Stomach and esophageal cancers

Food travels down the esophagus and into the stomach where it is mixed with stomach juices that help to digest food. Stomach cancer develops when cells in the lining of the stomach change and grow out of control.

If it is not found and treated early stomach cancer can spread to other parts of the body.

About 2,580 people are diagnosed with stomach cancer each year in United States. Men are almost twice as likely as women to be diagnosed with stomach cancer. It is more common in people over 60, but it can occur at any age.

Esophageal cancer begins when abnormal cells develop in the innermost layer of the esophagus. There are two types:

• esophageal adenocarcinoma which is most common in United States esophageal squamous cell carcinoma. If it is not found
• treated early
• esophageal cancer can spread to other parts of the body
• most commonly the liver

In United States, about 1740 people are diagnosed with esophageal cancer each year, with men much more likely to be diagnosed. Stomach and esophageal cancers may not cause symptoms in the early stages and the symptoms are usually common for other medical conditions. black-colored or bloody stools.

Black or bloody stools (poo).

Not everyone with these symptoms has stomach or esophageal cancer

If you have any of these symptoms or are worried, always see your doctor. There are some things that can make it more likely to develop stomach or esophageal cancer.

These are called risk factors

Lynch syndrome, gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) or hereditary diffuse gastric cancer (HDGC) Having one or more of these risk factors doesn’t mean you will develop stomach or esophageal cancer.

Often there is no clear reason for getting either cancer.

If you are worried about your risk factors, ask your doctor for advice

This allows the doctor to look inside your digestive tract to examine the lining. – during an endoscopy if the doctor sees any suspicious-looking areas they may remove a small amount of tissue from the stomach lining, known as a biopsy.

A pathologist will then examine the tissue under a microscope to check for signs of disease. (EUS) – a doctor passes an endoscope with an ultrasound probe on the end into your mouth, down your throat and esophagus, and into your stomach and small bowel. The ultrasound probe then uses sound waves that echo when they bounce off anything solid, such as an organ or tumor, helping to see if the cancer has spread.

CT scan combined with a PET scan, which provides more detail than a CT scan on its own and can also be used to determine if the cancer has spread to other parts of the body.

– a surgical procedure that allows your doctor to look inside your abdomen and examine the outer layer of your stomach and the lining of the wall of the abdomen for signs that the cancer has spread. The most common type of stomach cancer is adenocarcinoma of the stomach (also known as gastric cancer).

This cancer starts in the glandular tissue found on the stomach’s inner surface.

Other less common types of cancer can affect the stomach including small cell carcinomas, lymphomas, neuroendocrine tumors and gastrointestinal stromal tumors.

Your doctor will be able to explain more about these types of stomach cancer

There are two main types of esophageal cancer: This often starts near the gastro-esophageal junction and is linked with Barrett’s esophagus.

Adenocarcinomas are the most common form of esophageal cancer in United States. This starts in the thin, flat cells of the mucosa, which are called squamous cells. It often begins in the middle and upper part of the esophagus.

The stage of a cancer means how far it has grown in your body. The most common way doctors decide on a stage for stomach esophageal cancer is the TNM (tumor, nodes metastasis) staging system. The stages are based on the size of the tumor, whether or not lymph nodes are affected, and whether the cancer has spread: – describes early or limited cancer where tumors are found only in the stomach.

When someone is diagnosed with cancer, their doctor will give them a prognosis.

A prognosis is the doctor’s opinion of how likely it is that the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the person’s age and general health. Generally, the earlier stomach and esophageal cancer is diagnosed the better the chances of successful treatment.

If the cancer is found after it has spread from the stomach or esophagus, the prognosis is not usually as good. Your doctor will talk to you about your individual situation when working out your prognosis.

Every person’s experience is different, and there is support available to you

Treatment for stomach and esophageal cancer depends on the stage of the cancer, your age, medical history, nutritional needs and general health.

You might feel confused or unsure about your treatment options and decisions

It’s okay to ask your treatment team to explain the information to you more than once.

It’s often okay to take some time to think about your decisions. Very early-stage tumors that have not spread from the stomach or esophageal walls may be removed with a long, flexible tube (endoscope) that is passed down your throat and esophagus, and into your stomach.

For some people, this may be the only treatment they need

Surgery is the main treatment for stomach cancer that has not spread to other parts of the body. Surgery aims to remove all of the stomach cancer while keeping as much normal tissue as possible. There are 2 main types of surgery for stomach cancer: – this procedure removes all or part of the stomach, leaving as much healthy tissue as possible.

– this removes the lymph nodes around your stomach to reduce the risk of the cancer coming back and help in the staging. Surgery to remove part or all of the esophagus is called an esophagectomy (surgical resection).

Nearby affected lymph nodes are also removed

Depending on where in the esophagus the cancer is, the surgeon may also remove part of the upper stomach.

Surgery for esophageal cancer is complex

Surgeons who regularly perform this type of surgery have better outcomes, which means that if you live far from a specialist center, you will have to travel to have surgery. is the use of drugs to kill or slow the growth cancer cells. For stomach or esophageal cancer, chemotherapy may be given before surgery to shrink large tumors and destroy any cancer cells that may have spread.

It may also be used after surgery to reduce the chance of the cancer coming back or as part of palliative treatment to help control the cancer and improve quality of life. Targeted therapy is a type of drug treatment that attacks specific parts of cancer cells to stop the cancer growing and spreading.

Targeted therapy is only available for certain types of stomach cancer.

, also known as radiotherapy, is a type of treatment that uses a controlled dose of radiation to kill or damage cancer cells so they cannot multiply. Radiation therapy for stomach cancer is commonly used to control bleeding and is sometimes used before or after surgery. Radiation therapy is the main treatment for esophageal cancer that has not spread to other parts of the body and cannot be removed with surgery.

There have been some advances in treating advanced stomach or esophageal cancer with immunotherapy drugs known as checkpoint inhibitors. These use the body’s own immune system to fight cancer.

Speak to your doctor about whether immunotherapy is the right treatment for you

All cancer treatments can have side effects

Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. for support. Some people with stomach or esophageal cancer will have a feeding tube before and/or during treatment to help them maintain their weight and build up their strength.

Many people find that having a feeding tube makes eating easier and less uncomfortable. A feeding tube can be placed into your small bowel either through a nostril or with an operation that places a tube through the skin of your abdomen.

Your treatment team will show you how to care for the tube

It will be removed when it is no longer required. Having a feeding tube is a major change and it’s common to have a lot of questions. For information, talk to a dietitian or nurse.

A counselor or psychologist can provide emotional support and coping strategies

Before you start your treatment it is recommended you: – people with stomach cancer often lose a lot of weight and can become malnourished. Your doctor may refer you to a dietitian for advice on how to slow down the weight loss. This will help improve your strength, reduce side effects, and may mean the treatment works better.

– if you smoke, aim to quit before starting treatment.

If you keep smoking, you may not respond as well to treatment

For support, see your doctor or call Tel. – exercise will help build up your strength for recovery.

Talk to your doctor or physiotherapist about the right type of exercise for you. – talk to your doctor about your alcohol use. Alcohol can affect how the body works and increase the risk of complications after surgery (including bleeding and infections), and of the cancer returning.

– you may find it useful to talk to a counselor or psychologist about how you are feeling.

This can help you deal with any anxiety about diagnosis and treatment

Or call to find out about Cancer Council’s support services.

Having stomach or esophageal cancer and treatment can change the way you feel about yourself, other people,. These changes can be very upsetting and hard to talk about.

Doctors and nurses are very understanding and can give you support

You can ask for a referral to a counselor or therapist who specializes in body image, sex and relationships. Advanced cancer usually means cancer that is unlikely to be cured. Some people can live for many months or years with advanced cancer.

During this time palliative care services can help

Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and other people who specialize in palliative care.

Treatment may include chemotherapy, radiation therapy or another type of treatment.

It can help in these ways: Slow down how fast the cancer is growing

Shrink the cancer

Help you to live more comfortably by managing symptoms, like pain.

Treatment depends on: Where the cancer started

How far it has spread

Your general health

Your preferences and what you want to do

Caring for someone with cancer can be difficult sometimes.

If you are caring for someone with stomach or esophageal cancer, these organizations can help: Tel. – helps people affected by cancer find the information, resources and support services they may need following a diagnosis of cancer The esophagus and stomach The esophagus and stomach are part of the upper gastrointestinal (GI) tract, which is part of the digestive system About stomach cancer About esophageal cancer Signs and symptoms Common symptoms of stomach cancer unexplained weight loss or loss of appetite difficulty swallowing indigestion (pain or burning sensation in the abdomen, burping often, reflux) persistent nausea and/or vomiting with no apparent cause abdominal pain sense of fullness, even after a small meal swelling of the abdomen or feeling bloated unexplained tiredness vomit containing blood Common symptoms of esophageal cancer difficulty swallowing new heartburn or reflux reflux that doesn’t go away food or fluids “catching” in the throat, regurgitation or vomiting when swallowing pain when swallowing unexplained weight loss or loss of appetite feeling uncomfortable in the upper abdomen, especially when eating unexplained tiredness that won’t go away vomit that has blood in it Risk factors Stomach cancer risk factors older age (being over 60) infection with the bacteria Helicobacter pylori, which is a type of bacteria found in the stomach having had part of your stomach removed to treat non-cancerous conditions smoking tobacco low red blood cell levels (pernicious anemia) a family history of stomach cancer chronic inflammation of the stomach (chronic gastritis ) being overweight or obese drinking alcohol eating foods preserved by salt Esophageal cancer risk factors Adenocarcinoma being overweight or obese medical conditions, including gastro-esophageal reflux disease (GORD) and Barrett’s esophagus smoking tobacco older age (being over 60) Squamous cell carcinoma drinking alcohol smoking tobacco older age (being over 60) damage to the esophagus from hot or corrosive liquids such as acid Stomach and esophageal cancer tests Your doctor may do some tests to check for stomach or esophageal Endoscopy Biopsy or esophageal Endoscopic ultrasound If these tests show you have stomach or esophageal Blood tests Computerized tomography (CT) scan Positron emission tomography (PET)-CT scan Laparoscopy Stomach and esophageal cancer types Stomach cancer Esophageal cancer Esophageal adenocarcinoma – Esophageal squamous cell carcinoma – Stomach and esophageal cancer stages Stage 1 Stage 2 – 3 Stage 4 Prognosis and survival rates Treatment for stomach and esophageal cancer Endoscopic resection Surgery Gastrectomy Lymphadenectomy Chemotherapy Chemotherapy Targeted therapy Radiation therapy Radiation therapy Immunotherapy Side effects of cancer treatments Some side effects can be upsetting and difficult, but there is help if you need it.

Call the American Cancer Society 1-800-227-2345 or contact cancer support to speak with a caring cancer nurse Having a feeding tube What to do before treatment starts Improve diet and nutrition Stop smoking 1-800-QUIT-NOW (1-800-784-8669) Begin or continue an exercise program Avoid alcohol Talk to someone 1-800-227-2345 Sexuality and stomach or esophageal cancer relationships and sex Living with advanced cancer Ask your doctor about treatment and palliative care services Support for carers, family and friends of someone with stomach or esophageal cancer the American Cancer Society 1-800-227-2345 the Family Caregiver Alliance (caregiver.org) Where to get help Your primary care doctor (doctor) Your treatment team the American Cancer Society 1-800-227-2345 Information and support line 1-800-227-2345 language assistance ) Stomach and esophageal cancers Cancer Council Michigan, My Cancer Guide Find support services that are right for you.

WeCan website .

Key Points

• more common in people over 60, but it can occur at any age
• Not everyone with these symptoms has stomach or esophageal cancer
• If you have any of these symptoms or are worried, always see your doctor
• called risk factors
• If you are worried about your risk factors, ask your doctor for advice