisplatin/fluorouracil) and three cycles of post-operative chemotherapy (the MAGIC protocol).
or
2. Post-operative chemotherapy with fluorouracil, folinic acid and radiation (Intergroup protocol).
Prognosis
An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. Treatment is most effective if the cancer is found in its early stages; stomach cancer can be cured if the cancer is removed before it spreads. However, because of the absence or vagueness of symptoms in the early stages, stomach cancers are often not discovered until they are more advanced.
For more information, contact Cancer Council Helpline on 13 11 20 (cost of a local call).