Causes

Several factors can contribute to the development of stomach cancer, and it is essential to understand the possible causes of the disease. The main risk factors include:

diet: the consumption of processed foods (such as chips, cookies, and soft drinks), smoked foods (such as bacon and ham), and saturated fats (found in red meats and oils) is one of the main risk factors for the development of the disease
helicobacter pylori infection: a bacterium associated with stomach ulcers, linked to a higher risk of gastric cancer
smoking and excessive alcohol consumption: excessive use of alcohol and tobacco are known risk factors for the development of stomach cancer
family history: having close relatives who have had stomach cancer may increase the risk of developing the disease
exposure to chemicals: prolonged contact with harmful chemical substances, such as pesticides and solvents, may increase the risk of gastric cancer
environmental contamination: exposure to water contamination by substances such as nitrate, found in fertilizers, may also increase the risk of stomach cancer
radiation exposure: high doses of radiation, whether from medical treatments or occupational exposure, are linked to an increased risk of gastric cancer

Diagnosis

The diagnosis of stomach cancer usually involves a combination of exams and tests performed by a doctor. Early diagnosis is essential for successful treatment. The exams may include:

upper gastrointestinal endoscopy (EGD): this is a procedure in which a thin, flexible tube with a camera at the tip (endoscope) is inserted through the patient’s mouth to examine the inside of the esophagus, stomach, and part of the small intestine
biopsy: a biopsy is a procedure in which a small tissue sample is taken from the stomach during the endoscopy or through a surgical procedure. The collected sample is sent to a laboratory for analysis, where a pathologist will evaluate it to determine if cancer cells are present
imaging tests: tests such as computed tomography (which uses X-rays), magnetic resonance imaging (which uses magnetic fields), and ultrasound (which uses sound waves) may be performed to assess the size, location, and extent of the tumor
blood tests: some certain blood tests, such as tumor markers, may help detect the presence of stomach cancer
staging: after the diagnosis of stomach cancer, it is important to determine whether it is localized at its point of origin or if the tumor has spread to other areas of the body (metastasis)

Treatment

O tratamento do câncer de estômago depende do estágio da doença, da saúde geral do paciente e de outros fatores individuais. As principais opções de tratamento incluem:

surgery: in early stages of stomach cancer, surgery may be performed with curative intent to remove the tumor, the stomach, and its lymph nodes (structures that are part of the immune system)
chemotherapy: uses medications to destroy stomach cancer cells or prevent their growth and spread
radiation therapy: involves the use of high-energy radiation to destroy cancer cells. It may be used before surgery to shrink the tumor, after surgery to destroy remaining cancer cells, or as palliative treatment to relieve symptoms in advanced stages of the disease
targeted therapy: these are drugs aimed at specific genes or proteins in cancer cells to eliminate or reduce the tumor
immunotherapy: immunotherapy is a form of treatment that uses the body’s own immune system to fight stomach cancer
palliative care: combined with the above strategies or applied offered alone, palliative care is essential in the treatment of any serious and incurable disease, to better control patients’ symptoms and improve their quality of life

Einstein Oncology and Hematology offers comprehensive care from diagnosis to treatment. Learn more.

Prevention

Some healthy habits can help reduce the risk of stomach cancer:

healthy diet: consume a diet rich in fruits, vegetables, and whole grains, and low in processed, fatty, and salty foods
avoid smoked and pickled foods: smoked, pickled, and processed foods, as well as red and processed meats, may increase the risk of stomach cancer. Whenever possible, choose fresh and unprocessed foods
do not smoke: smoking is associated with a higher risk of stomach cancer
limit alcohol consumption: excessive alcohol consumption may also increase the risk of stomach cancer
maintain a healthy weight: maintaining a healthy body weight, having a balanced diet, and engaging in regular physical activity can help reduce the risk of stomach cancer
treatment of H. pylori infections: if an infection by the H. pylori bacterium is diagnosed—a known risk factor for stomach cancer—the recommended treatment by a healthcare professional should be followed to eradicate the bacterium and reduce the risk of future complications

References

National Cancer Institute – INCA. Stomach Cancer, 2022

Brazilian Society of Clinical Oncology – SBOC

Brazilian Society of Surgical Oncology – SBCO