Stomach cancer is cancer arising from the lining of the stomach, it can arise near the junction of the oesophagus and stomach and if it crosses to this junction are called gastro-oesophageal or cardio-oesophageal junction cancers.
About 1900 new cases of stomach cancer are diagnosed each year and the incidence is gradually decreasing due to treatment of Helicobacter Pylori, changes in diet and reduction in smoking.
What are the causes of Stomach Cancer?
One of the strongest risk factors for developing stomach cancer is infection with Helicobacter pylori which is a bacteria infection of the stomach that can cause stomach ulcers and irritation. Treatment of this infection, if found, can reduce the risk of stomach cancer.
Other factors associated with higher risks of stomach cancer includes diets low in fruit and vegetables, a high intake of cured or pickled foods and eating heavily grilled or barbecued meats (charcoaled/burnt areas).
High salt intake has also been associated with an increased risk of developing stomach cancer.
Certain countries have much higher rates of stomach cancer including people from Japan, Korea, China, Chile and Russia.
Some stomach cancer (<5% overall) are associated with certain genetic conditions such as hereditary nonpolyposis colorectal cancer syndrome.
Screening with gastroscopies can potentially detect early cancers in countries with high rates of this cancer (e.g. Japan).
What Are the symptoms of Stomach Cancer?
Stomach cancer may not cause symptoms until the cancer is more advanced.
Symptoms are usually quite generalised and can include unexplained weight loss, loss of appetite, upper abdominal pain or vomiting.
Some people will present with bright red blood or “coffee ground” vomit which is the blood that has been altered by the stomach, problems with swallowing or food getting stuck can also occur particularly with cancers that involve the oesophagus.
What Are the treatments for Stomach Cancer?
The main curative treatment for stomach cancer is the surgical removal of the stomach and surrounding lymph nodes that the cancer can spread to. For patients with “early” stage cancers surgery may be the only treatment they require.
For more advanced cancers, (e.g. spread through the whole thickness of the stomach wall or spread to lymph nodes), but have not spread to other organs, then chemotherapy before and after surgery to improve the chance of cure is often utilised.
Radiation therapy combined with chemotherapy can be given to some patients following surgery if there are features that have a higher risk of recurrence of the cancer in that area (e.g. a cancer reaches the edges of the surgical operative cuts).
Radiation therapy with chemotherapy is sometimes used to help control the tumour and re-strain its growth if surgery is not possible.
Radiation therapy is usually delivered to the stomach and surrounding lymph node areas.
What Are the side effects of Radiation Therapy?
Treatments of stomach cancers may require a multi-modality approach with surgery, chemotherapy and radiation therapy. Each treatment has its own side effects and sometimes the side effects of radiation therapy can worsen side effects from the other treatments.
Side effects of radiation therapy are described as acute or late.
Acute side effects are those that happen during and within a few weeks after treatment. They are usually more temporary and tend to resolve, although this is not always the case. Sometimes severe acute side effects can result in late effects.
Late side effects are side effects that can occur 3 months after completing radiotherapy. Late side effects are less common. They may not show themselves during or immediately after radiation therapy but occur later on. The risk with late side effects is that they could be permanent or irreversible and become a more long term situation.
A recent report on the Intergroup 0116 trial comparing surgery alone to surgery and chemo-radiation therapy showed no significant increase in long term side effects from chemo-radiation therapy.
www.eviq.org.au is a resource for patients written by oncologists that provides detailed information on side effects.
Acute side effects
- Nausea and vomiting – sometimes patient need to be admitted for hydration intravenously
- Loss of appetite
- Loss of taste
- Trouble swallowing
- Painful swallowing
- Loss of weight
- Skin reaction
- Rarely – irritation of the food pipe or stomach that can cause bleeding
Some patients cannot get enough nutrition while the above side effects occur and occasionally need a feeding tube either via the nose (naso-gastric tube) or stomach (gastrostomy tube) to support them while they are having treatment.
Late side effects
- Inflammation or scarring on the lungs that can cause cough and shortness of breath
- Inflammation of the covering of the heart (called the pericardium)
- Inflammation of the liver or deterioration in the function of the liver
- Deterioration in the function of the kidney – this is uncommon
- Narrowing of the food pipe, causing trouble swallowing
- Ulceration of the food pipe or stomach that can cause bleeding too
- Narrowing or ulceration (can cause bleeding) of the small or large bowel
- Very rare – another tumour in years to come as a result of the radiation therapy
The best person to discuss radiation therapy for stomach cancer with is a radiation oncologist. You can ask your Surgeon or General Practitioner for a referral to a Radiation Oncologist for a discussion about whether radiation therapy is a suitable treatment option for you.
Find your closest radiation oncology Treatment Centre
Page last updated: 28/10/2020