It seems that stomach cancer is a type of cancer we don’t hear a lot about; why is that?
It’s one of the rarer types of cancer, and in the United States we’ve been seeing the number of new cases decrease over the past decade. This may be for a number of reasons, and one of those is that the incidence of Helicobacter pylori bacteria is much lower in more resourced countries. This bacteria is a significant risk factor in stomach cancer, and it’s still prevalent in developing countries, where sanitation and clean water is still lacking.
Besides the Helicobacter pylori bacteria, what are some of the other risk factors for stomach cancer?
We know that gender is a factor, because stomach cancer is more common in men than in women, and we know that age is, too. A majority of cases are diagnosed in people older than 50. We also know that tobacco use increases stomach cancer risk, as does a diet high in red meat and preserved foods. Diets lower in vegetables and fruits are known risk factors.
A very small number of people have genetic risk – for example, we know that mutations of the CDH1 gene are a risk factor, but those happen in only a very small proportion of patients. In those cases, there’s usually a very strong family history of stomach cancer or breast cancer.
What are some of the stomach cancer symptoms to look out for?
Probably the most common symptom is abdominal pain and weight loss when you weren’t trying to lose weight. Sometimes people notice black stool or blood in their stool, and they may experience reflux that doesn’t go away or that persists despite medication. Nausea and vomiting are also common, and so is a feeling of fullness after eating even a small amount of food.
Many of these symptoms occur with other conditions that aren’t cancer, or even other types of cancer. What advice do you give people who hesitate to mention their symptoms to their physician?
It’s true that many of these symptoms most likely are caused by something other than stomach cancer. But speaking as a physician, I absolutely would want patients to mention any symptoms they’re having, anything that’s worrying them. If it’s out of the ordinary for you, or if it persists for several months and doesn’t go away, please mention it to your doctor.
It’s not as common to detect stomach cancer in its earlier stages, but I’ve seen it caught when it has not yet spread and become stage IV. This is another reason I encourage people to mention symptoms that are worrying them to their doctor. Just as an example, there’s a very classic lymph node spread that can happen with stomach cancer – a spread to lymph nodes in the left side of the neck – and sometimes that can be caught in a physical exam. But you need to mention your symptoms to your doctor so they can make a point of feeling for that.
What is some of the promising research that’s happening in stomach cancer?
We’re finding a lot of interesting biomarkers, so targeted drugs are being heavily investigated right now as a way of personalizing care to individual patients. Chemotherapy is still the mainstay of treatment for stomach cancer, but we are incorporating immunotherapy more and more and, with patients who are receptive to it, seeing some impressive results.
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