Can Teenagers Get Stomach Cancer?

Stomach cancer (also called gastric cancer) occurs when cells in the stomach grow out of control. 

Stomach cancer tends to affect older people. The average age at stomach cancer diagnosis is 68 and about 60% of patients are 65 years or older. However, stomach cancer can occur in people at any age, even teenagers, though it is rare.

What Are Symptoms of Stomach Cancer?

Stomach cancer rarely causes symptoms early in the disease. Symptoms of stomach cancer tend to occur when the disease is more advanced and may include:

• Loss of appetite
• Weight loss without trying
• Abdominal pain
• Vague discomfort in the abdomen, usually above the bellybutton (navel)
• Heartburn or indigestion
• Nausea
• Vomiting, with or without blood
• Feeling full after eating a small meal
• Swelling or fluid build-up in the abdomen
• Blood in the stool
• Low red blood cell count (anemia)

The cause of stomach cancer may be due to certain genetic changes but the reason these changes occur is unknown. 

Risk factors for developing stomach cancer include: 

• Certain precancerous changes in the stomach lining
  • Chronic atrophic gastritis
  • Intestinal metaplasia
• Gender
  • More common in men than in women
• Age
  • Most people are diagnosed between their late 60s and 80s
• Ethnicity
  • In the U.S., it is more common in Hispanic Americans, African Americans, Native Americans, and Asian/Pacific Islanders than in non-Hispanic whites
• Geography
  • More common in Japan, China, Southern and Eastern Europe, and South and Central America
  • Less common in Northern and Western Africa, South Central Asia, and North America
• Helicobacter pylori (H pylori) infection
• Stomach lymphoma: mucosa-associated lymphoid tissue (MALT) lymphoma 
• Diet
  • Diets that include large amounts of smoked foods, salted fish and meat, and pickled vegetables increase the risk
• Tobacco use
• Being overweight or obese
• Previous stomach surgery
• Pernicious anemia
• Menetrier disease (hypertrophic gastropathy)
• Type A blood
• Inherited cancer syndromes
  • Hereditary diffuse gastric cancer
  • Lynch syndrome or hereditary non-polyposis colorectal cancer (HNPCC)
  • Familial adenomatous polyposis (FAP)
  • BRCA1 and BRCA2
  • Li-Fraumeni syndrome
  • Peutz-Jeghers syndrome (PJS)
• A family history of stomach cancer
• Certain types of stomach polyps
• Epstein-Barr virus (EBV) infection
• Certain occupations
• Workers in the coal, metal, and rubber industries appear to have a higher risk 
• Common variable immune deficiency (CVID)

Stomach cancer is diagnosed with a physical examination, patient history, and tests such as: 

• Upper endoscopy (also called esophagogastroduodenoscopy or EGD) 
• Endoscopic ultrasound
• Biopsy
• Imaging tests
  • Upper gastrointestinal (GI) series
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Positron emission tomography (PET) scan
  • Chest X-ray (to check if the cancer has spread to the lungs)
• Laparoscopy
  • Usually done after stomach cancer has been diagnosed 
  • Can help confirm the cancer is only in the stomach and can be completely removed surgically
  • Can also be done before chemotherapy and/or radiation if these are planned before surgery
• Lab tests
  • Complete blood count (CBC) 
  • Fecal occult blood test 
  • Liver and kidney function tests 
  • Blood clotting tests
• Electrocardiogram (EKG) and echocardiogram (ultrasound of the heart) to make sure the heart is functioning well if surgery is planned

Treatment for stomach cancer may involve one or more of the following: 

• Surgery 
  • Endoscopic resection
  • Removal of the tumor and part of the normal stomach wall around it
  • Used only to treat some very early-stage cancers, where the chance of spread to the lymph nodes is very low
  • Not performed as much in the U.S. as in countries such as Japan where stomach cancer is more common and often found at an earlier stage due to screening
  • Subtotal (partial) gastrectomy
  • Removal of part of the stomach, sometimes along with part of the esophagus or the first part of the small intestine (the duodenum) and the remaining section of stomach is reattached
  • Used if the cancer is only in the lower part of the stomach and sometimes for cancers only in the upper part of the stomach
  • Total gastrectomy
  • Removal of the entire stomach, nearby lymph nodes, and omentum, and sometimes the spleen and parts of the esophagus, intestines, pancreas, or other nearby organs
  • Used if the cancer has spread throughout the stomach or if the cancer is in the upper part of the stomach, near the esophagus
  • Feeding tube placement (jejunostomy tube or J tube)
  • Patients may have difficulty getting the nutrition they need after surgery for stomach cancer
  • With a feeding tube, liquid nutrition can be put directly into the intestine to help prevent and treat malnutrition
  • Lymph node removal
  • Lymph nodes are removed in a subtotal or total gastrectomy
  • Palliative surgery for unresectable cancer
  • Used to help control cancer or relieve symptoms when the tumor is unable to be removed completely
  • Subtotal gastrectomy
  • Gastric bypass (gastrojejunostomy)
  • Endoscopic tumor ablation
  • Stent placement
  • Feeding tube placement
• Chemotherapy, used alone or in combination
  • 5-FU (fluorouracil), often given along with leucovorin (folinic acid)
  • Capecitabine (Xeloda)
  • Carboplatin
  • Cisplatin
  • Docetaxel (Taxotere)
  • Epirubicin (Ellence)
  • Irinotecan (Camptosar)
  • Oxaliplatin (Eloxatin)
  • Paclitaxel (Taxol)
  • Trifluridine and tipiracil (Lonsurf), a combination drug in pill form
• Targeted therapies 
  • Trastuzumab (Herceptin) 
  • Ramucirumab (Cyramza)
• Immunotherapy 
  • Pembrolizumab (Keytruda)
• Radiation therapy 
  • External beam radiation therapy 
    • Three-dimensional conformal radiation therapy (3D-CRT) 
    • Intensity modulated radiation therapy (IMRT)

Life expectancy for stomach cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. 

Stomach cancer 5-year survival rates:

• Localized (no sign the cancer has spread outside the stomach): 69% 
• Regional (cancer has spread outside the stomach to nearby structures or lymph nodes): 31% 
• Distant (cancer has spread to distant parts of the body such as the liver): 5%