Gastric adenocarcinoma account for 95% of gastric tumors and arise from the gland cells that line the stomach, cells which are normally involved with the production of secretions such as mucin.
The cells undergo malignant or cancerous change, most commonly in the lower part where there is a high concentration of glandular cells or epithelium.
Polypoid – this is when the tumour grows in to the lumen or inner part of the stomach and accounts for approximately one third of all gastric tumour types
Ulcerating – as the name suggests, the tumour ulcerates the lining and has raised or nodular irregular edges classically. This accounts for 1/3 of tumours.
Diffuse or infiltrating – this is a “submucosal tumour” where the growth occurs within the wall. They are classically known as Linitis Plastica or a leather-bottle type. The wall becomes stiff rather than elastic to feel.
The cells classically are of “signet ring” type, where the mucin in the cell pushes the “nucleus” to the peripheral part of the cell giving the appearance of a signet ring.
Adenocarcinoma of the stomach often bleeds as the tumor can be "friable" or easily traumatised.
Anaemia is a relatively common scenario from this and you may also notice that your bowel motions become black in color.
These tumors are not only the most common, they are in a lot of ways the most difficult of the cancers to treat too. This is because they usually present quite late on when the tumor has already breached the stomach wall and spread both locally and further afield.
This form of tumor is usually diagnosed at endoscopy. Biopsies normally confirm the diagnosis.
Other investigations that may be needed include:
The treatment option depends on the stage of your stomach cancer. Curative treatment usually involves surgery, but other therapies may be required including chemotherapy and radiotherapy.
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