What is gastric cancer?

Gastric (stomach) cancer, is a disease in which stomach cells become cancerous and grow out of control, eventually forming a tumour. Although it is often referred to as stomach cancer, it can involve tumours that occur in the oesophagus (the tube that runs from your mouth to your stomach) as well. Because of this it is sometimes referred to as oesophagogastric cancer.

Gastric cancer is the second-leading cause of cancer deaths in the world, and around 350 New Zealanders will be diagnosed with it each year. It is more common in people over the age of 55 years and affects twice as many men as women.

Diagnosing gastric and oesophageal cancers

These types of cancers can be very difficult to detect and diagnose, as there are few symptoms in the early stages.

Most diagnoses are made at an advanced stage, where symptoms include:

• Discomfort in the upper or middle part of the abdomen
• Difficulty swallowing
• Blood in the stools (which appear as black, tarry stools)
• Vomiting or vomiting blood
• Sudden weight loss
• Pain or bloating in the stomach after eating
• Weakness or fatigue associated with anaemia (a deficiency in red blood cells)
• Early satiety (become full with small amounts of food)

Note: These symptoms may not necessarily be indicative of gastric and oesophageal cancer and you should seek medical advice for more definitive diagnostic tests as outlined below.

If the doctor is concerned that these symptoms are related to cancer they will recommend any one or combination of tests, these can include:

• Faecal occult blood test – used to detect blood in the stool, which may indicate stomach or other gastrointestinal (GI) cancers (e.g. colorectal cancer)
• Complete blood count (CBC) - a simple blood test used to measure the number of white blood cells, red blood cells, and platelets
• Upper GI series/barium swallow – patient drinks a thick, chalky liquid (barium) that coats the oesophagus and stomach and makes it easier to find abnormal areas on x-ray
• Gastroscopy a doctor inserts a thin tube that contains a camera (called a gastroscope) through the mouth and oesophagus and into the stomach.
• CT scan, ultrasound, and positron emission tomography (PET) scan – imaging tests similar to X-rays

Treatment for gastric and oesophageal cancer

Treatment options depend on a number of factors including the size, location and extent of the tumour, the stage of the disease as well as the general health and age of the patient. The treatments can be any combination of:

Surgery

The type of surgery depends on the extent of the disease. Resection may be used to treat early stomach cancer and this involves removing only the tumour and surrounding tissue. However, the most common treatment for stomach cancer is a Gastrectomy. In this surgery, the entire stomach or part of the stomach is removed.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells.