Stomach cancer

About stomach cancer

Stomach cancer is the fifth most common cancer in India, with an estimated 70,000 new cases every year. The prevalence of stomach cancer varies from region to region because of differences in diet and lifestyle.

Globally, the number of people getting it has been steadily decreasing. 

Early symptoms of stomach cancer may be quite vague and similar to . This means that many people with stomach cancer don’t find out until the cancer is quite advanced. Without treatment, stomach cancer can spread to other parts of your body including organs such as your liver. When cancer spreads through the body, the process is called metastasis.

Most (more than nine out of 10) stomach cancers start in gland cells in the lining of your stomach. These are called adenocarcinomas. Our information here is about this type of stomach cancer. 

Causes of stomach cancer

Stomach cancer is likely to be due to a combination of different factors. But it’s often linked to lifestyle, including diet. Although it’s possible to develop it at a younger age, stomach cancer is more common in older people – most people who get it are over 55. It’s also more common in men than women.

You're also more likely to develop stomach cancer if you:

• have a long-term stomach infection with a type of bacteria called Helicobacter pylori (H. pylori)
• have pernicious anaemia – where your body doesn't absorb enough vitamin B12 from your diet
• have a diet high in salt or preserved foods such as smoked, cured or pickled foods, or low in fruit and vegetables
• smoke
• drink a lot of
• are overweight or
• have acid reflux, also known as gastro-oesophageal reflux disease (GORD)
• are blood group A

A small number of people who develop stomach cancer also have a family history of the disease.

Having any of these risk factors doesn’t mean that you will definitely get stomach cancer – but they increase your chances of developing it. Similarly, you can still develop stomach cancer without having any of these risk factors.

Symptoms of stomach cancer

Symptoms of stomach cancer can be quite vague in the early stages. For many people, is one of the first symptoms.

Other symptoms of stomach cancer may begin to happen as the cancer advances. These can include:

• pain in your abdomen (tummy)
• losing weight without trying
• losing your appetite
• feeling unusually full after eating
• difficulty swallowing
• feeling sick or being sick
• blood in your poo, which can make it look black
• feeling tired and breathless, due to anaemia (a reduced number of red blood cells)

Many of these symptoms are often caused by other less serious problems or conditions such as , ulcers or reflux. Contact your doctor if you have new, unusual symptoms for you – or if they don’t go away after three weeks. You should also contact your doctor if you regularly take  but they seem to have stopped working. You should always seek medical help if you have difficulty swallowing.

Diagnosis of stomach cancer

Your doctor will ask about your symptoms and examine you. They’ll also ask you about your medical history and will arrange for you to have blood tests.

 If your doctor thinks you need further investigations, they may refer you for a test called a gastrointestinal endoscopy (also called a ). The test involves passing a narrow, flexible, tube-like telescopic camera called an endoscope down your throat to look inside your stomach. The endoscopist who carries out the test may remove small samples of tissue (biopsies) from any abnormal areas of your stomach at the same time. Any samples are sent to a laboratory to look for cancer cells.

If you're found to have stomach cancer, you’ll be referred to a specialist cancer doctor (oncologist) or surgeon. You’ll need further tests to find out how advanced your cancer is and if it’s spread. This process is known as staging. Tests may include:

• a chest
• a whole-body
• a PET-CT scan (a specialist CT scan using radioactive medicine to show up potential cancer cells)
• an endoscopic ultrasound, which combines endoscopy with ultrasound to show how deep the cancer goes
• a laparoscopy – a small operation to look inside your abdomen, using a thin tube (a laparoscope) inserted through small cuts in your tummy

Your doctor will explain which of these tests you may need and what they involve. Be sure to ask your doctor any questions you have about your tests.

Treatment of stomach cancer

Your treatment and care will be managed by a team of doctors and other cancer specialists. They will discuss with you what treatments they recommend in your particular circumstances. Treatment will depend on the size and position of your stomach cancer, if it has spread, and if you’ve had previous surgery to your stomach. Your general health and fitness will also be taken into account, along with your own wishes about your treatment.

If you’re diagnosed with stomach cancer early, it can be easier to treat and possible to cure. Many people with stomach cancer don’t find out until it’s at a late stage and it may not be possible to cure it. If this is the case, your treatment will focus on easing your symptoms, controlling the cancer and improving your quality of life.

Surgery

Surgery is the main treatment for early-stage stomach cancer because it may cure your cancer. If your cancer is very small and just in the stomach lining, you may be able to have an operation called endoscopic mucosal resection. This is when the affected areas of your stomach lining are removed through a tube passed down your throat, called an endoscope. You won’t need any cuts to your tummy for this.

For larger cancers, you may have an operation to remove part of your stomach (partial or subtotal gastrectomy) or all of your stomach (total gastrectomy). You might be able to have keyhole (laparoscopic) surgery rather than open surgery. This means your surgeon will make several smaller cuts in your abdomen to reach your stomach, instead of one larger one.

If your surgeon recommends you have surgery, they’ll explain what will happen before, during and after your operation – including potential side-effects. For more information, see our FAQs on dumping syndrome and on what you can eat and drink after surgery below.

Non-surgical treatment

Your doctor may offer you one of the following treatments as well as or instead of surgery.

• . This uses medicines to kill cancer cells. You may have chemotherapy both before and after surgery, to help cure your cancer. If you’re unable to have surgery, you may be offered chemotherapy to slow down the growth of your cancer and reduce symptoms.
• Targeted cancer drugs. These are medicines that can seek out cancer cells and interfere with the way they grow. If your stomach cancer has spread, you may be offered a medicine called trastuzumab (Herceptin®) alongside chemotherapy. This can help control the growth of your cancer. 
• . This uses radiation to destroy cancer cells. Sometimes, your doctor may offer you this alongside chemotherapy after surgery. It’s sometimes used to control symptoms if you have advanced cancer.

Prevention of stomach cancer

Over half of stomach cancers are preventable. You can control some of the risk factors for stomach cancer by making changes to your lifestyle. This may reduce your risk of getting stomach cancer and bring many other health benefits too. Changes you can make include the following. 

• Don’t eat too many salted, cured or preserved foods such as smoked meats and pickled vegetables.
• If you smoke, stop.
• Don’t drink alcohol, but if you do, cut down and only .
• Keep to a .

Help and support

Being diagnosed with stomach cancer and facing treatment can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects and practical issues, as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need – make sure you talk to them if you have any concerns.

Weight loss is a very common problem for people with stomach cancer. This is because the side-effects of the cancer and treatment can make it difficult to eat enough. Speak to your doctor, nurse or dietitian about how to make sure you’re and getting any help you need.

Talking to your family and friends can help them to understand what you’re going through and how you’re feeling. Organisations and support groups that specialise in helping people with cancer can be a great source of information and support.