Stomach Cancer

Gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach.

Risk Factors

Having any of the following conditions:

• Helicobacter pylori (H. pylori) infection of the stomach.
• Chronic gastritis (inflammation of the stomach).
• Pernicious anemia.
• Intestinal metaplasia (a condition in which the normal stomach lining is replaced with the cells that line the intestines).
• Gastric polyps.
• Epstein Barr virus infection.
• Familial syndromes (including familial adenomatous polyposis).

Behavioral and genetic factors:

• Eating a diet high in salted, smoked foods and low in fruits and vegetables
• Eating foods that have not been prepared or stored properly
• Being older or male
• Smoking cigarettes
• Having a mother, father, sister, or brother who has had stomach cancer

Signs and Symptoms

Early stages:

• Indigestion and stomach discomfort
• A bloated feeling after eating
• Mild nausea
•  Loss of appetite
• Heartburn

Advanced stages:

• Blood in the stool
• Vomiting
• Weight loss for no known reason
• Stomach pain
• Jaundice (yellowing of eyes and skin)
• Ascites (build up of fluid in the abdomen)
• Trouble swallowing

Testing

Providers use tests that examine the stomach and esophagus to diagnose gastric cancer.

• Physical exam and health history
• Blood chemistry studies
• Complete blood count (CBC)
• Upper endoscopy
• Barium swallow
• CT scan (CAT scan)
• Biopsy

Prognosis Factors

The prognosis and treatment options depend on the following:

• The stage of the cancer (whether it is in the stomach only or has spread to lymph nodes or other places in the body). 
• The patient's general health.

When gastric cancer is found very early, there is a better chance of recovery. Gastric cancer is often in an advanced stage when it is diagnosed. At later stages, gastric cancer can be treated but rarely can be cured.

Treatment Options

Seven types of standard treatments are used:

• Surgery - Removing the cancer in an operation. If the cancer hasn’t spread, surgery – in combination with other treatments – offers the best chance to cure the cancer.
• Endoscopic mucosal resection - An outpatient procedure in which physicians remove tumors just beneath the gastrointestinal (GI) wall without surgery.
• Chemotherapy - Using drugs to stop the growth of cancer cells either by killing the cells or by stopping the cells from dividing.
• Radiation therapy - Using high energy X-rays or other types of radiation to kill cancer cells or keep them from growing.
• Chemoradiation - Combines chemotherapy and radiation therapy to increase the effects of both.
• Targeted therapy - Using drugs or other substances to identify and attack specific cancer cells.
• Immunotherapy - Using substances made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against cancer.

Clinical Trials

Our providers are also testing new types of treatment in clinical trials, which patients may want to consider. You can enter clinical trials before, during, or after starting their cancer treatment.

Download our brochure for more complete information on treatments at the various stages of disease.

This content was last medically reviewed in May 2022 by Sharlotte Manley, MSN, FNP, Erlanger Gastroenterology.