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  • What are stomach and oesphageal cancers?


    The oesophagus and stomach

    The oesophagus and stomach are part of the upper gastrointestinal (GI) tract, which is part of the digestive system. The digestive system helps the body break down food and turn it into energy.

    The oesophagus (food pipe or gullet) is a long, muscular tube. It moves food, fluid and saliva from the mouth and throat to the stomach. A valve (sphincter) at the end of the oesophagus stops acid and food moving from the stomach back into the oesophagus.

    The stomach is a hollow, muscular sac, located between the end of the oesophagus and the beginning of the small bowel. The stomach expands to store and help digest food that has been swallowed. It also helps the body absorb some vitamins and minerals.

    Juices in the stomach break down food into a thick fluid, which then moves into the small bowel. In the small bowel, nutrients from the broken-down food are absorbed into the bloodstream. The waste matter moves into the large bowel, where fluids are absorbed into the body. The solid waste matter is passed out of the body as a bowel movement.

    The oesophageal wall has three layers of tissue and an outer covering known as the adventitia. The stomach wall has four layers of tissue.

    What is stomach cancer?

    Stomach cancer develops when cells in the lining of the stomach grow and divide in an abnormal way. Tumours can begin anywhere in the stomach, although most start in the glandular tissue found on the stomach’s inner surface (mucosa). This type of cancer is called adenocarcinoma of the stomach (also known as gastric cancer).

    If it is not found and treated early, stomach cancer can spread through the lymphatic system to nearby lymph nodes or through the bloodstream to other parts of the body, such as the liver and lungs. It may also spread to the walls of the abdomen (peritoneum). Rarely, it can grow through the stomach wall into nearby organs such as the pancreas and bowel.

    How common is stomach cancer?

    About 2200 people are diagnosed with stomach cancer in Australia each year. Men are twice as likely as women to be diagnosed with stomach cancer. It is more common in people over 60, but it can occur at any age. About one in 130 men and one in 300 women are likely to develop stomach cancer before the age of 75.

    What is oesophageal cancer?

    Oesophageal cancer begins when abnormal cells develop in the innermost layer (mucosa) of the oesophagus. A tumour can start at any point along the length of the oesophagus. There are two main subtypes:

    Oesophageal adenocarcinoma – often starts near the gastro-oesophageal junction and is linked with a condition called Barrett’s oesophagus. Adenocarcinomas are the most common form of oesophageal cancer in Australia.

    Oesophageal squamous cell carcinoma – starts in the thin, flat cells in the lining of the oesophagus, which are called squamous cells. It often begins in the middle and upper part of the oesophagus. In Australia, squamous cell carcinomas are less common than adenocarcinomas.

    If it is not found and treated early, oesophageal cancer can spread through the lymphatic system to nearby lymph nodes or through the bloodstream to other parts of the body, most commonly the liver and lungs. It can also grow through the oesophageal wall and invade nearby structures.   

    How common is oesophageal cancer?

    This is an uncommon cancer. In Australia, about 1500 people are diagnosed with oesophageal cancer each year. Men are much more likely than women to be diagnosed with this cancer. It is more common in people over 60, but can occur in younger people. About 1 in 160 men and 1 in 580 women are likely to develop oesophageal cancer before the age of 75.

    Rare types of stomach and oesophageal cancer

    Some cancers start at the point where the stomach meets the oesophagus (the gastro-oesophageal junction). Depending on the type of gastro-oesophageal cancer, it may be treated similarly to stomach cancer or oesophageal cancer. 

    Some less common types of cancer can affect the stomach and oesophagus. These include small cell carcinomas, lymphomas, neuroendocrine tumours and gastrointestinal stromal tumours. These types of cancer aren’t covered on these web pages as treatment may be different. For more information about your situation, talk to your treatment team or call Cancer Council 13 11 20.

    What are the symptoms?

    Stomach and oesophageal cancers may not cause symptoms in their early stages. This means that they are usually diagnosed when the cancer is more advanced. Common symptoms are listed in the table below. These symptoms can also occur in many other conditions and do not necessarily mean that you have cancer. Speak with your general practitioner (GP) if you are concerned.

    What are the risk factors?

    The exact causes of stomach and oesophageal cancers are unknown, but the factors listed in the table below may increase your risk. Having one or more of these risk factors does not mean you will develop cancer.

    GORD and Barrett’s oesophagus

    Reflux is when stomach acid flows up into the oesophagus. Some people with reflux are diagnosed with gastro-oesophageal reflux disease (GORD).

    Over time, stomach acid can damage the lining of the oesophagus, causing inflammation or ulceration (oesophagitis). This may cause the squamous cells lining the oesophagus to be replaced by column-shaped cells, which look like the cells lining the stomach. This condition is called Barrett’s oesophagus and it can lead to oesophageal adenocarcinoma.

    If you have Barrett’s oesophagus, your doctor may recommend you have regular endoscopies to look for early cell changes that may lead to cancer. Most people with Barrett’s oesophagus will not develop oesophageal cancer.

    This website page was last reviewed and updated March 2020.

    Information reviewed by: Prof David Watson, Senior Consultant Surgeon, Oesophago-gastric Surgery Unit, Flinders Medical Centre, and Matthew Flinders Distinguished Professor of Surgery, Flinders University, SA; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Katie Benton, Advanced Dietitian, Cancer Care, Sunshine Coast Hospital and Health Service, QLD; Alana Fitzgibbon, Clinical Nurse Consultant, Gastrointestinal Cancers, Royal Hobart Hospital, TAS; Christine Froude, Consumer; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Dr Spiro Raftopoulos, Interventional Endoscopist and Consultant Gastroenterologist, Sir Charles Gairdner Hospital, WA; Grant Wilson, Consumer; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT.

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