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What is stomach cancer?

Stomach cancer, also known as gastric cancer, usually begins in the lining in the upper part of the stomach.

Stomach cancer is a relatively 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.

In 2016, 2197 new cases of stomach cancer were diagnosed in Australia. In 2019 it was estimated that the risk of being diagnosed with stomach cancer by age 85 was 1 in 65 for men compared to 1 in 144 for women.

In 2018, there were 1138 deaths due to stomach cancer in Australia. 

The five year survival rate for stomach cancer is 31%.



Stomach cancer symptoms

  • a painful or burning sensation in the abdomen

  • heartburn or indigestion (dyspepsia)

  • 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.



Causes of stomach cancer

Some factors that can increase your risk of stomach cancer include:

  • smoking

  • being aged over 60

  • infection with the bacteria Helicobacter pylori

  • a diet high in smoked, pickled and salted foods and low in fresh fruit and vegetables

  • alcohol consumption

  • being overweight or obese

  • pernicious anaemia (low red blood cells)

  • chronic gastritis (inflammation of the stomach)

  • 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.



Diagnosis of stomach cancer

If your doctor thinks you may have stomach cancer, you will be referred for further tests. The main test is an endoscopy (also known as a gastroscopy). The doctor will use a thin, flexible tube with a camera (endoscope), which passes into the mouth, down the throat and oesophagus into the stomach in order to look at the digestive tract. 

If any suspicious-looking areas are detected, a small amount of tissue from the stomach lining may be removed (biopsy) and examined under a microscope. Less commonly used is an endoscopic ultrasound where the endoscope has an ultrasound probe at the end. 



Treatment for stomach cancer

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.

Types of 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 surgery to shrink larger tumours. It can also be used after surgery to reduce the risk of the cancer returning.

Palliative care

In some cases of stomach cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.

As well as slowing the spread of stomach cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.

Treatment Team

Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
  • GP (General Practitioner)- looks after your general health and works with your specialists to coordinate treatment.
  • Gastroenterologist- specialises in diseases of the digestive system.
  • Upper gastrointestinal surgeon- specialises in surgery to treat diseases of the upper digestive system.
  • Radiation oncologist- prescribes and coordinates radiation therapy treatment.
  • Cancer nurses- assist with treatment and provide information and support throughout your treatment.
  • Other allied health professionals- such as social workers, pharmacists and counsellors.


Screening for stomach cancer

There is currently no national screening program for stomach cancer available in Australia.



Preventing stomach cancer

There are some steps you can take to minimise the risk of stomach cancer including:

  • not smoking or quitting smoking
  • reducing consumption of smoked, pickled and salted food
  • a diet high in fresh vegetables and fruit
  • treatment of Helicobacter pylori infection may be protective.


Prognosis for stomach cancer

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. 



Sources

Understanding Stomach and Oesophageal Cancer, Cancer Council Australia, ©2019. Last medical review of source booklet: October 2019. 

Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) books: Stomach cancer. Canberra: AIHW. 

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