Aravind Sanjeevaiah, M.D. Answers Questions On: Stomach Cancer

With about 22,000 people diagnosed each year, stomach cancer – also called gastric cancer – is relatively uncommon in the mainland U.S. For reasons we don’t yet understand, stomach cancer is much more prevalent in Alaska and countries such as Japan and Korea.

Although there are many theories, we don’t fully understand why some people get gastric cancer. We do know that age and smoking are risk factors. About 60 percent of people diagnosed with stomach cancer are 65 and older, and smokers have a 40 percent greater chance of developing the disease than non-smokers. In addition, men are about 70 percent more likely to develop gastric cancer than women.

Genetic factors play a minor role in this disease. Approximately 10 percent of gastric cancer cases show familial clustering, but only 1 to 3 percent of gastric carcinomas arise as a result of inherited gastric cancer predisposition syndromes.

Dietary factors – eating smoked meats, for example – and a bacteria called Helicobacter pylori (H. pylori) have been implicated in increasing the risk of gastric cancer, but haven’t been definitively proven.

People with gastric cancer may experience early satiety – the feeling of being full after eating very little – which may lead to poor appetite and weight loss. Black stools, which indicate bleeding in the stomach, may be another symptom. In more advanced stages, patients may experience abdominal discomfort, pain, or swelling.

We typically treat gastric cancer with a combination of chemotherapy, surgery, and/or radiation therapy. The treatments we use and the order in which we use them depends upon the stage, location, and size of the cancer, as well as a patient’s overall health, preferences, and goals.

Immunotherapies for treating gastrointestinal cancers hold a lot of promise for the future. There are currently a number of clinical trials evaluating the use of immunotherapy drugs in gastric cancer, including some at UT Southwestern. The initial results from the immunotherapy trials have been very promising, and this might change GI cancer care over the next decade.