- The innermost layer is the mucosa. This is where stomach acid and digestive enzymes are made. Most stomach cancers start in this layer.
- Next is a supporting layer called the submucosa.
- Outside of this is the muscularis propria, a thick layer of muscle that helps move and mix the stomach contents.
- The outer 2 layers, the subserosa and the outermost serosa, wrap the stomach.
The layers are important in determining the stage (extent) of the cancer, which can affect a person’s treatment options and prognosis (outlook). As a cancer grows from the mucosa into deeper layers, the stage becomes more advanced and treatment might need to be more extensive.
Development of stomach cancer
Stomach cancers tend to develop slowly over many years. Before a true cancer develops, pre-cancerous changes often occur in the inner lining (mucosa) of the stomach. These early changes rarely cause symptoms, so they often go undetected.
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Cancers starting in different sections of the stomach can cause different symptoms and tend to have different outcomes. The cancer’s location can also affect treatment options. For example, cancers that start at or grow into the GE junction are usually staged and treated the same as cancers of the esophagus. (For more information, see Esophagus Cancer.)
Types of stomach cancer
Adenocarcinomas
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Most cancers of the stomach (about 90% to 95%) are adenocarcinomas. These cancers develop from the gland cells in the innermost lining of the stomach (the mucosa).
If you are told you have stomach cancer (or gastric cancer), it will almost always be an adenocarcinoma. The information on the following pages that discusses stomach cancer refers to this type of cancer.
There are 2 main types of stomach adenocarcinomas:
- The intestinal type tends to have a slightly better prognosis (outlook). The cancer cells are more likely to have certain gene changes that might allow for treatment with targeted drug therapy.
- The diffuse type tends to grow spread more quickly. It is less common than the intestinal type, and it tends to be harder to treat.
Other types of cancer that can start in the stomach
Gastrointestinal stromal tumors (GISTs)
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These uncommon tumors start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal. Some GISTs are much more likely than others to grow into other areas or spread to other parts of the body. Although GISTs can start anywhere in the digestive tract, most start in the stomach. For more information, see Gastrointestinal Stromal Tumor (GIST).
Neuroendocrine tumors (including carcinoids)
Neuroendocrine tumors (NETs) start in cells in the stomach (or other parts of the digestive tract) that act like nerve cells in some ways and like hormone-making (endocrine) cells in others. Most NETs tend to grow slowly and do not spread to other organs, but some can grow and spread quickly. NETs are discussed in more detail in Gastrointestinal Neuroendocrine (Carcinoid) Tumors.
Lymphomas
These cancers start in immune system cells called lymphocytes. Lymphomas usually start in other parts of the body, but some can start in the wall of the stomach. The treatment and outlook for these cancers depend on the type of lymphoma and other factors. For more information, see Non-Hodgkin Lymphoma.
Other cancers
Other types of cancer, such as squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas, can also start in the stomach, but these cancers are very rare.
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