Understanding Stomach Cancer
- Teresa Tiano, who lost her dad to colon cancer and her mom to brain cancer, was diagnosed with the most common type of stomach cancer called adenocarcinoma at age 44.
- Tiano ultimately had 80% of her stomach removed before undergoing treatment and discovered she had a rare genetic condition called lynch syndrome, a genetic mutation that leads to an increased risk of colorectal cancer. It also leads to an increased risk of other cancers, including uterine cancer, endometrial cancer, stomach cancer, ovarian cancer and more.
- Gastric cancer, or stomach cancer, arises from the cells lining the stomach, an organ integral to the digestive process. This type of cancer is characterized by its aggressive nature and a tendency to be diagnosed in advanced stages, which poses treatment challenges.
- Because stomach cancer is often diagnosed in later stages, it is important to be aware of symptoms, such as indigestion, heartburn, appetite changes, weight loss, abdominal pain and discomfort, nausea and early satiety, swelling in the abdomen, weakness, and fatigue.
Now, 58, Tiano is spreading awareness on the importance of cancer screenings and pushing for answers when symptoms arise as she had 80% of her stomach removed and discovered she had a rare genetic condition called lynch syndrome, which the American Cancer Society (ACS) says can lead to a heightened risk of developing cancers of the ovary, stomach, small intestine, pancreas, kidney, brain, ureters and bile duct.
Read MoreView this post on Instagram
Following the surgery, Tiano had to adjust to a new way of consuming food, by only eating “tiny” portions and not going to restaurants as much as she used to.
“I always had to make sure I knew where the bathroom was. Nine times out of 10 I would throw up. Even on my first Christmas, I could eat next to nothing. By the afternoon, I was just completely done in, and had to go rest. I was just out for about a week in terms of exhaustion,” she told Yahoo! Canada.”
However, two months into treatment, in February 2012. learned she had Lynch Syndrome, which is also called hereditary non-polyposis colorectal cancer (HNPCC). The diagnosis led her to share with others about how a genetic mutation can increase one’s risk of getting cancer.
“Stomach cancer eats away at you… it affects everybody. Not just the patient, but their caregivers, their families because it’s this overall change … We don’t want anyone to be alone in their journey,” Tiano said, following her diagnosis, and after she and her friend Katy Kosyachkova crated My Gut Feeling.
Expert Resources On Stomach Cancer
- Advanced Gastric Cancer: The Importance of a Diagnostic Laparoscopy
- ‘A Marathon vs. A Sprint’ — How Treatment for Advanced Gastric Cancer Differs From Early-Stage Disease
- Chemotherapy for Gastric Cancer: Everything You Need To Know
- Current Progress on Early Detection of Gastric Cancer
- Endoscopic Resection for Gastric Cancer: An Advanced Treatment Offering Hope
- Genetic Testing for Gastric Cancer: What to Know & What to Ask Your Doctor
- Initial Workup and Staging Strategy For Gastric Cancer
- How to Maintain a Healthy Lifestyle While Undergoing Chemotherapy for Gastric Cancer
Tiano added, “Cancer never leaves you. It has a really high recurrence rate. People ask, ‘How are you going to live without a stomach?’ It’s a journey and that journey never ends.”
The resilient stomach cancer advocate, who previously battled stage zero battle cancer eight years before her stomach cancer diagnosis, was later diagnosed with uterine cancer in 2020. The diagnosis led her to have her ureter and right kidney removed, followed by chemotherapy.
View this post on Instagram
In an effort to encourage others to get checked, she told Yahoo! Canada, “We tell people not to take ‘no’ for an answer. With stomach cancer, a month can be the difference between stage 2 and stage 4 [cancer].”
She added, “I’ve had good days but there’s not a day goes by that I don’t have an upset stomach or digestive issue or something or I’m tired. But I’m here, I’m here and I’m thrilled to be here.”
Understanding Gastric/Stomach Cancer
Gastric cancer, also known as stomach cancer, originates in the stomach. The most common type, called adenocarcinoma, begins in the stomach’s inner lining. Other types of the disease can begin in the middle or outer parts of the stomach, but these are more rare.
Thanks to advanced endoscopic techniques — which allow doctors to insert a thin, lighted tube with a tiny camera on it through the mouth and view the throat, esophagus, stomach, and more — gastric cancers are now frequently caught earlier, which makes treatment easier.
The Staging System for Gastric Cancer — Finding the Right Treatment Plan
Surgery is often the most critical part of the treatment process and can be curative for patients whose cancer is caught at an earlier stage.
Even for those with more advanced cancer, surgery may still be an option to help control symptoms and improve quality of life. There are also some new and innovative treatment options for gastric cancer that has progressed.
Surgery is especially helpful in cases where the disease is localized and has not spread extensively beyond the stomach. The goal of surgery is to remove the cancer, along with part or all of the stomach, depending on how much the cancer has spread. Surgeons aim to ensure that no cancer cells are left behind, which gives patients the best chance at long-term survival.
Surgery for Gastric Cancer: What You Need to Know
For patients whose cancer is at an earlier stage, surgery can often be curative. Surgery may still be an option even for patients with more advanced cancer.
Systemic therapies, like chemotherapy, targeted therapies, and immunotherapy, may also be used. Eligibility for these treatment approaches will depend on several factors, like the stage of the cancer, the patient’s general health, and the results of biomarkers testing.
Meanwhile, when gastric cancer has spread beyond the stomach and surgery is not an option, it’s important to realize that there are still several treatment options and approaches. They just may look a bit different than the approach to more localized cancer.
Dr. Nicholas J Hornstein, a medical oncologist at Northwell Cancer Institute in Manhattan, previously told SurvivorNet that treatment at the advanced stage is a “bit of a marathon” rather than a sprint.
“In advanced cancers, we focus on things a little bit differently. Now it’s a bit of a marathon: we’re trying to sequence therapies in a way to provide patients for the best quality of life for as long as possible,” Dr. Hornstein explains.
“We employ a variety of different systemic therapies. These are treatments that go through the entire body such as chemotherapy, immunotherapy, or targeted therapy. Those are the three major buckets of treatment that I think of when I counsel patients.”
Eligibility for these systemic treatments depends on several factors, including stage of the cancer, previous treatments, biomarkers testing, general health, and allergies, among other factors.
Genetic Testing & Family History
“Genetic testing is very, very important when it comes to management of gastric cancer,” Dr. Sofia Pintova, a gastrointestinal medical oncologist at Mount Sinai Hospital in New York City, told SurvivorNet in an earlier interview.
People who have a family history of gastric cancer may be more likely to develop the disease due to an inherited mutation.
When it comes to the management of this disease, doctors can look for mutations in two ways: by looking at your DNA or at the tumor cells.
“The first category is genetic testing of the patient, of you, and that [checks if] there are any mutations or changes in your DNA that you were born with, whether you were born with it as the first person in the family or [it’s] something you inherited from one of your parents [that affected] all the cells in your body,” Dr. Pintova explains.
Inherited Genetic Disorders in Colon Cancer: Lynch Syndrome
“That’s an important aspect of an evaluation of somebody who has either a family history of stomach cancer, has other potential concerns for stomach cancer, or already has a diagnosis of stomach cancer,” she adds.
Knowing your family health history can play a critical role in taking care of your overall health and assessing what diseases you may be prone to in the future. But when it comes to cancer, this information is not always straightforward.
While it can be helpful to speak to relatives, not all patients have access to their family health histories — another reason why genetic testing is important.
Assessing the Characteristics of Your Cancer
The other ways doctors use genetics to assess gastric cancer is by examining the features of cancer that has already developed.
“The other aspect of it is genetic testing … or pathologic features of the stomach cancer itself,” Dr. Pintova explains. “So, not of the patient, not yours, but the genes of the cancer … That is a very important aspect of evaluation and treatment for stomach cancer because we have a number of therapies that work better when the cancer has or doesn’t have certain features. And we also have a number of targeted therapies these days that target specific changes in the DNA of the tumor.”
Truly hereditary (familial) gastric cancer accounts for 1 to 3% of the global burden of gastric cancer. The specific types of gastric cancer linked to family history include:
- Hereditary diffuse gastric cancer (HDGC)
- Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS)
- Familial intestinal gastric cancer (FIGC).
The risk of developing gastric cancer is high in these families, but only HDGC has a specific gene mutation associated.
Inherited Syndromes Linked to Gastric Cancer
Gastric cancer has also been associated with several other inherited syndromes, including:
- Lynch syndrome (hereditary nonpolyposis colorectal cancer)
- Familial Adenomatous polyposis
- Li-Fraumeni syndrome
- Peutz-Jeghers syndrome
- Juvenile polyposis
- Hereditary breast and ovarian cancer syndrome
However, it’s rare that these syndromes will lead to the development of gastric cancer.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
