Stomach cancer, also called gastric cancer, is a malignant tumor that develops in the lining of the stomach. Most stomach cancers are adenocarcinomas. Symptoms may be absent early and can later include indigestion, upper abdominal discomfort, nausea, difficulty swallowing, loss of appetite, weight loss, anemia or gastrointestinal bleeding.
Stomach cancer develops in the stomach. Most gastric cancers are adenocarcinomas arising from gland-forming cells in the stomach lining. Other less common tumors include gastrointestinal stromal tumors, neuroendocrine tumors and lymphomas, which have different treatment approaches. Early stomach cancer may cause few or nonspecific symptoms.
The stomach is a muscular digestive organ between the esophagus and small intestine. It includes the cardia, fundus, body, antrum and pylorus. Its wall contains mucosal, submucosal, muscular and outer layers. Lymphatic drainage connects the stomach to regional lymph-node groups.
Stomach cancer develops after abnormal cells acquire changes that disrupt normal growth and repair. Some gastric cancers develop through a sequence involving chronic inflammation and precancerous changes in the stomach lining.
Abnormal cells in the stomach lining acquire genetic and cellular changes that allow uncontrolled growth. The tumor can invade deeper stomach layers, spread to nearby lymph nodes and eventually metastasize to distant organs.
Most stomach cancers are adenocarcinomas. Gastric adenocarcinomas may be classified using histologic and molecular characteristics. Less common gastric malignancies include gastrointestinal stromal tumors, neuroendocrine tumors and lymphomas, which require different diagnostic and treatment strategies.
The most common type is gastric adenocarcinoma. Other stomach tumors include gastrointestinal stromal tumors, neuroendocrine tumors and gastric lymphomas. Histologic and molecular classification helps determine prognosis and treatment.
Persistent indigestion or dyspepsia
Upper abdominal discomfort or pain
Feeling full after eating a small amount
Loss of appetite
Unexplained weight loss
Nausea or vomiting
Difficulty swallowing
Fatigue or anemia
Gastrointestinal bleeding or black stools
Early disease may cause few or no symptoms
There is no single cause of stomach cancer. Risk is associated with chronic Helicobacter pylori infection, chronic gastritis and atrophic changes, certain dietary patterns, tobacco use, family history and inherited susceptibility. Some precancerous gastric conditions can also increase risk.
Helicobacter pylori infection
Chronic gastritis
Atrophic gastritis or intestinal metaplasia
Smoking
Family history of gastric cancer
Inherited susceptibility such as hereditary diffuse gastric cancer
Increasing age
Certain dietary patterns
Previous gastric surgery or selected gastric disorders
Upper gastrointestinal endoscopy with biopsy is the main diagnostic test when stomach cancer is suspected. Blood tests may identify anemia or other abnormalities. CT imaging helps evaluate spread. Endoscopic ultrasound, PET/CT and diagnostic laparoscopy may be used in selected cases for staging.
Persistent upper abdominal discomfort
Unexplained weight loss
Pallor or findings suggesting anemia
Abdominal tenderness
Difficulty swallowing
Early satiety
Vomiting or gastric outlet symptoms
Evidence of gastrointestinal bleeding
Complete blood count
Iron studies when iron-deficiency anemia is present
Liver function tests
Kidney function and blood chemistry tests
Nutritional assessment when indicated
Helicobacter pylori testing
Tumor biomarker or molecular testing when treatment selection requires it
HER2 testing in selected gastric cancers
PD-L1 and other biomarker testing in selected advanced disease
Contrast-enhanced CT of the chest, abdomen and pelvis
Endoscopic ultrasound
PET/CT in selected patients
MRI in selected clinical situations
Diagnostic laparoscopy with peritoneal evaluation in selected locally advanced disease
Upper gastrointestinal endoscopy with biopsy
Endoscopic ultrasound
Diagnostic laparoscopy
HER2 and other molecular biomarker testing
Genetic counseling and germline testing when hereditary risk is suspected
Peptic ulcer disease
Gastritis
Gastroesophageal reflux disease
Functional dyspepsia
Helicobacter pylori-associated gastritis
Gallbladder or biliary disease
Pancreatic disease
Stomach cancer is commonly staged using TNM principles and grouped into stages 0 through IV. Staging considers how deeply the tumor has invaded the stomach wall, whether regional lymph nodes contain cancer and whether distant metastases are present.
Staging or grading systems differ between diseases. The information here is educational and should be interpreted by a qualified healthcare professional in the context of the individual case.
Treatment depends on tumor type, stage, location, molecular characteristics and overall health. Options include endoscopic treatment for selected early cancers, surgery, chemotherapy, radiation therapy, chemoradiation, targeted therapy, immunotherapy and supportive or palliative care. Treatment is often multidisciplinary.
Chemotherapy medicines selected by the oncology team
Targeted therapy for tumors with actionable biomarkers
Immunotherapy for selected patients
Antiemetic medicines for treatment-related nausea
Pain-relieving medicines
Iron or other nutritional replacement when deficiencies are confirmed
Medicines listed here are for educational information only. Do not start, stop, or change a medicine without professional medical advice.
Possible complications include gastrointestinal bleeding, anemia, gastric outlet or intestinal obstruction, difficulty eating, malnutrition, perforation, pain, blood clots and metastatic disease.
Vomiting blood
Black, tarry stools or significant gastrointestinal bleeding
Severe or rapidly worsening abdominal pain
Persistent vomiting with inability to keep fluids down
Fainting, severe weakness or symptoms suggesting major blood loss
Fever with severe abdominal symptoms
If symptoms are severe, rapidly worsening, or life-threatening, seek emergency medical care immediately.
Prognosis is influenced by stage, depth of invasion, lymph-node involvement, distant metastases, tumor biology, surgical resectability and response to treatment. Earlier diagnosis generally provides more opportunities for curative treatment.
Survival statistics describe outcomes in groups of people and cannot predict exactly what will happen to one individual. Prognosis depends on factors such as cancer stage, tumor biology, treatment response, overall health, and follow-up.
Risk of stomach cancer increases with age. Important risk factors include Helicobacter pylori infection, chronic gastric inflammation, tobacco exposure, family history, inherited susceptibility and certain dietary exposures. Incidence varies substantially between geographic populations.
Risk reduction includes avoiding tobacco, limiting alcohol, maintaining a healthy weight and balanced diet, and testing and treating Helicobacter pylori when clinically appropriate. People with hereditary risk or high-risk gastric conditions should discuss surveillance with a specialist.
What type of stomach cancer do I have?
What is my TNM stage?
Has the cancer spread to lymph nodes or distant organs?
Do I need an endoscopy and biopsy?
Should my tumor be tested for HER2 or other biomarkers?
Is surgery appropriate for my cancer?
Could endoscopic treatment be an option?
Will I need chemotherapy before or after surgery?
How can I maintain nutrition and weight during treatment?
Which symptoms should make me seek urgent medical care?
BimariDur provides educational health information to help people understand diseases, symptoms, tests, and treatment concepts. It does not replace examination, diagnosis, or treatment by a qualified healthcare professional.
Do not delay professional medical care because of information read on BimariDur.