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Gastric and Esophageal Cancer
Gastric Cancer
Cancer that originates or develops in the lining of the stomach is called gastric or stomach cancer. It usually grows slowly over several years before resulting in symptoms. This results in cancer getting diagnosed at a later stage, which usually affects the prognosis. Gastric cancer can develop at any part of the stomach, but mostly, they form in the main part (stomach body) or the esophagus (the part that carries food to the stomach when you swallow.
Adenocarcinoma - Almost 95 % of people develop adenocarcinoma, which starts in the tissues that line the stomach. The three types of adenocarcinoma are:
- Non-cardia (Distal) Stomach Cancer - This type is associated with long-term infection with H.pylori (Helicobacter pylori) or long periods of inflammation or irritation in the stomach’s lower part. It is more commonly seen in people living in developing countries.
- Proximal Stomach Cancer - The first part of the stomach that is connected to the esophagus is commonly affected. Proximal stomach cancer is common in the US and affects obese people and people with gastroesophageal reflux disease (GERD).
- Diffuse Stomach Cancer - It is an aggressive type of cancer that develops rapidly in the cells that line the stomach wall. As it does not form a growth or a mass, it is challenging to diagnose. This type commonly affects younger people with a family history or genetic mutations.
- Gastrointestinal Stromal Tumors - Cancer that originates in the connective tissue or stomach muscle. Try out MSK's Gastrointestinal Stromal Tumor - Survival Without Recurrence Following Surgery (Prediction Tool) nomogram!
- Proximal Stomach Cancer - The first part of the stomach that is connected to the esophagus is commonly affected. Proximal stomach cancer is common in the US and affects obese people and people with gastroesophageal reflux disease (GERD).
- Carcinoid Tumors - Tumor from the stomach’s hormone-producing cells.
- Lymphoma - Cancer that develops in the stomach’s immune cells.
The location of stomach cancer determines the treatment plan. Surgery is recommended, along with other treatment options before or after the surgery. MSK's gastric cancer experts offer complete cancer care for people with all types of stomach cancer. These experts see more patients with this type of cancer than any other cancer center in the US. The advanced and accurate staging of gastric cancer and improved surgical techniques, diagnosis, treatment, and prognosis have significantly improved. Depending on the test results, the doctor might suggest surgery, chemotherapy, radiotherapy, or a combination of therapies. Patients can also benefit from the thousands of clinical trials ongoing at MSK that explore new therapies.
Esophageal Cancer
Instead of the stomach body, esophageal cancer develops inside the 10-inch hollow tube that carries food to the stomach called the esophagus. When the cells that line this tube start growing out of control, a tumor can form. The cells in the innermost layer mostly undergo a cancerous transformation, which can grow and multiply uncontrollably and invade the lymph nodes and other organs. Esophageal cancer is rare, but more people are developing the adenocarcinoma type in the past few years.
- Adenocarcinoma - t is the most common type of esophageal cancer in the US, and it accounts for almost 50 % of all new cases. This cancer begins in the glandular cells present in the lining of the esophagus and most commonly in the lower end of the esophagus and the upper part of the stomach. The recent increase in esophageal adenocarcinoma is believed due to an increase in the number of gastroesophageal reflux disease (GERD) cases, where the acid and stomach content move up into the esophagus repeatedly, resulting in chronic inflammation.
- Squamous Cell Carcinoma - It is the second most common type of esophageal cancer, which originates in the thin and flat cells (squamous cells) that line the inside of the esophagus. This type is linked to smoking and alcoholism.
- Small Cell Carcinoma - A rare type of esophageal cancer that begins in neuroendocrine cells (cells that releases hormones in response to nerve signals).
MSK's esophageal cancer experts use various methods, such as physical examination, imaging tests (CT scan, PET scan), and endoscopy, to diagnose and stage esophageal cancer. The type of surgery will be decided based on the cancer type and stage and the patient’s general health. Depending on the results, the doctor might suggest surgery, chemotherapy, radiotherapy, or a combination of therapies. Patients can also benefit from the thousands of clinical trials ongoing at MSK that explore new therapies. Patients with conditions that increase esophageal cancer risk, such as Barrett’s esophagus, get screened and monitored regularly for cancerous changes by MSK experts. Endoscopic or minimally invasive therapy is also available for precancerous and early-stage cancerous conditions.
