How a Healthier Lifestyle Can Help Reduce Your Risk of Stomach Cancer.

In 2023, stomach cancer, also called gastric cancer, accounted for about 1.4% of newly diagnosed cancer cases in the U.S., with an estimated 26,500 new cases diagnosed. Globally, it represents the 5th most commonly diagnosed cancer.  The rates of new cases of stomach cancer in the U.S. has been falling by about 1.2% per year over the last decade, but not equally for everyone. 

The number of people younger than 50 diagnosed with stomach cancer increased by about 3% between 2004 and 2015, despite the downward trend in overall cases.  

Stomach cancer is also more common in Hispanic, Black, and Asian/Pacific Islander Americans than whites.  In addition, men are almost twice as likely as women to be diagnosed with stomach cancer—a fact that was underscored by the recent death of 62-year-old country music star Toby Keith, who had been diagnosed with stomach cancer in 2021.

Almost 27,000 new cases of stomach cancer are diagnosed in the U.S. each year, and about 11,000 people die from the disease. Spotting cancer early offers a better chance for a successful outcome. 

MedStar Health offers the latest stomach cancer screening and diagnostic technology. Our patients have access to the most effective treatments for stomach cancer, including advanced surgery, immunotherapy, chemotherapy, and radiation therapy. 

While some cases are associated with family history, some risk factors are within your control. Let’s discuss how to spot the signs of gastric cancer and what you can do to reduce your risk.

Symptoms of stomach cancer.

Early in the disease, stomach cancer often doesn’t cause noticeable symptoms. When symptoms are present, they could include:

• Bloated feeling after eating
• Heartburn
• Decreased appetite 
• Nausea
• Stomach discomfort and indigestion

More advanced stomach cancer can include those symptoms and:

• Bloody stool (poop) that looks black or tarry
• Vomiting blood 
• Difficulty swallowing
• Jaundice (yellow eyes and skin)
• Stomach pain 
• Unexplained weight loss
• Fatigue

Talk with your doctor if you notice changes in your bowel habits or signs of stomach cancer—you have the best chance at good outcomes when cancer is diagnosed in the early stages.

Risk factors for stomach cancer.

Stomach cancer is caused by chronic inflammation or genetic mutational changes in the stomach lining. This results in abnormal cells that can become cancer over time. Some of the reasons this happens are out of a person’s control, including:

• H. pylori infection: This common bacterium infects the stomach lining and can increase the likelihood of cancer. While some infections can present with heartburn symptoms, many infections do not cause symptoms, but some patients develop atrophic gastritis, which can lead to severe changes in the stomach lining and, eventually, cancer.
• Other medical conditions: Obesity, gastroesophageal reflux disease (GERD), pernicious anemia, and some types of inflammation of the stomach lining (gastritis) can all increase your risk.
• Family history: The risk of stomach cancer is higher in people who have relatives who have had stomach cancer or family cancer syndromes such as hereditary diffuse gastric cancer syndrome, Lynch syndrome, juvenile polyposis syndrome, familial adenomatous polyposis, and Peutz-Jeghers syndrome.
• Environmental exposures: People who have been exposed to high levels of radiation or who work in the rubber or coal industries are at higher risk of stomach cancer.

There are stomach cancer risk factors that you can control. To stay your healthiest, consider your:

• Body weight and exercise: Excessive body weight/obesity can increase your risk for cancer
• Diet: Eating lots of foods that are high in salt, smoked, or poorly preserved can increase your risk. So can eating too few fruits and vegetables. 
• Tobacco use: People who don’t use tobacco have a lower risk of stomach (and other) cancers than people who do. 
• Alcohol use: Excessive alcohol use can increase your risk of stomach inflammation and cancer.

Related reading: 5 Myths About Gastrointestinal Cancer Debunked.

Diagnosis and treatment of stomach cancer.

Diagnosis and treatment starts with a biopsy and staging diagnostics to understand the if and how much the disease has spread. After an in-depth conversation about your family history and a physical exam, your gastroenterologist may perform exams such as:

• Endoscopy with biopsy: A thin camera with a special light is placed in your stomach to locate the tumor and remove cells to be examined in the lab for cancer. 
• Endoscopic ultrasound: A specialized test to learn specifics about the local spread of cancer through the stomach wall and to nearby lymph nodes. 
• CT scan: Your doctor will check to see if cancer has spread with these computerized pictures of your organs.
• PET scan: Sometimes your doctor will use this test to help identify additional sites of cancer.
• Diagnostic laparoscopy: Sometimes a surgeon will make an incision and insert a specialized camera into your abdomen to look for small amounts of cancer that may have spread that a CT scan or PET scan may not pick up.

Some very early stomach cancers that are small and at the earliest stages can be cured with endoscopic resection, a procedure to cut out the tumor.

In this outpatient procedure, a gastroenterologist inserts an instrument through your mouth and into the stomach to see and cut out the tumor and some surrounding tissue, leaving most of the stomach otherwise intact. 

If cancer is confined to the stomach but more advanced locally, a partial or total gastrectomy—surgery to remove part or all of the stomach and nearby lymph nodes—may be recommended instead. 

In some cases where the cancer is locally advanced but has not spread to other organs, chemotherapy, and sometimes immunotherapy, before and after surgery can improve outcomes for many patients. Before surgery, chemotherapy shrinks the tumor. Afterwards, it can help prevent the stomach cancer from coming back. 

For cancers in some parts of the stomach, radiation combined with chemotherapy before surgery therapy has been shown to be effective. Radiation therapy uses intense energy beams or particles to kill cancer cells. MedStar Health offers state-of-the-art radiation technology to deliver precise radiation while preserving healthy tissue and organs.

Often, patients who have gastrectomy surgery will need to make changes to their diet before and after the procedure. Meeting with a dietitian and a social worker can help you learn what to expect and what resources are available to you. After surgery, our dietitian will continue to provide support as you make changes to your eating habits, like smaller, more frequent meals. We’ll monitor your progress and make sure the cancer isn’t coming back.

If the cancer has spread to other organs outside of the stomach, we use treatments like chemotherapy and targeted therapy to shrink and control cancer to improve symptoms, quality of life, and survival.  Molecular profiling of your tumor is especially important in these advanced stages. By understanding individual tumors on a molecular level, we can recommend treatments that are designed to target each tumor’s biomarkers—a process of seek and elimination. 

For example, your doctor may recommend the addition of immunotherapy, drugs that unmask cancer from your body’s immune system, or other targeted therapies based on molecular test results. These drugs can be used alone or in combination with chemotherapy depending upon each cancer’s biomarkers, stage, location, and size. Our team has clinical trials looking at new combinations of targeted therapies and treatment modalities in patients with advanced disease.

Tips to reduce your risk of stomach cancer.

Building and maintaining healthy habits can lower your chances of developing gastric cancer:

• Discuss symptoms with your doctor: Keep an eye out for heart burn, bloating, and chest/abdomen pain.
• Drink less: Avoid excessive alcohol consumption.
• Eat a balanced diet: Reduce your intake of salty, highly processed foods and increase how much fresh foods and vegetables you eat.
• Get exercise: At least 30 minutes per day, five days per week. 
• Quit smoking: Ask your doctor if you need help.