Stomach cancer

Stomach cancer (also called gastric cancer) starts in the stomach. There are a few types, but almost all cases are adenocarcinomas of the stomach, tumors that develop from the cells that form the mucosa, the innermost lining of the stomach.

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Stomach cancer: learn more

Symptoms, risk factors, FAQs Diagnosis and staging Treatment and recovery

Overview

Most people use the word “stomach” to refer to the body below the chest and above the pelvis. The medical word for this area, though, is “abdomen.” What you might call a stomachache, doctors call abdominal pain because the stomach is only one of many organs in the abdomen, including the small intestine, large intestine or colon, and pancreas.

Stomach cancer should not be confused with other cancers that can occur in the abdomen—these cancers have different symptoms, different outlooks, and different treatments.

The stomach

The stomach is a sac-like organ that holds food and starts to digest it by secreting gastric juice. The food and gastric juice are mixed and then emptied into the first part of the small intestine called the duodenum.

The stomach has five parts:

  • Cardia. The part closest to the esophagus, where chewed food comes from the mouth through the chest.
  • Fundus. The upper part of the stomach next to the cardia.
  • Body or corpus. The main part of the stomach, between the upper and lower parts.
  • Antrum. The lower portion near the small intestine, where food mixes with gastric juice.
  • Pylorus. The last part of the stomach, which acts as a valve to control emptying of the stomach contents into the small intestine.

The stomach wall has five layers, which are important in determining the stage of stomach cancer, plus treatment and prognosis:

  • Mucosa. The innermost layer, where stomach acid and digestive enzymes are made. Most stomach cancers start in this layer.
  • Submucosa. A supporting layer.
  • Muscularis propria. A thick layer of muscle that moves and mixes the stomach contents.
  • Subserosa. One of two outer layers that wrap the stomach.
  • Outermost serosa. The other outer layer.

Stomach cancer occurs when cells in these layers—most often the mucosa—begin growing out of control. This happens because of genetic mutations in these cells. We still don’t know the exact cause of stomach cancer, but research has identified several risk factors, including a stomach infection from the H. pylori bacteria.

As a cancer grows from the mucosa into deeper layers, the stage becomes more advanced. Stomach cancers typically develop slowly over many years. Before a true cancer develops, pre-cancerous changes often occur in the mucosa—these early changes rarely cause symptoms and often go undetected.

Types of stomach cancer

Adenocarcinomas. About 90% to 95% cancers of the stomach are adenocarcinomas. These cancers develop from the mucosa, the mucus-producing cells that line the stomach.

Lymphomas. These are cancers of the immune system tissue that are sometimes found in the wall of the stomach. The treatment and outlook depend on the type of lymphoma.

Gastrointestinal stromal tumor (GIST). These rare tumors start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal. Some of these tumors are non-cancerous. Although GISTs can be found anywhere in the digestive tract, most are found in the stomach.

Carcinoid tumor. These tumors start in hormone-making cells of the stomach. Most of these tumors do not spread to other organs.

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