Mayo Clinic
Exact cause of stomach cancer not known, though a
number of factors can increase risk
DEAR MAYO CLINIC: My mother
was diagnosed with stomach cancer
and has begun chemotherapy. Her doctors say she may need surgery, too. I
know this type of cancer is rare, but
what are the survival rates for those
who do get it? What causes it?
ANSWER: Although it greatly depends
on the individual situation, overall the
outlook for people diagnosed with
stomach cancer is often good after
treatment, especially when it is caught
early. The exact cause of stomach cancer is not known. However, a number
of factors can raise a person’s risk for
this cancer, including diet, family history and other medical conditions.
In the United States, stomach cancer
used to be much more common than it
is today. The number of stomach cancer
cases has dropped dramatically within
the past few decades, and now it is rare
in this country. Stomach cancer is still
common, however, in other parts of the
world, particularly Japan.
There’s a strong correlation between a
diet high in smoked, salted and pickled
foods and stomach cancer. Other risk
factors include smoking, a diet low in
fruits and vegetables and eating foods
contaminated with aflatoxin-producing
fungus. People who have had a bacterial infection with Helicobacter pylori
also are at a slightly increased risk.
A variety of medical conditions may
raise the risk of stomach cancer, too,
including stomach polyps; an infection
that involves long-term inflammation
of the stomach known as chronic gastritis; and vitamin B12 deficiency due
to pernicious anemia. In addition, some
genetic mutations that run in families
can predispose a person to stomach
cancer.
There are several kinds of stomach
cancer. The one that makes up the vast
majority of cases is adenocarcinoma stomach cancer that begins in the glandular cells. These glandular cells line
the inside of the stomach and secrete
a protective layer of mucus to shield
the lining of the stomach from acidic
digestive juices.
If the cancer has not spread outside the
stomach, a typical treatment approach
includes chemotherapy followed by
surgery to remove the tumor. In many
cases, chemotherapy after surgery is
recommended, as well.
Research has shown that this approach
of using chemotherapy before and after
surgery is associated with improved
survival when compared to just surgery
alone. That’s because with stomach
cancer, some tiny cancer cells that may
be difficult for a surgeon to see can be
effectively eliminated by chemotherapy. Chemotherapy before the surgery
also is helpful because it can shrink the
tumor, making surgical removal easier.
Chemotherapy drugs used for stomach
cancer have improved a great deal in
the past 15 to 20 years. Before that, not
many chemotherapy agents existed that
were proven to be effective in treating
stomach cancer. But stomach cancer is
usually quite responsive to many of the
newer drugs. With the choices available now, doctors are often able to pick
a chemotherapy drug that is aggressive
against the cancer while minimizing
side effects such as nausea, vomiting,
weakness and hair loss.
After surgery to remove the cancer and
follow-up chemotherapy, your mother
will likely have checkup appointments
periodically for several years to make
sure the cancer is gone. But for now,
if she hasn’t already done so, it may
be helpful for her to have a conversation with her oncologist to discuss her
overall treatment plan. That will give
her a chance to ask questions and better understand the long-term outlook
for her specific situation. - Robert
McWilliams, M.D., Medical Oncology,
Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is
an educational resource and doesn’t
replace regular medical care. E-mail
a question to medicaledge(AT SIGN)
mayo.edu. For more information, visit
www.mayoclinic.org.)
(c) 2014 MAYO FOUNDATION
FOR MEDICAL EDUCATION AND
RESEARCH. TRIBUNE CONTENT
AGENCY.
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