A National Cancer Institute-designated Comprehensive Cancer Center

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Stomach Cancer

Stomach (Gastric) Cancer
At City of Hope, a multidisciplinary team of nationally recognized experts in the research, diagnosis and treatment of gastrointestinal cancer provides outstanding medical care to patients with stomach cancer, also known as gastric cancer. We are experts in treating patients with all stages and all types of stomach cancer, including:
  • Adenocarcinoma
  • Sarcomas
  • Lymphomas
City of Hope researchers and physicians have pioneered new approaches for stomach cancer. We use aggressive therapies, minimally invasive and robotic-assisted surgery, and state-of-the-art technologies and highly compassionate care to give patients the best possible outcomes. Treatment for stomach cancer may involve:
  • Surgery (gastrectomy)
  • Chemotherapy
  • Radioimmunotherapy
  • Radiation therapy, including helical TomoTherapy
Through our active clinical trials research program — among the most extensive in the nation — we can often provide patients with access to promising new anticancer drugs and technologies not available elsewhere.
About Gastric (Stomach) Cancer
  • Gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach.
  • The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) in foods that are eaten and helps pass waste material out of the body. Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.
  • The wall of the stomach is made up of 3 layers of tissue: the mucosal (innermost) layer, the muscularis (middle) layer, and the serosal (outermost) layer. Gastric cancer begins in the cells lining the mucosal layer and spreads through the outer layers as it grows.
  • Stromal tumors of the stomach begin in supporting connective tissue and are treated differently from gastric cancer.
Recurrent Gastric Cancer
Recurrent gastric cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the stomach or in other parts of the body such as the liver or lymph nodes.
Gastric Cancer Risk Factors
Many common factors are associated with the risk of developing stomach cancer. Some of these include:
  • Age over 50
  • Male gender
  • History of chronic stomach infection with Helicobacter pylori
  • Asian/Pacific Islander, Hispanic-American or African-American heritage
  • Heavy consumption of smoked, salted and pickled foods
  • Cigarette smoking
  • Extreme obesity
  • Previous stomach surgery
  • Pernicious anemia
  • Menetrier disease leading to atrophic gastritis
  • Hereditary nonpolyposis colorectal cancer
  • Familial adenomatous polyposis
  • Family history of stomach cancer

Gastric Cancer Signs and Symptoms
Early stomach cancer often does not cause clear symptoms. A stomach cancer (tumor) may grow very large before it causes symptoms.

In the early stages a patient may experience:
  • Indigestion or stomach discomfort
  • A bloated feeling after eating
  • Mild nausea
  • Loss of appetite
  • Heartburn
In more advanced stages a patient may have:
  • Pain in the stomach
  • Blood in the stool (dark black or red)
  • Vomiting
  • Weight loss

How We Diagnose Stomach Cancer

City of Hope diagnostic tests may include:
  • Physical exam and history
  • Gastroscopy: A thin, lighted tube called a gastroscope is inserted through the mouth and guided into the stomach. A local anesthetic or other medicine may be given to minimize discomfort.
  • Barium swallow/Upper GI series: A series of X-rays is taken after the patient drinks a liquid to improve the visualization of the inside of the upper gastrointestinal tract.
  • Biopsy: If tests indicate that stomach tissue seems abnormal, a small sample may be taken for examination under a microscope to check for cancer cells.

Stomach Cancer Treatment Approaches

A patient’s chances of recovery as well as medical decisions about the most promising treatment options, depend on the specific type of stomach cancer, the stage of the cancer (whether it is found only in the stomach or has spread to other places in the body), as well as the patient’s overall health. Stomach cancers are frequently diagnosed at an advanced stage, when they may be more difficult to cure.
At City of Hope, our multidisciplinary approach to treating gastric cancer is designed to enhance the evaluation and treatment of patients at all stages of the disease. Care is provided by the departments of Surgical Oncology, Medical Oncology, Gastroenterology and  Radiation Oncology working together to achieve the best possible outcomes.

Treatment of gastric cancer often requires the removal of affected stomach tissue. This surgical procedure, called a gastrectomy, may be partial or total, depending on the location of the tumor. Lymph nodes around the stomach may also be removed to reduce the risk of cancer cells spreading to other parts of the body.
At City of Hope, our surgeons specialize in minimally invasive procedures performed by laparoscopy. These procedures use small keyhole incisions rather than the large incisions used in traditional open surgery. Results with laparoscopy are comparable to open surgery, but often with less pain, reduced loss of blood, faster recovery, shorter hospital stays and a lower risk of post-operative complications.
City of Hope surgeons are also highly skilled in robotic-assisted surgery, using the most advanced da vinci S Surgical System. A surgeon directs and controls the movements of a specially designed robot, equipped with a camera and miniature surgical tools. At the same time, a sophisticated, computerized imaging system provides real-time three-dimensional views of the surgical area, with better visualization than can be achieved with the surgeon’s eye alone.
Chemotherapy and Radioimmunotherapy
Chemotherapy refers to drugs that are given either intravenously or orally to treat cancer. Chemotherapy may be combined with other treatments, and is often used to combat cancers that have spread beyond the stomach.
At City of Hope, chemotherapy may be combined with radiation therapy or with radioimmunotherapy (treatment with a radioactive substance linked to an antibody that can attack the tumor and destroy it).

Radiation is a form of energy that has long been used to treat many kinds of cancers. In stomach cancer, radiation may be given to relieve pain, in combination with chemotherapy, or after surgery to minimize the risk of recurrence. Treatments in which beams of energy are directed at the tumor from an outside source are referred to as external beam radiation.
At City of Hope, external beam radiation treatments may include:
  • Three-dimensional conformal therapy
  • Helical TomoTherapy - Considered the most advanced radiation therapy available, helical TomoTherapy allows doctors to target and destroy cancer cells very precisely while sparing healthy tissues nearby.
    City of Hope was the first in the western U.S. to provide treatment for stomach cancer using this therapy.

Stomach Cancer Resources

All of our patients have access to the  Sheri & Les Biller Patient and Family Resource Center, which offers a wide array of support and educational services. Patients and loved ones may work with a coordinated group of social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center, as well as participate in programs such as music therapy, meditation and many others.
Additional Resources
American Cancer Society
866-228-4327 for TYY
The American Cancer Society has many national and local programs, as well as a 24-hour support line, to help cancer survivors with problems such as travel, lodging and emotional issues.
The National Comprehensive Cancer Network, an alliance of 19 of the world's leading cancer centers, is an authoritative source of information to help patients and health professionals make informed decisions about cancer care.
National Cancer Institute (NCI)
The National Cancer Institute, established under the National Cancer Act of 1937, is the federal government's principal agency for cancer research and training.

Stomach Cancer Research/Clinical Trials

City of Hope has long been a leader in gastrointestinal cancer research, including
stomach cancer. Multiple clinical trials are ongoing, offering patients access to new and advanced treatments involving chemotherapy, radioimmunotherapy and radiation. As a patient at City of Hope, you may qualify to participate in a test of these new investigational therapies.

To learn more about our clinical trials program and specifically about clinical trials for stomach cancer, click here.

Gastric (Stomach) Cancer Team

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Joe Komsky
Senior Director
Phone: 213-241-7293
Email: jkomsky@coh.org

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