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Stomach Cancer

The most common form of stomach cancer is adenocarcinoma-a cancer that develops from cells in the innermost mucosa lining of the stomach.  Adenocarcinoma accounts for more than 90% of stomach/gastric cancer.  Other, less common types of stomach cancer are lymphoma (stomach wall), gastrointestinal stromal tumor (GIST, which begins intersititial cells of the stomach wall), and carcinoid tumors, which begin in the hormone-producing cells of the stomach.  Carcinoid tumors do not metastasize to other organs.

People with chronic gastritis, pernicious anemia and a family history of GI cancers are at greater than average risk for stomach cancer.  Additionally, stomach cancer is more often diagnosed in people over age 72, in men, and in people Asian, Hispanic, African-American and Pacific Islander individuals, as we. A diet high in salted, smoked or pickled foods may also increase risk. Chronic h.pylori infection also increases the risk of stomach cancer.

Like many GI cancers, stomach cancer has subtle symptoms that may go unnoticed until the disease has is more advanced.  Symptoms include abdominal discomfort, feeling full or bloated after a small meal, nausea, vomiting, unexplained weight loss.

How is it diagnosed?
How is it treated?
How does Advocate Christ Medical Center make a difference?
Frequenstly Asked Questions

How is it diagnosed?

Accurately identifying the type of cancer and its origin is important for the most effective treatment. Doctors use various methods to diagnose stomach cancer.

  • Upper endoscopy - uses a probe inserted through the mouth and into the digestive tract and to the stomach. The physician can look inside the organs for signs of cancer. Your doctor also may X-ray the stomach.  Some patients are asked to drink a barium contrast solution, which enhances the X-ray images.
  • Computed tomography (CT scan) - a CT scan takes multiple X-ray "slices" to reconstruct a detailed image of the stomach.
  • Magnetic resonance imaging (MRI) - a diagnostic procedure that combines radiofrequencies, very powerful magnet and a computer to create detailed images of body tissues. 
  • Positron Emission Tomography (PET) scan - a nuclear medicine procedure that assesses metabolic activity within organs or tissue, and can be useful in detecting cancer.  The metabolic activity within malignant tissue differs from metabolic activity in non-cancerous tissue.
  • Endoscopic retrograde cholangiopancreatography (ERCP) - may be used to diagnose problems in the stomach. ERCP combines X-rays and an endoscope, and enables the physician to view inside the biliary tract.  Dye may be injected to enhance visibility on the X-ray.
  • Tissue biopsy - a small sample of tissue is taken and analyzed to confirm whether it is malignant (cancerous) or benign (non-cancerous). Detailed pathology testing can reveal important details about the cancer's molecular and cellular characteristics, and is a key step in staging a cancer (determining how advanced the cancer is).
  • Endoscopic ultrasound (EUS or endosonography) - is a relatively new technology that features an ultrasound transducer positioned at the tip of the endoscope, so it can get much closer to the organs than traditional ultrasound performed from outside the body.  As a result, EUS creates images that are much clearer and more detailed than traditional ultrasound-which is especially useful for diagnosing stomach cancers.

How is it treated?

Treatment of stomach cancer is based on consideration of many factors, including the type of cancer, its location and its stage.   Treatment may include surgery, radiation therapy or chemotherapy.

  • Surgery is the most common treatment for stomach cancer.  In a partial gastrectomy, the surgeon removes a portion of the stomach, as well as port of the esophagus, small intestine or lymph nodes.  In a total gastrectomy, the surgeon removes the entire stomach, part of the esophagus, small intestine and lymph nodes, and also may remove part of the spleen.  The surgeon will reconnect the esophagus directly to the small intestine, and may reconstruct a stomach-like structure from intestinal tissue.
  • Chemotherapy - uses anti-cancer drugs to kill cancer cells. Most chemotherapy is given intravenously, and may require multiple sessions over several weeks on an outpatient basis instead of staying in the hospital.  Chemotherapy may be given before surgery to shrink a tumor, or after surgery to kill off remaining cancer cells.
  • Radiation Therapy - is sometimes used before surgery to shrink a tumor, or can be used after surgery to kill off remaining cancer cells. Radiation therapy can be given external or internal.
    • External radiation therapy is delivered by a linear accelerator, and often can be done on an outpatient basis. Patients may need therapy up to five days per week for several weeks.
    • Three-dimensional (3-D) conformal radiation therapy and intensity-modulated radiation therapy (IMRT) are more sophisticated methods of external radiation therapy that can be helpful against stomach cancer.
    • Internal radiation-also called brachytherapy-involves implanting tiny radioactive tubes or seeds close to the cancer site. Brachytherapy takes a shorter time than external therapy, but most patients stay in the hospital during this therapy.
    • Radiation therapy also may be delivered directly to the tumor during open surgery, in a process called intra-operative radiation therapy.
    • Chemotherapy and radiation therapy may be combined, for improved effectiveness against stomach cancer.
  • Endoscopic ultrasound also can be used to relieve pain associated with cancer.  Using the ultrasound imaging, the physician guides a special needle through the scope and directly to nerve fibers. Blocking the celiac nerves then prevents transmission of pain sensation.

How does Advocate Christ Medical Center make a difference?

The Cancer Institute at Advocate Christ Medical Center offers a complete range of cancer-fighting modalities, using standard, state-of-the-art and investigational approaches.  Many patients benefit from multimodality treatment that combines radiation and/or chemotherapy with surgery.  Radiation and/or chemotherapy may be given before surgery to shrink a tumor or after surgery to help kill any remaining cancer cells.

The GI cancer team at Christ Medical Center includes surgeons with experience performing complex surgery for stomach cancer, including reconstructive techniques to restore the digestive process.

Christ Medical Center is one of few medical centers in the Chicago region that uses endoscopic ultrasound (also called EUS or endosonography) for staging and removal of tumors in the stomach. This non-surgical technique can find tumors measuring 1 cm (about 0.4 inches)-too tiny to be detected by CT scan, and can determine whether or not cancer has invaded lymph nodes.  When performed before surgery, endoscopic ultrasound reveals details that are significant for planning the most appropriate treatment, such as whether chemotherapy or radiation therapy should be considered before surgery or whether surgery should be avoided because of lymph node involvement. 

Patients at Advocated Christ Medical Center benefit from the collaboration of many specialists who have expertise in a broad range of areas yet all dedicated to providing the best solutions to diagnose and treat cancers of the digestive system.  Gastroenterologists, GI surgeons, medical oncologists, radiation oncologists, pathologists, hepatologists, oncology nurses and others work collaboratively to consider all perspectives and potentialities before recommending a treatment plan tailored to each individual's situation.

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