Dr Deepak Varma Gastro Surgeon Cochin

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Stomach Cancer

When abnormal cells come together to form a tumour in any part of the stomach, it is known as stomach cancer. Also known as gastric cancer, malignant and cancerous mucous-secreting cells develop inside the lining of the stomach causing adenocarcinoma. Stomach cancers are the second most-common cause of cancer around the world. The disease is common among the male population and developing nations. Stomach cancer develops gradually over the years. Tumours in different parts of the stomach metastasize in a variety of ways and reveal various symptoms.

Types Of Stomach Cancer

  • Adenocarcinoma: Most cancers are adenocarcinoma of the stomach. This kind of stomach cancer develops in the mucosal cells of the innermost lining of the stomach.
  • GIST or gastrointestinal stromal tumour: Cancer develops in the muscle or connective tissues in the wall of the stomach also known as interstitial cells of Cajal. GIST can also affect other parts of the digestive tract as well.
  • Lymphoma: Stomach lymphomas account for at least 4% of all stomach cancers.
  • Neuroendocrine tumours: Cancers that develop from the neuroendocrine cell nests are called Neuroendocrine tumors. They are hormone producing tumors which in late stages of its growth can cause systemic symptoms due the secreted hormones. They are also known as carcinoid tumours, this type of cancer is very rare.
  • Others: There are several other types of cancer such as sarcoma, small cell carcinoma and squamous cell carcinoma which are all rare tumors.

Causes And Risk Factors

The cause of stomach cancer is mostly attributed to flaws in lifestyle. Other risk factors are prior diseases and situations that are progressive risk factors to the development of stomach cancer. Some causes and risk factor of stomach cancer are:

  • Preexisting medical conditions such as GERD, oesophagitis, Barrett s syndrome, stomach polyps, peptic stomach ulcer, etc.
  • H.Pylori infection can cause stomach infections and ulcers leading to cancer
  • Smoking
  • Family history and genetics
  • Irregular diet such as eating excessive pickled foods, salted fish, smoked meats, etc.
  • Aflatoxin fungus present in foods such as groundnuts, cocoa beans, dried foods, etc.
  • Atrophic gastritis
  • Surgical procedures inclusive of partial gastrectomy

Signs And Symptoms

  • Loss of appetite is the most common symptom
  • Vomiting or passing blood
  • Bloating after meals
  • Heartburn
  • Indigestion with weight loss or anaemia
  • Black, tarry stools
  • Fatigue

Tests And Diagnosis

  • CBC with chemistry profile
  • Electrolyte panels
  • Oesophagogastroduodenoscopy (endoscopy) is best diagnostic modality
  • CT scan / MRI
  • Endoscopic ultrasound
  • Staging of the cancer is done with CT scan / PET scan.


The mainstay of treatment of gastric cancer is surgery and removal of part or whole of the stomach along with the nearby lymph nodes and omentum. A proper surgical removal is essential and is the most important determinant factor for long-term survival. Early-stage removal of the cancer is conducted with an endoscopy to resect small tumours. Neoadjuvant chemo-radiation therapy may be administered before the surgery followed by adjuvant radiation and chemotherapy after the surgery in advanced stomach cancers.

For more than two decades now, we have conducted several therapeutic operations for stomach cancer. We have worked relentlessly to restore and recuperate lifestyles of people suffering from stomach cancer.

Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)

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