Overview
Gastric cancers develop from the stomach lining and are most often adenocarcinomas. Other types can include lymphomas and neuroendocrine tumours.
Risk Factors
- Helicobacter pylori
- Due to causing inflammation resulting in atrophy and metaplasia
- Pernicious anaemia
- Atrophic gastritis
- Smoking
- Family history
- Foods rich in salts and nitrates, and salt-preserved foods
Presentation
Patients initially may present with epigastric and vague abdominal pain and weight loss. Other features include:
- Anorexia
- Nausea and vomiting
- Anaemia
- Dysphagia
- May occur if cancer emerges in the proximal stomach
- Lymphadenopathy:
- Left supraclavicular node (Virchow’s node)
- Periumbilical node (Sister Mary Joseph’s node)
Investigations
Referral
- See Dyspepsia for referral steps
Overview
- Upper gastrointestinal endoscopy with biopsy:
- May show signet ring cells
- CT scan:
- Used for staging
Management
Management may involve surgery, such as endoscopic resection, partial or total gastrectomy, and chemotherapy.
Prognosis
In the UK, around 20 out of 100 people survive their cancer for 5 years or more
