Gastric Cancer

What is Gastric Cancer?

Gastric cancer is the second cause of cancer deaths behind lung cancer with most tumors being
adenocarcinomas. Most cases of gastric cancer are linked to an infectious cause but have also
been linked to environmental factors.

What causes gastric cancer?

The cause of gastric cancer is considered multifactorial with the primary cause being infectious
with the bacteria Helicobacter pylori. The bacteria cause an immune response that affects the
gastric tissue leading to gastritis, which can lead to precancerous change in the host. Another
infectious cause that has been found to be associated with gastric cancer but to a lesser extent
is a virus known as Ebstein-Barr virus. Furthermore, environmental factors also are known to
increase the risk of gastric cancer which consist of tobacco use, high dietary salt consumption
and processed meat consumption.

What are symptoms of gastric cancer?

- Weight loss
- Persistent abdominal pain
- Difficulty swallowing
- Nausea
- Early fullness following meals
- Gastrointestinal bleeding
- Abdominal mass
- Dark pigmented patches on skin folds

How is gastric cancer diagnosed?

The diagnosis may be suspected in patients presenting with weight loss, history of gastric ulcer,
or abdominal pain warranting an upper endoscopy procedure to biopsy and examine the gastric
tissue. Radiographic imaging may also be used to assist in diagnosis (e.g. abdominal computed
tomography (CT)).

How is gastric cancer managed?

If diagnosed early, antibiotic therapy is started to treat infection of H. pylori, endoscopic resection and a surgery known as gastrectomy may also be considered depending on if the criteria are met by the patient. However, the goal is to alleviate symptoms and improve survival with the use of chemotherapy and immunotherapy if the cancer is diagnosed late in the disease course.

References
Correa P. Gastric cancer: overview. Gastroenterol Clin North Am. 2013 Jun;42(2):211- 7. doi: 10.1016/j.gtc.2013.01.002. Epub 2013 Feb 21. PMID: 23639637; PMCID: PMC3995345.


Mansfield P. Clinical features, diagnosis, and staging of gastric cancer. In: Savarese D, Grover S, ed. UpToDate. UpToDate; 2021. Accessed October 10, 2021. https://www.uptodate.com/contents/clinical-features-diagnosis-and-staging-of-gastric- cancer


Morgan D. Early gastric cancer: Treatment, natural history, and prognosis. In: Robson K, Savarese D, ed. UpToDate. UpToDate; 2021. Accessed October 11, 2021. https://www.uptodate.com/contents/early-gastric-cancer-treatment-natural-history-and- prognosis