Common GI Conditions

Common GI Condition > GI Tract > Gastric Cancer

Gastritis, Peptic Ulcer Disease and Helicobacter Pylori Infection

What is Gastric Cancer

Stomach cancer (Gastric Cancer) happens when normal cells in the stomach change into abnormal cells and eventually become cancerous. The stomach is part of the digestive system. There are different kinds of stomach cancer, depending on the type of cells and part of the stomach involved. Some people who get stomach cancer have a condition called Helicobacter pylori infection.

H. pylori is a type of bacteria that can infect the stomach and intestines. Infection with H. pylori sometimes causes symptoms such as abdominal pain, bloating, nausea, or vomiting. If it is not treated, it can lead to stomach cancer. Stomach cancer is the 7th most common cancer in men and 8th most common cancer in women in Singapore currently.

Early on, stomach cancer might not cause any symptoms. When stomach cancer causes symptoms, they can include: Weight loss, upper abdominal pain, difficulty swallowing, loss of appetite, or feeling full after eating a small amount of food, nausea, feeling tired or short of breath (from a condition called “anemia,” which is when people have too few red blood cells).

Test for Gastric Cancer

Gastroscopy – This is the test most often done for stomach cancer. During this test, the doctor puts a thin tube with a camera and light on the end into the mouth and down into the stomach. This lets the doctor look at the stomach lining.
Biopsy – Doctors do this test during an upper endoscopy. During a biopsy, the doctor takes a small sample of tissue from an abnormal-looking area of the stomach. The tissue is then examined under the microscope for suspicious looking cells.
Blood tests
Imaging tests (such as a CT scan) – Imaging tests create pictures of the inside of the body.
Your doctor may also check for H. pylori infection. Doctors can do this in different ways, including breath tests, blood tests, and other lab tests.

Once the cancer is diagnosed, it needs to be staged (Figure 6). Cancer staging is a way in which doctors find out if cancer has spread past the layer of tissue where it began, and, if so, how far. The right treatment for you will depend a lot on the type and stage of your stomach cancer and your other medical problems.

Stomach Cancer Is Then Treated In The Following Ways:

Surgery to remove cancer – During surgery, the doctor might remove part or all of your stomach. If the doctor removes all of your stomach, he or she will reconnect your digestive tract so that you can eat.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Sometimes, people get chemotherapy before they have surgery.
Radiation therapy – Radiation kills cancer cells.

Can Stomach Cancer Be Cured?

Stomach cancer can sometimes be cured with treatment. This is most likely when the cancer is found at an early stage. But, often, stomach cancer is not found at an early stage.

If your stomach cancer cannot be cured, your doctor can do other treatments to help with your symptoms. If you have H. pylori infection, your doctor will treat it with medicines. This usually involves taking 3 or more medicines for 1 to 2 weeks. Treating the H. pylori infection will make the infection go away, but it will not make the stomach cancer go away.

After the treatment, your doctor will check you every so often to see if cancer comes back. Follow-up tests might include physical examinations, blood tests, gastroscopy, or imaging tests. You should also watch for the symptoms listed above. Having those symptoms could mean your stomach cancer has come back. Tell your doctor if you have any symptoms.

If your stomach cancer comes back or spreads, you might have more chemotherapy or radiation therapy. You might also have other treatments to help with your symptoms.

It is important to follow all of your doctor’s instructions about visits and tests. It is also important to talk to your doctor about any side effects or problems you have during treatment. Getting treated for stomach cancer involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment.

Any time you are offered a treatment, ask:

What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?

References:

UpToDate Patient education: Stomach cancer (The Basics)
Singapore Cancer Registry Report No. 8