Once considered a rare disease, stomach cancer has seen a troubling rise, especially in certain age groups and regions. According to a 2024 study issued in the Journal of Cancer Research and Therapeutics, in India, carcinoma of the stomach is the sixth (4.5 per cent of all cancers) most common cancer. And, around 0.8 percent of men and women will be diagnosed with stomach cancer at some point during their lifetime.

 

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Stomach cancer, also known as gastric cancer, can develop from a variety of factors. Could it be our changing diets, the rise in processed foods, or even stress and pollution? Many factors could be at play, and understanding them is crucial in tackling this silent yet deadly illness. While no single cause guarantees its onset, certain risk factors significantly increase the likelihood. 

Here’s a breakdown of the primary causes:

• Dietary choices: Consuming large amounts of processed meats, smoked foods, and pickled items can introduce carcinogenic compounds like nitrates and nitrites into the stomach lining. Besides, lack of fresh produce can deprive the body of antioxidants and fibre, both of which are protective against cancer. Apart from these, diets high in salty foods can irritate the stomach lining, which may eventually lead to cancerous changes.
• Infection with helicobacter pylori: Did you know that a tiny bacterium called Helicobacter pylori (H. pylori) could be a significant player in stomach health? This common infection takes up residence in the stomach lining and is a major contributor to stomach cancer. Over time, chronic H. pylori infection can spark inflammation and ulcers, paving the way for cell mutations that heighten cancer risk. 
• Smoking and alcohol use: Tobacco use doubles the risk of stomach cancer, especially in the upper stomach near the esophagus. On the other hand, heavy drinking can also damage the stomach lining and contribute to the development of cancer cells.
• Genetic factors: When it comes to stomach cancer, our genetics and family background play a crucial role. If someone in your close family has battled this disease, your own risk may be heightened. Additionally, certain genetic mutations linked to hereditary diffuse gastric cancer can make you more susceptible to developing this condition.
• Chronic stomach conditions: Long-term inflammation of the stomach lining can lead to cellular changes. Pernicious anemia is an autoimmune condition that interferes with vitamin B12 absorption and can damage the stomach lining. Intestinal metaplasia and dysplasia are pre-cancerous changes that can occur in the stomach lining, increasing cancer risk over time.
• Obesity: Excess weight, especially around the abdomen, has been linked to a higher risk of stomach cancer. Obesity can alter hormone levels and cause chronic inflammation, both of which are conducive to cancer growth.
• Environmental exposures: Certain occupations expose individuals to harmful chemicals, like those in coal mining, metal processing, and rubber manufacturing. These can increase the risk of developing stomach cancer.
• Age and gender: Stomach cancer risk increases with age, typically affecting those over 50. Indian Council of Medical Research shows that the incidence of gastric cancer shows a sharp increase after the age of 50 years. Most individuals are diagnosed with gastric cancer between their late 60s and 80s. Men are also more likely than women to develop the disease, though the exact reasons are not fully understood.  

 

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Screening for Stomach Cancer

Diagnosing stomach cancer involves several methods, each aimed at accurately detecting cancer and determining its stage. Early detection plays a crucial role in successful treatment outcomes, especially as stomach cancer often shows few symptoms in its initial stages. Here’s a closer look at the main diagnostic techniques, screening guidelines, and the importance of early detection.

• Endoscopy
• Biopsy
• CT Scans (Computed Tomography)
• PET Scans (Positron Emission Tomography)
• MRI (Magnetic Resonance Imaging)
• X-rays and Barium Swallows

 

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Treatment for Stomach Cancer

Once stomach cancer is diagnosed, treatment depends on the cancer’s stage, location, and type, as well as the patient’s overall health. 

1. Surgery: Surgery is often the main treatment for stomach cancer, particularly in early-stage cases. The goal is to remove as much of the cancer as possible while preserving stomach function.
In a partial gastrectomy, the surgeon removes the portion of the stomach containing the cancer, along with nearby lymph nodes. This approach is used when the cancer is localized to a specific section of the stomach.

Total Gastrectomy: In cases where cancer affects a large part of the stomach, a total gastrectomy may be necessary. This surgery involves removing the entire stomach and connecting the esophagus directly to the small intestine. Total gastrectomy requires major lifestyle adjustments, as patients must eat smaller, more frequent meals. Digestive complications are common, and recovery can be challenging.

2. Chemotherapy: Chemotherapy uses drugs to kill cancer cells throughout the body. It’s often used before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to destroy any remaining cancer cells. Chemotherapy is commonly used for advanced stomach cancers and cases where surgery alone may not be sufficient.

3. Radiation Therapy: Radiation therapy uses high-energy beams to target and kill cancer cells in a specific area. It’s often used in combination with chemotherapy for a more effective result. Radiation may be used before or after surgery or as palliative care to relieve symptoms in advanced cases.

4. Targeted Therapy: Targeted therapies target specific molecules involved in cancer growth. This treatment is generally used with chemotherapy for advanced cases that test positive for certain molecular markers.

5. Immunotherapy: Immunotherapy leverages the body’s immune system to attack cancer cells. Immunotherapy is typically reserved for advanced stomach cancer that hasn’t responded to other treatments and may be used in combination with other therapies. Side effects can vary widely but often include fatigue, skin reactions, and in rare cases, autoimmune responses where the immune system attacks healthy tissue.

 

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The rising cases of stomach cancer highlight the critical importance of awareness, early detection, and proactive management. Advances in diagnostic tools and treatments—such as endoscopy, targeted therapies, and immunotherapy. While treatment options like surgery, chemotherapy, and radiation come with challenges, they are life-saving interventions that provide options for those battling this disease.

Early detection significantly improves the survival rate for stomach cancer. When detected at an early stage, treatment is more likely to be effective, and patients have a better chance of a full recovery.