is a cancer that starts in the stomach
and is the growth of abnormal cells
in the lining and wall of the stomach. It occurs mainly in men over 40
years of age.
Stomach cancer is difficult to detect in its early stages because it
causes few or no symptoms.
play a role in the development of stomach cancer.
Among these is infection with a type of bacterium
called Helicobacter pylori (H. pylori), a
leading cause of stomach irritation and ulcers.
Countries such as China and Colombia, where at least
half the children are infected with H. pylori,
have a correspondingly high prevalence of stomach
cancer. Heavily salted, smoked and pickled foods
also are known to cause stomach cancer, and the
disease is more common in countries where these
foods form a large part of the diet. When
refrigeration replaces salting and pickling as a way
of preserving food, the incidence of stomach cancer
Stomach cancer is more readily treated when
caught early. Unfortunately, by the time it's
diagnosed the disease is often at an advanced stage
and may have spread beyond the stomach to nearby
lymph nodes or to other organs such as the liver,
pancreas and colon.
When possible, the most common treatment for
stomach cancer is an operation that removes part or
all of your stomach. Chemotherapy or radiation also
may be used, especially to help relieve symptoms in
the later stages of the disease.
The encouraging news about stomach cancer is that
you can greatly reduce your risk by eating a varied
and healthy diet, and by receiving prompt treatment
for any H. pylori infection.
Signs and symptoms
The most common early sign of both noncancerous (benign) and cancerous
(malignant) stomach tumors is microscopic internal bleeding, which is
usually only detected by tests that check your stool for blood.
Sometimes you may feel tired if the bleeding causes you to lose too many
healthy red blood cells (anemia).
When the cancer is more advanced, you may experience signs and symptoms
Discomfort in the
upper or middle region of your abdomen that may not be relieved by
food or antacids. In the early stages of stomach cancer, pain often
may be alleviated by the acid-buffering effect of food or antacids.
discomfort aggravated by eating.
The vomiting of
and weight loss.
Full feeling after
meals, even when eating less than normal.
Having one or more of these signs and symptoms doesn't necessarily mean
you have stomach cancer. Other conditions, especially peptic ulcers, can
cause similar problems.
Your stomach is a muscular sac located on the upper left-hand side of
your abdomen, just below your ribs. If you're an average adult, it's
about the size of a small melon, but can stretch at the sides to hold
nearly 1 gallon of food and liquid. Your stomach folds in on itself when
it's empty and expands when you eat or drink.
Although your stomach plays a major role in digestion, the digestive
process really begins in your mouth, where your saliva begins breaking
down carbohydrates, sugars and fats. From there, food passes into your
esophagus, a tube approximately 10 inches long that connects your throat
and stomach. At the end of your esophagus is a muscle valve (lower
esophageal sphincter) that relaxes to allow food to pass into your
The walls of your stomach are lined with three layers of powerful
muscles that churn food into smaller pieces and mix it with enzymes and
acids produced by glands in the stomach's inner lining. Under normal
conditions, your stomach produces 2 to 3 quarts of gastric juices every
day. One of these juices, hydrochloric acid, is so corrosive it can
dissolve iron nails. Your stomach's delicate tissues are protected from
this powerful acid by a thick, jelly-like mucus that coats the stomach
Once the food in your stomach is thoroughly broken down and mixed,
muscular contractions push it toward the pyloric valve, which leads into
the upper portion of your small intestine (duodenum). The valve opens
just enough to release barely an eighth of an ounce of food at a time.
It may take three to four hours for your stomach to empty after you eat,
depending on your diet. Foods high in fat increase the amount of time it
takes for your stomach to empty.
The great majority of stomach cancers start in the glandular cells in
the stomach lining (adenocarcinomas). Occasionally, tumors may also
develop in the stomach's lymphatic tissue (lymphoma) or muscle
(sarcoma). About 3 percent of stomach cancers are carcinoid tumors that
originate in the stomach's hormone-producing cells. Carcinoid tumors
spread (metastasize) less frequently than do other stomach cancers,
which often spread throughout the stomach or grow into the esophagus or
small intestine. They may also extend through the stomach wall to nearby
lymph nodes and eventually spread to other organs such as the liver,
pancreas and colon.
What causes stomach cancer?
Healthy cells grow and divide in an orderly way. This process is
controlled by DNA the genetic material that contains the instructions
for every chemical process in your body. Some of the genes in your DNA
promote cell division and some slow cell division or program cells to
die at the right time. Still other genes control processes that help
repair DNA. When DNA is damaged, these genes may not function properly,
causing cells to grow out of control and eventually form a tumor a
mass of malignant cells.
Although the causes of many types of cancer aren't clear, researchers
have made real progress in pinpointing factors that damage DNA in
stomach cells and in understanding how that damage leads to cancer.
These factors include:
Nearly two-thirds of the world's population is infected with
corkscrew-shaped bacteria called Helicobacter pylori (H. pylori)
that live deep in the mucous layer that coats the lining of the
stomach. Although it's not entirely clear how the bacteria are
transmitted, it's likely they spread from person to person through
the oral-fecal route or are ingested in contaminated drinking water.
H. pylori infection frequently occurs in childhood and can
last throughout life if not treated. It's now known to be the
primary cause of stomach ulcers, accounting for at least 80 percent
of all cases. It may also be the main cause of stomach cancer.
Nitrates are naturally occurring chemical compounds that form when
bacteria in the soil break down nitrogen. Millions of tons of these
compounds mainly from large-scale use of nitrogen fertilizers and
from livestock and poultry farming find their way into surface
water and groundwater every year. Nitrates are also added to many
processed meats to preserve color and enhance flavor. In your
stomach, certain bacteria, including H. pylori, convert
nitrates into nitrites, another nitrogen-based chemical. Nitrites
are also added to certain foods, especially cured meats such as ham
and bacon. The nitrites then combine with other nitrogen-containing
substances in your stomach to form N-nitroso compounds powerful
carcinogens that are known to cause stomach cancer.
or pickled foods and red meat.
Before the advent of refrigeration, food was commonly preserved by
salting, smoking or pickling. Preserved foods often contain large
amounts of nitrites and nitrates, which can be converted in your
stomach into cancer-causing compounds. Countries where consumption
of salted meat and fish and pickled vegetables is high Japan is a
notable example tend to have correspondingly high rates of stomach
cancer. Eating a diet high in red meat, especially when the meat is
barbecued or well done, has also been linked to stomach cancer.
Both can irritate the stomach lining and are especially likely to
cause cancer in the upper part of the stomach closest to the
Low-income children and adults are more likely to develop stomach
cancer than are those with higher incomes. Researchers believe this
may be due to the rapid spread of H. pylori in crowded living
conditions. In addition, breastfeeding can help protect infants
against H. pylori, but low-income mothers are more likely to
bottle-feed their babies.
Having H. pylori infection makes you two to six times as likely
to develop stomach cancer as someone who isn't infected. Even so, most
people with H. pylori don't get stomach cancer, and researchers
believe that genetic factors make some people more susceptible to the
disease. Studies show that having both H. pylori and a form of a
gene that causes low stomach acid greatly increases your risk of stomach
Other risk factors for stomach cancer include:
Stomach cancer is twice as common in men as it is in women.
Most people who develop stomach cancer are between the ages of 50
and 70. The disease rarely occurs in people younger than 40.
A diet high in foods preserved by smoking, salting or pickling
increases your risk of stomach cancer. So do foods that contain
nitrites and nitrates, such as bacon, ham and processed meats.
Eating large amounts of red meat particularly if it's barbecued or
well done also increases your risk. On the other hand, using
plenty of fruits and vegetables, especially those that are red or
deep yellow, such as tomatoes, carrots and sweet potatoes, helps
protect against stomach cancer.
Drinking in moderation, which is generally defined as no more than
one drink a day for women and two for men, may have certain health
benefits. But drinking more can cause a number of problems,
including irritation of the stomach and esophagus that may lead to
cancer. Smoking has also been implicated in stomach cancer. Men who
smoke are more than twice as likely to die of stomach cancer as are
those who don't smoke, and rates are even higher for men who have
smoked longer or who have a history of ulcers and heartburn. Women
who smoke also have about a 50 percent increased risk of stomach
The risk of stomach cancer may increase in people who have had part
of their stomach and their pyloric valve removed usually as a
treatment for peptic ulcers. After stomach surgery, bile and
sometimes pancreatic juices can back up, causing irritation and
inflammation of the stomach lining (gastritis). This can lead to
stomach cancer in some people. In general, the risk is greatest
about 20 years after the initial surgery.
These are small growths in the lining of your stomach. Most are
benign, but adenomatous polyps especially those larger than 1
centimeter in diameter are often precancerous.
These include hereditary nonpolyposis colon cancer and familial adenomatous polyposis, inherited disorders that slightly increase
your risk of stomach cancer.
gastric cancer is a rare form of stomach cancer associated with
mutations in a gene called CDH1. A parent with the defective gene
has a 50 percent chance of passing it on to each child. Because
nearly three-fourths of people who inherit the gene eventually
develop stomach cancer, doctors once recommended surgery to remove
all or part of the stomach for all children of parents with the
gene. Now, however, DNA testing can determine exactly who is at
risk. If you have a family history of diffuse gastric cancer, your
doctor or a genetic counselor can answer your questions about DNA
You're two to four times as likely to develop stomach cancer if you
have a parent or sibling with the disease.
This condition, which is often associated with atrophic gastritis,
occurs when your body lacks enough vitamin B-12 to produce healthy
red blood cells. Although pernicious anemia is easily treated with
B-12 injections, having the disease slightly increases your risk of
Type A blood.
Your blood type is determined by the presence or absence of two
proteins A and B that occur on red blood cells. For unknown
reasons, people with type A blood have a somewhat higher risk of
stomach cancer than do people with other blood types.
Stomach cancer is more common in some parts of the world
especially Japan, Korea, parts of eastern Europe, and Latin America
than it is in the United States. These differences are likely
related to diet and H. pylori infection. Stomach cancer
occurs most often in countries where large amounts of meat or
smoked, heavily salted or pickled foods are consumed or where
refrigeration isn't readily available.
Certain workplace contaminants, including coal dust, asbestos and
nickel, have been linked to an increased risk of stomach cancer.
Men weighing 25 to 30 pounds more than their ideal weight may be at
increased risk of stomach cancer.
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of blood under a specialized high powered ultra-dark
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