Stomach & oesophageal cancer

Reviewed by: Dr Stuart Roberts, Director Gastroenterology, The Alfred

Taken from Stomach & Oesophageal Cancer booklet (2.1MB)

On this page: The stomach and oesophagus | Stomach cancer | Oesophageal cancer | Causes of stomach and oesophageal cancer | How common is stomach and oesophageal cancer?

The stomach and oesophagus

The oesophagus and stomach are parts of the digestive system.

The oesophagus is a hollow tube that takes food and fluids from the mouth to the stomach. When you swallow, the muscular walls of the oesophagus push food down to the stomach.

The stomach is a hollow, muscular organ between the end of the oesophagus and the beginning of the small bowel. It sits in the upper left part of the abdomen. The stomach's role is to store food that's been swallowed, begin breaking down food, and pass the food into the small bowel.

Muscles in the stomach mash food. Gastric juices are released from glands in the mucosa - the innermost layer of the stomach. These juices turn the food into a thick fluid. The thick fluid passes into the bowel, where digestion continues. Nutrients begin to be absorbed from the broken-down food, through the walls of the small bowel, into the bloodstream.

Stomach cancer

Most stomach cancers develop in cells that line the mucosa. These are called adenocarcinoma of the stomach. Other types of stomach cancer are:

• lymphoma: cancer of lymphatic tissue
• gastric stromal tumours: cancer of muscle or connective tissue cancer
• carcinoid tumours: cancer of hormone-producing cells.

Stomach cancer grows slowly. It may grow for many years before any symptoms are felt.

Stomach cancer can grow through the wall of the stomach and into nearby organs, such as the liver, pancreas or colon.

It can also spread via the lymphatic system into local lymph glands or nodes. If the cancer cells get into the bloodstream, the cancer can spread to other parts of the body, such as the liver, lungs and bones. Cells can also leak into the space around the bowel and other abdominal organs and this may cause swelling in the abdomen.

Oesophageal cancer

There are 2 main types of oesophageal cancer: squamous cell carcinoma, which begins in squamous cells that line the middle and upper part of the oesophagus; and adenocarcinoma, which begins in glandular tissue in the lower part of the oesophagus.

Oesophageal cancer can spread to nearby lymph nodes and then to other parts of the body if it's not found and treated early.

Causes of stomach and oesophageal cancer

It's not known what causes stomach and oesophageal cancer.

Some risk factors make it more likely that a person will develop stomach or oesophageal cancer. These risk factors include:

• smoking
• age over 50
• being male: both cancers are more common in men than in women
• adenocarcinoma of the oesophagus is related to being overweight or obese.

Additional risk factors for stomach cancer include:

• infection with the bacteria Helicobacter pylori
• a diet high in smoked, pickled and salted foods and low in fresh fruit and vegetables
• a family history of stomach cancer
• partial gastrectomy for ulcer disease (after about 20 years)
• inheriting a genetic change that causes the bowel disorders FAP or HNPCC.

Additional risk factors for oesophageal cancer include:

• alcohol
• obesity
• long-term gastro-oesophageal reflux disease (GERD)
• frequent drinking of very hot liquids
• a diet low in fresh fruit and vegetables
• occupational exposure to solvents used for dry-cleaning, and some other chemical fumes
• a history of Barrett's oesophagus. This is a condition where some of the lining of the oesophagus changes, usually due to long-term reflux of stomach contents into the oesophagus with accompanying heartburn
• coeliac disease (intolerance to gluten in food).

Having one or more of these risk factors doesn't mean that you'll develop stomach or oesophageal cancer. However, these factors are often seen in people who have these cancers.

How common is stomach and oesophageal cancer?

About 530 Victorians develop stomach cancer each year and 330 people develop oesophageal cancer. These cancers are more common in people over the age of 50, but can sometimes occur in younger people.

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