Welcome to the new Gustave Roussy website
A new website designed to offer you a simpler, clearer, and more intuitive experience. Patients, caregivers, healthcare professionals, and donors: find information, news, and services more easily.
Stomach Cancer
Director:
Prof. Michel Ducreux
Contact:
+33 (0)1 42 11 57 99
Email
Understanding the Disease
Stomach cancer is associated with several risk factors, including infection with the bacterium Helicobacter pylori, which causes chronic inflammation of the stomach (chronic gastritis), smoking, a diet high in salty foods and low in fresh fruits and vegetables, a family history of stomach cancer, or a genetic predisposition that increases the risk of developing stomach cancer.
In 90% of cases, stomach cancers develop from cells in the innermost layer of the stomach (mucosa). These are known as adenocarcinomas. Adenocarcinomas can form in any part of the organ: in the upper two-thirds of the stomach, in the body or fundus (proximal tumors), or in the lower third of the stomach, in the antrum (distal tumors).
More rarely, stomach cancers develop as neuroendocrine tumors, gastrointestinal stromal tumors (GISTs), or lymphomas. These rare types of stomach cancer are treated differently from adenocarcinoma.
What is the stomach?
The stomach is a key organ of the digestive system. Located in the upper abdomen, between the esophagus and the small intestine, it acts as a true “processing chamber” for food. After swallowing, food enters the stomach, where it is mixed with powerful gastric juices that break it down and begin the digestion process.
The stomach also plays a regulatory role: it gradually releases digested food into the small intestine, where nutrients are absorbed. Its inner lining is protected by a special mucus that shields it from the acidity of its own secretions. When this balance is disrupted, certain diseases can develop, ranging from inflammation to more complex lesions.
Stomach Cancer by the Numbers
-
4,657
new cases in France each year.
-
65%
New cases are being diagnosed in men.
-
90%
Stomach cancers are adenocarcinomas.
Figures: National Cancer Institute.
Prevention and Risk Factors
When stomach cancer develops, it often progresses gradually from preexisting lesions in the gastric mucosa. Certain chronic inflammations, infections such as Helicobacter pylori, or lifestyle factors can weaken the stomach over time. Identifying and reducing these factors can lower the risk and, in some cases, lead to earlier detection of precancerous lesions.
Chronic infection with the bacterium Helicobacter pylori is one of the main risk factors for stomach cancer. It causes long-term inflammation of the stomach lining, which can progress to precancerous lesions. Screening for and treating this infection can significantly reduce the risk of developing stomach cancer.
Smoking increases the risk of stomach cancer by promoting inflammation of the stomach lining and impairing cellular repair mechanisms. Quitting smoking is a key preventive measure, as it gradually reduces the risk of developing stomach cancer.
A diet high in salt, smoked foods, or foods preserved by salting can irritate the stomach lining and increase the risk of cancer. Conversely, a varied diet rich in fruits and vegetables helps protect the stomach lining thanks to its fiber and antioxidant content.
Some forms of stomach cancer are associated with genetic predispositions or a family history of the disease. In these situations, appropriate medical follow-up may be recommended to monitor for the development of early-stage lesions and to intervene quickly if necessary.
The risk increases with age due to prolonged exposure to irritating or infectious factors. Certain chronic stomach conditions, such as atrophic gastritis or gastric polyps, can also contribute to the development of precancerous lesions. Regular follow-up visits help ensure these conditions are monitored.
Symptoms
Stomach cancer often causes few symptoms at first, which can delay diagnosis. When symptoms do appear, they are related to irritation or progressive damage to the stomach lining and the progression of the disease. These symptoms include:
- Abdominal pain or discomfort: Persistent pain or a burning sensation in the upper abdomen may be a sign of stomach cancer.
- Loss of appetite and weight loss: A decreased appetite, sometimes accompanied by unintentional weight loss, is common.
- Nausea, vomiting, or digestive problems: Nausea, difficulty digesting food, a feeling of heaviness after meals, or vomiting may accompany the disease.
- Early satiety: Feeling “full” very quickly, even after eating small amounts of food, may be a sign of obstruction or inflammation.
- Persistent fatigue: Long-lasting fatigue may be related to anemia caused by subtle but repeated gastrointestinal bleeding.
- Blood in the stool or bloody vomiting: These signs may indicate bleeding from the stomach lining and require prompt medical attention.
- Bloating or discomfort after meals: A feeling of bloating or discomfort after eating may occur when the stomach is no longer functioning normally.
Diagnosis
The symptoms of gastric cancer are nonspecific and may include epigastric pain or even weight loss. Because the symptoms are nonspecific, a series of tests is essential to establish a diagnosis.
The first test is a gastroscopy (fibroscopy), which allows the lesion to be visualized, precisely located within the stomach, and biopsied.
It is also recommended to supplement the evaluation with a CT scan of the chest and abdomen to assess the extent of the disease and look for possible metastases. Depending on the clinical presentation, further tests may be recommended, such as an exploratory laparoscopy, tumor marker tests, molecular analyses, a transgastric ultrasound, a PET scan, etc.
Coverage
Gustave Roussy provides diagnosis and treatment for stomach cancer, but also treats patients who have already received a diagnosis.
All the medical disciplines involved in the management of gastric cancer are represented at Gustave Roussy. Expert teams in surgery, gastrointestinal oncology, interventional radiology, and radiation oncology have access to state-of-the-art technical facilities (PET scans, MRI, hybrid operating rooms, robotic surgery, etc.) and can offer each patient the most appropriate treatment.
Decisions regarding treatment plans are made during multidisciplinary team (MDT) meetings. These meetings involve several physicians from different specialties: gastrointestinal oncologists, surgeons, radiation oncologists, and interventional radiologists. An MDT report is prepared for each patient.
Nutrition
The Nutrition Unit at Gustave Roussy is particularly involved in the care of patients with gastric cancer. This expertise helps limit the negative effects of malnutrition by tailoring care to each specific condition. In the context of stomach cancer, the unit supports patients’ return to a normal diet by improving the nutritional quality of meals, both in the hospital and at home.
Treatments
The prognosis for gastric cancer varies. Treatment must be tailored and personalized based on test results
The team at Gustave Roussy is a pioneer and possesses rare expertise in the robotic surgical management of gastric cancers. The institution was the first in Europe to work with the most advanced model and to develop this innovative treatment approach.
Surgical resection involves removing part or all of the stomach, depending on the tumor’s location. This procedure can be performed using robot-assisted surgery to improve postoperative outcomes. The introduction of robotic surgery has now made it possible to expand the range of indications thanks to greater surgical dexterity and 3D visualization.
In most cases, this procedure allows patients to return to a normal life. The team at Gustave Roussy is a pioneer and possesses rare expertise in the robotic surgical treatment of gastric cancers. The institution was the first in Europe to work with the most advanced model and to develop this innovative treatment approach.
→ More information on robotic surgery [notes: links to be reviewed]
Chemotherapy is most often used in conjunction with surgery. The choice of treatment drugs depends on each patient’s specific presentation. It is tailored not only to the stage of the disease but also to the patient’s overall health. It also depends on the molecular status of the disease. Numerous studies conducted at Gustave Roussy have helped refine the medical management of stomach cancer.
Targeted therapies are drug-based treatments that act on mechanisms specific to cancer cells. Currently, the main targeted therapy drug approved for use in the treatment of gastric cancer is a HER2 inhibitor. Other drugs are currently being evaluated in clinical trials.
The peritoneum (the membrane surrounding all the organs in the abdomen) may be affected in cases of stomach cancer. The medical and surgical teams at Gustave Roussy are leaders in the management of peritoneal involvement and have developed a wide range of intraperitoneal treatments, including PIPAC (aerosol-delivered chemotherapy) and CHIP (hyperthermic intraperitoneal chemotherapy), which may be recommended depending on the clinical situation.
Gustave Roussy specializes in the management of peritoneal disease. All locoregional treatment techniques are available, and most were developed in-house at the institution.
Percutaneous tumor ablation and radiation therapy can be used to treat certain secondary lesions.
Percutaneous ablation is a minimally invasive, image-guided technique that destroys the tumor using heat (radiofrequency) or cold (cryotherapy), significantly reducing the risk of complications. The procedure is performed through the skin under general anesthesia by an interventional radiologist specializing in medical imaging-guided treatments.
Stereotactic radiation therapy may be indicated, in particular, for patients with localized secondary lesions.
The effectiveness of immunotherapy varies in the treatment of gastric cancer. Your medical oncologist will be available to answer any questions you may have about the indications for this treatment.
Search
Depending on the characteristics and stage of the cancer, Gustave Roussy may offer patients the opportunity to participate in clinical research trials. The therapeutic innovations in these trials provide patients with access to new drugs and precision medicine through the molecular characterization of each tumor. If appropriate, the possibility of participating in a clinical trial will be discussed with patients during their care with their referring oncologist, allowing them to access innovative treatments.
► View ongoing clinical trials for stomach cancer.
Join a clinical trial
Many clinical trials are open to patients with cancer. Participating in a clinical trial provides access to innovative treatments while contributing to the development of new therapies.
Contacts
Head:
Prof. Michel Ducreux
Contact:
Phone: +33 (0)1 42 11 57 99
Appointments and Second Opinions
-
Classement du Point : Gustave Roussy progresse parmi les meilleurs hôpitaux français en cancérologie
Gustave Roussy progresse dans le classement des meilleurs hôpitaux français publié par le magazine Le Point. L’Institut figure 11 fois dans le top 10 pour plusieurs spécialités en cancérologie, dont 8 fois dans le top 5. À noter : Gustave Roussy est premier pour la prise en charge des cancers ORL depuis plus d’une décennie. Une performance qui reflète l’engagement quotidien de l’ensemble des équipes de Gustave Roussy.
-
Digestive Cancers in 2024
Therapeutic Innovations in Stomach Cancer
Stomach cancer is often linked to infection with the bacterium Helicobacter pylori, an unbalanced diet (high in salty or smoked foods, low in fruits and vegetables), smoking, excessive alcohol consumption, or a family history of the disease. Certain chronic stomach conditions, such as atrophic gastritis, can also increase the risk.
The most common symptoms include persistent stomach pain, difficulty swallowing, repeated nausea or vomiting, unexplained weight loss, severe fatigue, or gastrointestinal bleeding (black stools or bloody vomit). It is important to see a doctor if these symptoms last longer than two weeks.
The diagnosis is based primarily on an upper gastrointestinal endoscopy (gastroscopy) with a biopsy, supplemented by imaging tests such as a CT scan or endoscopic ultrasound. Blood tests may also be performed to refine the evaluation.
Helicobacter pylori is a bacterium that infects the lining of the stomach. It is responsible for the majority of peptic ulcers and is the leading risk factor for stomach cancer. This infection, often acquired during childhood, can cause chronic inflammation (gastritis) and, over the long term, contribute to the development of precancerous lesions. A simple test (serology, breath test, or stool test) can detect the infection, and treatment with antibiotics can eradicate it.