What Are the Symptoms of Gastric Cancer?

Gastric cancer develops when the stomach cells' DNA undergoes a genetic mutation. DNA is the genetic code that instructs cells when to develop and when to die. Due to the mutation, instead of dying, the cells grow quickly and form a tumor.

Cancer cells can break free from the original tumor and move through the blood or lymphatic system to distant body parts, forming new tumors.

The probable causes of gastric cancer are:

• Atrophic gastritis (caused by autoimmune disorders)
• A history of gastric cancer
• Infection with Helicobacter pylori (H. pylori)
• Gastro-esophageal reflux disease
• Acid reflux disease
• Infection with the Epstein-Barr virus
• A history of stomach ulcers or growths
• A high-fat, salty, smoked, or pickled diet
• A diet that is deficient in fruits and vegetables
• Frequent contact with substances, such as coal, metal, and rubber
• Smoking or chewing tobacco
• Excessive alcohol consumption
• Obesity

1. Stage I
   • Stage IA
     • Cancer forms in the stomach's mucosal lining and may spread to the submucosa (a layer beside the mucosa).
   • Stage IB
     • Cancer forms in the stomach's mucosal lining and may spread to the submucosa, one or two lymph nodes, and the muscle layer of the stomach.
2. Stage II
   • Stage IIA
     • Cancer may spread to the submucosa and three to six nearby lymph nodes.
     • Cancer may spread to the muscle layer of the stomach and one or two lymph nodes.
   • Stage IIB
     • Cancer may spread to the submucosa and 7 to 15 nearby lymph nodes.
     • Cancer may spread to the muscle layer of the stomach and spread to three to six lymph nodes.
3. Stage III
   • Stage IIIA
     • Cancer may spread to the muscle layer of the stomach and 7 to 15 nearby lymph nodes.
     • Cancer has spread to the subserosa, a layer of connective tissue next to the muscle layer and three to six lymph nodes.
   • Stage IIIB
     • Cancer may spread to the submucosa or muscle layer and more than 16 lymph nodes.
     • Cancer has spread to the serosa, subserosa, or muscle layer and more than 7 to 15 nearby lymph nodes.
     • Cancer has spread to nearby organs, such as the spleen, colon, liver, diaphragm, pancreas, abdominal wall, and kidneys.
   • Stage IIIC
     • Cancer has spread to the serosa, subserosa, or muscle layer and more than 16 nearby lymph nodes.
     • Cancer has spread to nearby organs and more than seven lymph nodes.
4. Stage IV
   • Cancer has spread to other body parts, such as the lung, liver, and distant lymph nodes.

The practitioner will go over the health information, ask about the symptoms and perform a physical exam, which may include examining the stomach. They may order several tests.

• Upper endoscopy: Used to detect gastric cancer. During the procedure, the practitioner inserts an endoscope (thin tube) with a small camera at its tip into the mouth to reach the stomach. Small surgical equipment can move through the endoscope to obtain tissue samples (biopsy). A lab can examine the sample for cancer cells.
• Endoscopic ultrasound: An ultrasound probe is attached to the tip of the endoscope to obtain pictures of the stomach. It can determine whether cancer has spread from the stomach lining to the stomach wall.
• Radiologic tests: A CT scan, barium swallow, and MRI, among other tests can help detect tumors and other malformations that could be cancer. Individuals should drink a substance that highlights the stomach lining on an X-ray during a barium swallow. A positron emission tomography scan can determine whether cancer has progressed throughout the body.
• Blood tests: Help determine abnormal organ functions. Poor organ function could indicate cancer spread.
• Laparoscopy: Helps evaluate the spread of cancer when other methods, such as imaging, have not provided enough information. During laparoscopy, the healthcare provider places a tiny camera through small cuts in the abdomen to view the organs up close.

Treatment is determined by the extent of cancer spread and the person’s health and treatment preferences. A care team could include a primary care physician, an oncologist, and a gastroenterologist.

• Surgery: The doctor may advise surgery to remove precancerous cells, a tumor, or all or a part of the stomach.
  • Upper endoscopy: When the cancer is limited to the stomach's superficial (uppermost) layers, it can be viewed with an upper endoscopy. A gastroenterologist uses endoscopic submucosal dissection to cut the tumor from the stomach wall and remove it through the mouth.
  • Gastrectomy: Once the tumor has spread beyond the superficial layers of the stomach, individuals will require surgery to eliminate all or part of the stomach. Subtotal gastrectomy removes the cancerous portion of the stomach. The entire stomach is removed during a total gastrectomy. Following total gastrectomy, the provider will connect the esophagus to the small intestine so one can continue eating.
• Other Treatments: Additional therapies to target cancer cells.
  • Chemotherapy: Before surgery, drugs are used to shrink cancer, making it simpler to remove. Chemotherapy can be used to eliminate any cancerous tissue after surgery. It is typically used in conjunction with radiation. Chemotherapy can be combined with targeted drug therapy.
  • Radiation: Cancer cells are destroyed using targeted energy beams, such as X-rays. Radiation can help relieve symptoms.
  • Immunotherapy: Supports the immune system in identifying and destroying cancer cells that could be difficult to detect. It is most frequently used in the treatment of repeated or advanced cancer.
  • Palliative care: Improves the person’s quality of life. Doctors, nurses, and other specialists work toward symptom relief. They offer additional assistance to supplement the care individuals receive from regular providers. Palliative care can be combined with other treatments.