Stomach cancer: symptoms, causes, therapy

Stomach cancer usually starts from degenerate cells in the stomach lining. Early signs are often absent or unspecific, which is why gastric cancer is often discovered late

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Carcinoma can lead to constrictions at the stomach outlet

© W & B / Dr. Ulrike Möhle

Definition: what is stomach cancer?

Tumors of the stomach that originate in the lining of the stomach are usually referred to as "stomach cancer". Since these gastric carcinomas usually originate from the glandular cells of the gastric mucosa, they belong to the so-called adenocarcinomas.

In addition to classic gastric carcinomas, other types of tumors can also occur in the stomach, for example:

  • Leiomyosarcomas, which are derived from the muscle tissue in the stomach wall
  • Gastrointestinal stromal tumors (GIST), a group of soft tissue tumors
  • MALT lymphomas, which are a malignant disease of the lymph tissue

This text is limited to the classic gastric carcinoma that originates in the gastric mucosa.

Stomach cancer is one of the few types of cancer whose incidence in Western countries has decreased in recent decades. Some scientists attribute this to the refrigerators and freezers and the resulting reduced consumption of meat preserved by salting, curing or smoking (more on this in the "Causes" section).

Nevertheless, stomach cancer is still widespread in Germany. Around 15,000 new cases occur in this country every year. The mean age of onset is around 72 for men and 75 for women. Men are affected slightly more often than women.

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Symptoms: what are the signs of stomach cancer?

In the early stages, stomach cancer causes few or no symptoms. The disease is therefore often only discovered when the tumor has progressed beyond this stage at which the healing successes are greatest. If the tumor is no longer operable, the chances of recovery are poor.
If symptoms occur, these are often very unspecific and do not necessarily suggest stomach cancer, for example:

  • difficulties swallowing
  • frequent vomiting
  • Loss of appetite
  • unclear weight loss
  • Blood in stool, stool black in color
  • unclear anemia

Therefore, if you have repeated complaints in the upper abdominal area, consult a doctor to be on the safe side. He can clarify the cause.

Most important risk factor for stomach cancer: the bacterium Helicobacter pylori

© iStock / Axel Kock

Causes and Risk Factors

In its genetic material, every cell in the body contains instructions as to which tasks to fulfill and when to divide. It also stipulates the circumstances under which she has to commit "suicide", for example when she is advanced in age, certain genetic changes or impaired function. In this context, one speaks of so-called programmed cell death (apoptosis).
However, some cells change in such a way that this protective mechanism no longer works properly for them. As a rule, such a cell dies after a while. It seldom happens that it completely eludes the other control mechanisms of the body and divides uncontrollably at short intervals. A tumor develops. The degeneration of cells and thus the development of cancer - for example in the stomach - can be promoted by certain risk factors.

Risk factors for stomach cancer include:

  • Helicobacter pylori infection
  • Smoke
  • excessive alcohol consumption
  • frequent consumption of heavily salted, cured, smoked or heavily grilled foods
  • Stomach cancer in parents, siblings, or children
  • previous gastric surgery
  • pernicious anemia
  • certain hereditary predispositions for cancer (carcinoma predisposition syndromes) such as the predisposition for so-called hereditary diffuse gastric carcinoma (HDGC) or hereditary nonpolypous colorectal carcinoma (HNPCC)
  • older age

HDGC carriers and HNPCC patients have an increased risk of gastric cancer compared to the general population. They have regular gastroscopy to detect stomach cancer at an early stage.

The most important risk factor for gastric cancer is infection with the bacterium Helicobacter pylori. Helicobacter pylori occurs in every second person worldwide; 48 percent of adults are also affected in Germany. Helicobacter pylori causes a type of stomach inflammation called type B gastritis. Chronic inflammation can promote the development of tumors. In addition, the bacterium is the causative factor for the majority of all gastric ulcers.

An inflammation of the gastric mucosa caused by the bacterium Helicobacter pylori can now be reliably treated with medication. This is not only recommended because of the symptoms caused by gastritis, but also because of the increased risk of gastric cancer.

diagnosis

If the doctor suspects a stomach disease, he will ask the patient about his symptoms and eating habits. Then he examines him. Among other things, he looks for swollen lymph nodes and a lump in the abdominal area.

In order to diagnose a stomach disease, however, it is usually necessary to look into the organ. A gastroscopy makes this possible. The patient swallows a kind of tube that the doctor pushes from the mouth through the esophagus and into the stomach. This tube-like device is equipped with a light source and a small video camera at the front end, so that the inner wall of the stomach can be examined on a monitor. With the help of small pliers, the doctor can take tissue samples, which can later be used to detect or rule out, for example, inflammation, Helicobacter pylori infestation, but also stomach cancer.