Most stomach cancers are adenocarcinomas, which develop in the cells of the stomach’s inner lining. However, stomach cancer can develop anywhere in the organ.
Stomach anatomy
Many times, people refer to the abdomen, the area between the hips and chest, as the stomach. But in medical terms, the word stomach refers only to the organ.
The stomach sits in the upper abdomen. After you chew and swallow food, it moves through a hollow tube called the esophagus into the stomach. The stomach mixes the food with gastric juices and begins digestion of the food.
The lining of the stomach has three main layers:
- Mucosal (inner)
- Muscularis (middle)
- Serosal (outer)
Generally, adenocarcinoma stomach cancer starts when cells in the mucosal layer change. Sometimes these changes develop into cancer, but most times they do not.
The other types of cancer found in the stomach are considered rare. They include:
- Lymphoma, which affects a body’s immune system
- Gastrointestinal stromal tumors, often called GIST or gastric sarcomas
- Carcinoid tumors, which affect the hormone-producing cells of the stomach
Stomach cancer statistics, survival rates
According to the National Cancer Institute, about 26,200 new cases of stomach cancer will be diagnosed in 2018. More than 60% of these will are for people age 65 or over, with the median age of diagnoses at 68. The five year survival rate for the disease is 31%.
Stomach cancer, also called gastric cancer, has become much less common in the United States and Europe over the past 60 years. While the rates of stomach cancer in general are declining, cancers in the area of the stomach near where it joins the esophagus are increasing.
While stomach cancer is becoming less common in this country, it is the second leading cause of cancer death in much of the rest of the world, especially Japan, Eastern Europe, South America and parts of the Middle East. This may be due to differences in diet, the rate of infection with Helicobacter pylori (a type of bacteria) and the environment.
Stomach cancer risk factors
Although the exact cause of stomach cancer is not known, certain factors seem to increase your risk of developing the disease. These include:
- Eating foods preserved through pickling, salting and drying or that contain nitrates
- Eating foods that have not been stored or prepared correctly
- Obesity: Men who are obese have a higher risk of cancer in the part of the stomach nearest the esophagus.
- Infection with Helicobacter pylori: This type of bacteria, or germ, is a common cause of ulcers and may cause chronic inflammation in the stomach lining. This sometimes develops into pre-cancerous changes and cancer.
- Tobacco and alcohol abuse: Smoking and drinking excessive amounts of alcohol appear to increase the likelihood of cancer in the upper part of the stomach. Some studies have shown that smoking doubles the risk of stomach cancer.
Family history. If close relatives have any of the following conditions, you may be at a higher risk of stomach cancer:
- Stomach cancer
- Hereditary non-polyposis colon cancer (HNPCC)
- Li-Fraumeni syndrome
Having any of the following medical conditions:
- Pernicious anemia
- Chronic stomach inflammation and intestinal polyps
- Menetrier disease
- Epstein-Barr virus
- Acid reflux or chronic indigestion
- Stomach lymphoma
- Type A blood
- Prior stomach surgery
Other factors include:
- Gender: The majority of stomach cancer patients are male.
- Age: Most individuals who develop stomach cancer are older than 55.
- Ethnicity: In the United States, stomach cancer occurs more often in Hispanic Americans and African Americans than in non-Hispanic whites. It is found most in Asian/Pacific Islanders.
- Working in the rubber, metal, coal and timber industries, as well as those who have been exposed to asbestos fibers, have a higher risk for stomach cancer
- Geography: More people in Japan, China, Southern and Eastern Europe, and Central and South America develop stomach cancer than those in Northern and Western Africa, South Central Asia and North America.
Not everyone with risk factors gets stomach cancer. However, if you have risk factors, you should discuss them with your doctor.
Learn more about stomach cancer:
Behavioral and lifestyle changes can help prevent stomach cancer. Visit our prevention and screening section to learn how to manage your risk.
In rare cases, stomach cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
Why choose MD Anderson for stomach cancer treatment?
When you receive treatment for stomach cancer at MD Anderson's Gastrointestinal Center, you are the focus of some of the world's leading experts. They discuss your case at every juncture, planning together to ensure you receive personalized care that ensures the most advanced treatments with the least impact on your body.
Your personal team of experts may include oncologists, surgeons and radiation oncologists, as well as specially trained nutritionists, nurses and others. They provide complete yet specialized stomach cancer treatment that is designed to provide optimum results and recovery. Stomach cancer can have a marked impact on your life, and our experts guide you every step of the way to help you cope and adjust.
World-class Surgeons
Stomach cancer surgery often is challenging, and your highest chances for a successful outcome are with a surgeon who has a high degree of experience and skill in these highly specialized procedures. Because MD Anderson is one of the nation's most active cancer centers, our surgeons use the latest techniques to perform a large number of delicate stomach cancer surgeries each year, with outcomes higher than many other cancer centers.
With groundbreaking research, MD Anderson's physicians have pioneered many improvements in treating stomach cancer. We have led some of the largest international studies on chemotherapy for stomach cancer, and we continue to explore new, more-advanced treatments.
And at MD Anderson you're surrounded by the strength of one of the nation's largest and most experienced comprehensive cancer centers, which has all the support and wellness services needed to treat the whole person – not just the disease.
MD Anderson is a big organization, but it’s welcoming and it makes you feel safe. Help was always available.
Marne Shafer thought her running days were behind her after she received a total gastrectomy, a surgical removal of the stomach and nearby lymph nodes. She braced herself for the worst.
At age 33, the mother of two and experienced marathoner, learned she has a CDH1 gene mutation, which is associated with high-risk of a rare type of stomach cancer called hereditary diffuse gastric cancer, as well as lobular breast cancer.
Marne came to MD Anderson for genetic testing after several family members passed away from stomach cancer, including her father, grandmother and aunt. Since screening isn’t successful in identifying the disease in its early stages, the recommended treatment plan was for Marne to undergo the prophylactic total gastrectomy. But the surgery revealed she already had stage I cancer, which was removed during the procedure.
“It seems counterintuitive to feel in full health and then go out and get your stomach removed,” she says. “People ask, ‘how are you still alive?’”
Life without a stomach
While she had a feeding tube for nearly two months and worked hard to get enough nutrients post-surgery, Marne credits her quick recovery to the expert care provided by her surgeon, Paul Mansfield, M.D., in addition to her history of running.
“I thought I was supposed to still feel horrible two weeks after my surgery. I didn’t have a lot of strength, but I didn’t think I would feel that much better,” she says. “At the end of the day, Dr. Mansfield is just awesome. He is very personable in addition to being one of the best doctors in the world. He is extremely knowledgeable, and he put me at ease about the surgery.”
After her stomach removal, Marne resolved to help others facing similar situations. She started a blog, Life Without a Stomach, to share her experiences, including challenges with eating.
Because Marne’s esophagus is connected to her small intestine as a result of the gastrectomy, she can eat and swallow, but it’s a slower process. She focuses on eating several small meals packed with protein and nutrients. “It’s like a forced, healthy diet,” she says.
In addition to blogging, Shafer raises awareness and funds for stomach cancer research.
“I think I was meant to have this so I can help other people,” she says.
The stomachless runner
Marne’s return to running is another way that she’s inspiring others, including Dr. Mansfield. Just months after her gastrectomy, she began training for a half marathon in Houston. Three years later, on Jan. 15, 2017, she completed the full Chevron Houston Marathon, coming in just one minute shy of her 3:21 personal record.
“It felt doubly important to run a marathon without a stomach,” Marne says. “Look what you can do!”
Running the marathon wasn’t without its unique challenges. Marne experimented during training to see if her body could process sugar gels used by long-distance runners to boost energy. Throughout the race, she couldn’t gulp water or sports drinks to remain hydrated. Instead, she had to pinch the top of the cups and slowly sip while she ran.
She had never been so excited to cross a finish line.
“I had so many people supporting me because they knew what a milestone it was. Everyone has a meaning for the marathon. For me, not having a stomach is something that I deal with. Only through your trials do you understand your strength.”
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