Stomach Cancer

Stomach Cancer

In the United States, about 21,000 people are diagnosed with stomach cancer annually, and 10,000 die of the disease. Worldwide, stomach cancer is much more common, in part because of high rates of infection with the bacterium H. Pylori, which was found in the 1990s to increase the risk of stomach cancer, ulcers, and other stomach problems.

Since the late 1980s, major research findings have improved options for patients with early stage disease. While full surgical removal of the stomach (gastrectomy) was previously the only option to potentially cure early stage stomach cancer, studies showed that a partial removal of the stomach was just as effective for many patients. Other research found significant improvement in long-term survival with the addition of adjuvant radiation and chemotherapy.

For patients with advanced disease, survival remains relatively low and effective new treatments are urgently needed. Through clinical trials, doctors continue to refine chemotherapy regimens in ways that extend patients' lives and significantly delay problems like loss of appetite and weight loss.

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1997

Laparoscopy provides less invasive way to assess and treat stomach tumors

Laparoscopy provides less invasive way to assess and treat stomach tumors

Researchers begin to utilize this minimally invasive surgical procedure for "staging" of gastric cancer patients. Laparoscopy is found to be roughly as effective as more invasive approaches, but requires a much smaller incision and allows an easier and shorter recovery time for patients. With laparoscopy, a surgeon inserts a thin, lighted tube through a small incision to examine the abdominal organs.

As surgeons become more adept with the technique, many patients with gastric cancer are able to be surgically treated using laparoscopy, which is far less invasive than traditional open surgery on the stomach.

New chemotherapy regimen becomes standard for advanced stomach cancer

New chemotherapy regimen becomes standard for advanced stomach cancer

A major trial shows that a new combination chemotherapy regimen involving the drugs epirubicin, cisplatin and fluorouracil (together called ECF) helps extend survival and reduces serious side effects for patients with advanced stomach cancer, compared with an earlier three-drug regimen. The study establishes ECF as a new standard for advanced stomach cancer, helping patients live longer with a better quality of life.

1993

Bacterial infection linked to gastric cancer risk

Bacterial infection linked to gastric cancer risk

Researchers show a strong correlation between the incidence of stomach cancer and infection with a bacterium called H. pylori. Further studies estimate a 3- to 6-fold increased risk of stomach cancer for people infected with the bacteria.

H. pylori is spread through contaminated food, water and direct mouth-to-mouth contact. The U.S. Centers for Disease Control and Prevention estimates that approximately two-thirds of the world's population carries the bacterium, with infection rates being highest in developing countries. However, the bacterium does not cause illness in the majority of carriers.

In Western Europe and the United States, declining rates of H. pylori infection are thought to partly account for declines in stomach cancer cases in recent decades.

1990

Genetic risk factors for gastric cancer are identified

Genetic risk factors for gastric cancer are identified

Researchers find that patients with a family history of a condition called Lynch syndrome are at increased risk for gastric cancer, in addition to colorectal cancer. Later studies indicate that first-degree relatives (e.g., a parent or sibling) of patients with gastric cancer have a two- to three-fold increased risk of developing the disease, compared to the general population. These findings help doctors identify patients at high risk for developing the disease, potentially improving the chances of finding the cancer early when treatment is likely to be more effective.

1989

Less extensive stomach surgery offers same chance of cure

Less extensive stomach surgery offers same chance of cure

While surgery had long been established as the only chance of cure for gastric cancer, physicians had debated whether the full stomach needed to be removed (gastrectomy) or if removing only the part of the stomach containing the tumor (partial gastrectomy) would be sufficient.

In 1989, research shows that for patients with tumors in the lower (distal) part of the stomach, partial gastrectomy combined with removal of the surrounding lymph nodes is as effective and results in fewer complications than total gastrectomy.

1988

New ultrasound device offers minimally invasive cancer evaluation and treatment tool

New ultrasound device offers minimally invasive cancer evaluation and treatment tool

Doctors begin using advanced ultrasound techniques to assess the size, depth and spread of gastric cancers. In a procedure call endoscopic ultrasound, a thin, lighted tube is passed through the patient's mouth and into the stomach. The device then uses sound waves to create an image of the inside of the stomach.

Subsequent refinements to the procedure enable doctors to obtain small tumor biopsies or even to remove early-stage gastric tumors and precancerous lesions, a process known as endoscopic mucosal resection.

1985

New imaging tools help detect and evaluate stomach cancer

1980

Combination chemotherapy improves outcomes for advanced stomach cancer

Combination chemotherapy improves outcomes for advanced stomach cancer

Throughout the 1970's, many chemotherapy drugs are tested in combinations of two to four drugs in the hope of improving survival for patients with inoperable stomach cancer. While most combinations have no significant impact, a three-drug regimen called FAM (5-fluorouracil, mitomycin C and Adriamycin, also known as doxorubicin) provides some benefit and is widely used throughout the 1980s. In 1989, doctors find that adding methotrexate to fluorouracil and Adriamycin, a three-drug regimen called FAMTX, further improves survival for some patients.