15812 Stomach Cancer

Overview

Stomach cancer, also called gastric cancer, is a condition where abnormal cells grow out of control in the lining of the stomach. It usually develops slowly over many years and can spread to other parts of the body if not found early.

Stomach cancer is not as common as it used to be, but it still affects thousands of people each year. It is less common in the UK than in some other parts of the world.

Stomach cancer can affect anyone, but it is most often diagnosed in people over 60. It is slightly more common in men than in women. People with certain risk factors, such as an H. pylori infection or a family history of stomach cancer, have a higher chance of developing it.

Symptoms

Common symptoms

• Persistent indigestion or heartburn
• Feeling full after eating only a small amount
• Loss of appetite and unexplained weight loss
• Pain or discomfort in the stomach area
• Feeling sick or vomiting
• Difficulty swallowing
• Tiredness or low energy, sometimes due to anaemia (low iron in the blood)
• Blood in vomit or in stool (which may look black)

Symptoms in children

• Stomach cancer is extremely rare in children. Symptoms may be similar to adults but are more likely to be caused by other conditions. Watch for ongoing stomach pain, vomiting, weight loss, or paleness, and seek medical advice if these occur.

Symptoms in older adults

• Symptoms in older adults can be vague and easy to miss, such as a general feeling of unwellness, tiredness, poor appetite, or unexplained weight loss. Sometimes the first sign is anaemia found on a routine blood test.

Causes

Main causes

• Infection with a bacterium called Helicobacter pylori (H. pylori), which can cause long-term inflammation in the stomach lining.
• Long-term inflammation of the stomach, known as chronic gastritis.
• Certain inherited gene changes that run in families, though this is uncommon.
• Abnormal growths or polyps in the stomach lining.

Risk factors

• Being over 60 years old
• Being male
• Smoking tobacco
• Drinking alcohol heavily
• A diet high in salty, smoked, pickled, or processed foods
• A diet low in fresh fruits and vegetables
• Being very overweight (obesity)
• Having a family history of stomach cancer
• Having a condition called pernicious anaemia or certain genetic syndromes

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have persistent vomiting, blood in your vomit, black or bloody stools, unexplained weight loss, or difficulty swallowing.
• If your symptoms are sudden and severe, call your local emergency number or go to an urgent care department.

Book a routine appointment if:

• Make a routine appointment with your doctor if you have indigestion, heartburn, feeling full quickly, or stomach discomfort that lasts for more than three weeks.
• Also see a doctor if you have been feeling unusually tired or have lost your appetite for no clear reason.

Diagnosis

Your doctor will ask about your symptoms and medical history, and may press gently on your stomach to check for tenderness or swelling. If they think it could be stomach cancer, they will usually refer you to a specialist for further tests.

Tests that may be done

• Endoscopy: a thin, flexible tube with a camera is passed down your throat to look at the inside of your stomach. You are usually given a sedative, and it is not painful.
• Biopsy: during endoscopy, the specialist takes a small piece of tissue from the stomach lining to check for cancer cells.
• Blood tests: to check your general health and see if you have anaemia or other problems.
• Imaging scans: such as a CT scan or ultrasound, to see if the cancer has spread to other parts of the body.
• Barium meal (less common now): you drink a liquid that helps show the stomach clearly on X-rays.

What to expect at your appointment

If you are referred for tests, you may be asked to fast for a few hours beforehand. Endoscopy usually takes about 15 minutes and you can go home the same day. It may take a week or more to get your biopsy results. A care team will explain what the findings mean and discuss next steps with you.

Treatment

Treatment for stomach cancer depends on how far it has grown or spread (the stage), your general health, and your preferences. The main options include surgery, chemotherapy, radiotherapy, and newer targeted treatments. Your care team will recommend a plan that is right for you.

Self-care at home

• Follow your doctor's advice about eating and drinking during treatment.
• Eat small, frequent meals if large meals feel uncomfortable.
• Stay as active as you can, but rest when you need to.
• Ask for help with everyday tasks if you are feeling weak or tired.
• Keep in touch with your healthcare team and tell them about any new symptoms.

Medical treatments

Medical treatments for stomach cancer may include surgery to remove part or all of the stomach, chemotherapy (using medicines to kill cancer cells), radiotherapy (using high-energy rays), and targeted therapies or immunotherapy. The exact combination depends on the stage and the individual situation. Your healthcare team will explain the benefits and risks of each option.

When is surgery considered?

Surgery is often the main treatment if the cancer has not spread beyond the stomach. The surgeon may remove only the part of the stomach containing the cancer, or in some cases the whole stomach. This can be done as keyhole surgery or open surgery. After surgery, your digestive system will be adjusted, and you will need to learn to eat differently.

Living with this condition

Living with stomach cancer can be challenging, but many people adapt well over time. After treatment, you may need to change how you eat and what you eat. It is normal to feel tired, and you may need to take breaks during the day. Your healthcare team will guide you about what to expect and how to manage side effects.

Lifestyle tips

• Stop smoking if you smoke – it can improve your recovery and reduce the risk of cancer returning.
• Limit alcohol, especially after surgery or during treatment.
• Maintain a healthy weight with gentle activity, as advised by your doctor.
• Talk to a dietitian about the best foods for you, especially if eating is difficult.
• Get plenty of rest and allow yourself time to heal.

Diet and exercise

You may find that you cannot eat large meals after treatment, so having smaller meals more often can help. Chew food well and eat slowly. Foods that are soft, moist, and easy to digest are often easier to handle. A dietitian can give you individual advice. Gentle exercise like walking can help you regain strength, but check with your doctor before starting any exercise programme.

Mental health and emotional wellbeing

A cancer diagnosis can bring worry, sadness, or anxiety. These emotions are completely normal. It can help to talk openly with your family, close friends, or a professional counsellor. Some people find it useful to join a support group where they can speak to others going through the same experience.

Prevention

It is not always possible to prevent stomach cancer, but you can lower your risk by not smoking, limiting alcohol, eating a balanced diet with plenty of fruits and vegetables, cutting down on salty or smoked foods, and maintaining a healthy weight. Treating H. pylori infection early may also reduce the risk.

Screening programmes

There is no routine stomach cancer screening in the UK for the general public. For people at high risk due to family history or certain genetic conditions, doctors may offer regular endoscopy checks. If you are concerned about your risk, talk to your own doctor.

Complications

If left untreated

• The cancer can grow deeper into the stomach wall and spread to nearby lymph nodes or other organs, such as the liver, lungs, or bones.
• Bleeding from the stomach, which can lead to anaemia or severe blood loss.
• Blockage of the stomach, making it hard to eat or swallow.
• Severe weight loss and weakness due to trouble eating.

Long-term outlook

The outlook for stomach cancer is much better when it is found early. Many people are cured, especially if the cancer is caught before it spreads. Treatments have improved in recent years, and even when a cure is not possible, treatment can often control the cancer and help you live comfortably for as long as possible. Your doctor can give you a clearer idea based on your own situation.

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