Stomach Cancer: Types, Symptoms, Information

Updated/Revised Date: 2022-04-11

Synopsis: Information on stomach cancer also called gastric cancer and carcinoid tumors. Stomach cancer is cancer that occurs in the stomach, the muscular sac located in the upper middle of your abdomen, just below your ribs. The cancer may spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen and lymph nodes. There are five layers in the stomach wall, and it is important to know and understand these layers because as a cancer in the wall of the stomach grows deeper into them the prognosis deteriorates.

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Stomach cancer is also called gastric cancer and starts in the stomach. Once food has been chewed and swallowed, it enters the esophagus, a tube that carries food through the neck and chest to the stomach. The esophagus connects to the stomach right beneath your diaphragm, which is a muscle used for breathing underneath your lungs.

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The stomach is somewhat like a sack and holds food; it also starts to digest it by secreting gastric juice. Food and gastric juices are mixed in the stomach and then empty into the first part of the small intestine called the duodenum.

Sometimes people use the word, 'stomach,' to mean the entire area of the body between the chest and the pelvis. The medical term for this area of the body is the 'abdomen.' For example, sometimes people experiencing pain in their abdomen say they have a 'stomach ache,' when the pain could be coming from their appendix, small intestine, colon, or some other organs in their abdomen. Doctors talk about these kinds of pain as, 'abdominal pain.'

The reason this is important is that the stomach is one of several organs in the abdomen, and cancer might start in any of these organs. It is essential not to confuse Stomach cancer with colon cancer, for example, or small intestine cancer or liver cancer because these forms of cancer have different symptoms. These forms of cancer also have different outlooks, and different treatments.

Labelled illustration of the human abdomen showing the location of the stomach and digestive system.

Parts of the Stomach

The human stomach has five parts:

The Cardia: The Cardia is the upper portion of the stomach, closest to the esophagus.
The Fundus: The Fundus is located next to the Cardia. There are some cells in these areas of the stomach that make acid and pepsin, which is a digestive enzyme; these are the parts of the gastric juice that helps to digest food.
The Antrum: The Antrum is the lower portion, closest to the intestine, and is where food is mixed with gastric juices.
The Pylorus: The Pylorus acts functions as a valve, controlling the emptying of the stomach's contents into the small intestine.
The Body, or Corpus: The Body, or Corpus, is the area between the upper and lower parts of the stomach.

The first three parts of the stomach; the Cardia, Fundus, and Body, are referred to as the 'Proximal Stomach.'

The lower two parts; the Antrum and the Pylorus, are referred to as the 'Distal Stomach.'

There are two curves in the stomach that form the upper and lower borders. These curves are referred to as the 'Lesser Curve," and 'Greater Curve.' There are other organs near the stomach; they include the liver, colon, small intestine, spleen, and pancreas.

There are five layers in the stomach wall, and it is important to know and understand these layers because as a cancer in the wall of the stomach grows deeper into them the prognosis deteriorates.

The innermost layer is the mucosa and this is where stomach acid and digestive enzymes are made as well as where most forms of stomach cancers begin.
Under the mucosa is a supporting layer called the submucosa. The submucosa is surrounded by a layer of muscle called the 'muscularis', which is a layer of muscle that moves and mixes the stomach's contents.
The outermost two layers, called the 'subserosa,' and the 'serosa,' perform as wrapping layers for the stomach.

Development of Stomach Cancer

Cancers that start in different sections of the stomach might cause different symptoms; they also usually have different outcomes. Treatment options can also be affected by the location of the cancer.

Stomach cancers typically develop slowly, and over a period of many years. Pre-cancerous changes often occur in the lining of the stomach before a true cancer develops. Many times the early changes do not cause any symptoms and go undetected.

There are different ways that stomach cancers can spread. One way they can grow is through the wall of the stomach, and then continue on to invade nearby organs. They may also spread to lymph vessels and nearby lymph nodes, which are bean-sized structures located near many body structures that help fight infections. One of the features of the stomach is a very extensive network of lymph vessels and nodes. The outlook for survival decreases significantly if cancer spreads to the lymph nodes. As stomach cancer advances, it has the potential to travel through the blood stream and spread, or, "metastasize,' to organs such as the lungs, liver, and bones.

Types of Stomach Cancer

Adenocarcinoma

Approximately 90% to 95% of cancerous tumors of the stomach are Adenocarcinomas. The term, 'stomach cancer,' nearly always refers to Adenocarcinoma. This form of cancer develops from the cells that form in the innermost lining of the stomach, or, 'Mucosa.'

There are also some other, less common tumors that may be found in the stomach, such as:

Lymphoma

Lymphomas are cancers of the immune system tissue and are sometimes found in the wall of the stomach, accounting for about 4% of all stomach cancers. The prognosis and treatment of a Lymphoma depends on whether it is aggressive or is a slow-growing lymphoma.

Gastrointestinal Stromal Tumor

Gastrointestinal Stromal Tumors are rare and seem to start in cells in the wall of the stomach called, 'interstitial cells of Cajal.' Some of these tumors are non-cancerous, or benign; others are cancerous. About 60% to 70% of these tumors occur in the stomach, but they can be found anywhere in the digestive tract.

Carcinoid Tumor

Carcinoid Tumors start in hormone-making cells in the stomach, and most of them do not spread to other organs. Approximately 3% of all stomach cancers are carcinoid tumors.

Stomach Cancer Symptoms

Early symptoms may include:

Heartburn
Upper abdominal pain
Nausea and loss of appetite

Later signs and symptoms may include:

Vomiting
Weight loss
Yellow skin
Blood in the stool
Difficulty swallowing

Stomach Cancer Facts and Statistics

Stomach cancer occurs most commonly in East Asia and Eastern Europe, and it occurs twice as often in males as in females.
Globally, stomach cancer is the fifth leading cause of cancer and the third leading cause of death from cancer, making up 7% of cases and 9% of deaths. In 2012, it occurred in 950,000 people and caused 723,000 deaths.

The American Cancer Society's estimates for stomach cancer in the United States for 2015 are:

About 10,720 people will die from this type of cancer (6,500 men and 4,220 women)
About 6 of every 10 people diagnosed with stomach cancer each year are 65 or older.
The average risk that a person will develop stomach cancer in their lifetime is about 1 in 111.
About 24,590 cases of stomach cancer will be diagnosed (15,540 in men and 9,050 in women)
This risk is higher in men than in women, and can also be affected by several other factors.
Stomach cancer mostly affects older people. The average age of people when they are diagnosed is 69.

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