Gastric Cancer

Key Points

Overview

Commonly affected areas:

Gastric cancer, commonly called stomach cancer, begins when cells in the inner lining of the stomach grow abnormally and form a tumour. It usually develops over many years, often after long-standing inflammation of the stomach lining. Because early symptoms are vague, many people are diagnosed at a later stage, when the cancer may have spread to lymph nodes, the liver or the lining of the abdomen. Treatment depends on the stage and may include surgery, chemotherapy, targeted therapy or immunotherapy. When found early, gastric cancer is often treatable with a good chance of long-term control.

Signs and Symptoms

People with gastric cancer may experience:

• Persistent indigestion, heartburn or upper-abdominal discomfort that does not settle
• Feeling full quickly after eating only a small amount of food
• Unexplained weight loss and loss of appetite over several weeks
• Nausea, vomiting, or occasionally vomiting blood
• Black, tarry stools caused by bleeding in the stomach
• Tiredness and breathlessness due to anaemia from slow blood loss

Things That Increase the Risk

Factors that raise the risk of gastric cancer include:

• Long-term Helicobacter pylori infection of the stomach
• Diets high in salted, smoked or pickled foods
• Smoking and heavy alcohol use
• Family history of stomach cancer or inherited cancer syndromes
• Chronic gastritis or previous stomach surgery
• Age over 50 and male sex

Diagnosis

Diagnosis typically involves:

• Upper GI endoscopy to examine the stomach lining
• Biopsy of suspicious tissue for pathology and biomarker testing
• CT scan of the chest, abdomen and pelvis for staging
• Endoscopic ultrasound to assess tumour depth
• PET-CT or diagnostic laparoscopy in selected cases

Treatment & Management

Treatment is planned by a multidisciplinary team based on the cancer's stage, location and biomarker results. Most patients receive a combination of therapies rather than a single treatment.

• Eat small, frequent, high-protein meals
• Follow a dietitian-guided nutrition plan
• Stop smoking and avoid alcohol
• Stay gently active as energy allows

• Endoscopic removal for very early cancers
• Partial or total gastrectomy with lymph node removal
• Chemotherapy before and after surgery
• Targeted therapy or immunotherapy for suitable tumours

Prevention

Steps that may help include:

Not all stomach cancers can be prevented, but reducing known risk factors lowers the chance of developing it.

• Test and treat H. pylori infection
• Eat more fresh fruit and vegetables
• Limit salted, smoked and pickled foods
• Avoid tobacco and limit alcohol
• Seek early endoscopy if symptoms persist or family history exists

Related Conditions

You might also want to learn about:

• Chronic Gastritis
• Peptic Ulcer Disease
• Oesophageal Cancer
• Gastroesophageal Reflux Disease (GERD)

Surgical Options

Learn about surgical procedures available for Gastric Cancer: