Stomach Cancer is one of the rarer types of cancer, and in the United States oncologists have seen the number of new cases decrease over the past decade.  According to Sunnie Kim, MD, there are a number of reasons for this occurrence, one of which is that the incidence of Helicobacter pylori bacteria is much lower in more resourced countries. "This bacteria is a significant risk factor in stomach cancer, and it’s still prevalent in developing countries, where sanitation and clean water is still lacking" says Dr. Kim.

Gender and age are also risk factors for stomach cancer with cases being more common in men and the majority of diagnoses occur in people aged 50 and older.   Tobacco use also increases the risk of stomach cancer as does a diet high in red meat and preserved foods.  

"A very small number of people have genetic risk – for example, we know that mutations of the CDH1 gene are a risk factor, but those happen in only a very small proportion of patients. In those cases, there’s usually a very strong family history of stomach cancer or breast cancer."

The most common symptom of stomach cancer is abdominal pain and weight loss when you weren’t trying to lose weight. Sometimes people notice black stool or blood in their stool, and they may experience reflux that doesn’t go away or that persists despite medication. Nausea and vomiting are also common, and so is a feeling of fullness after eating even a small amount of food.

Because many of these symptoms occur with other non-cancerous conditions so Dr. Kim has the following advice for people hesitant to mention their symptoms to their physician, "speaking as a physician, I absolutely would want patients to mention any symptoms they’re having, anything that’s worrying them. If it’s out of the ordinary for you, or if it persists for several months and doesn’t go away, please mention it to your doctor".

Although it’s not as common to detect stomach cancer in its earlier stages, Dr. Kim has seen it caught when it has not yet spread and become stage IV. Just another reason she encourages people to mention symptoms that are worrying them to their doctor. "There’s a very classic lymph node spread that can happen with stomach cancer ­– a spread to lymph nodes in the left side of the neck – and sometimes that can be caught in a physical exam. But you need to mention your symptoms to your doctor so they can make a point of feeling for that" says Dr. Kim. 

Researchers are finding a lot of interesting biomarkers in stomach cancer, so targeted drugs are being heavily investigated right now as a way of personalizing care to individual patients. "Chemotherapy is still the mainstay of treatment for stomach cancer, but we are incorporating immunotherapy more and more and, with patients who are receptive to it, seeing some impressive results".