Stomach cancer

Cancer can start in any part of the stomach, though most begin on the inside lining of the stomach – these are called adenocarcinomas. Stomach cancer is one of the most common cancers worldwide, but is less common in the UK where around 5,000 people are diagnosed with it each year.

Stomach cancer tends to affect older people – around half occur in people over 75 years.

You have a good chance of being cured if you diagnose and treat stomach cancer early. However, symptoms usually only occur once it’s more advanced, which means the outlook for stomach cancer is not as good as many other cancers. Treatment in the later stages of stomach cancer can slow its progress.

Early signs of stomach cancer include:

• Abdominal pain
• Dysphagia – difficulty swallowing
• Feeling full after only eating a small amount
• Frequent burping
• Indigestion
• Nausea and vomiting

Many of these symptoms are associated with other conditions (such as a stomach ulcer) which can make it difficult to diagnose.

Symptoms of more advanced stomach cancer include:

• Blood in your poo which is dark
• Loss of appetite
• Unintentional weight loss

Your GP will discuss your symptoms and examine your stomach for any swellings or tenderness. If they think stomach cancer could be a possibility, they’ll refer you to a specialist for tests. To check your general health and rule out other conditions, tests include:

• Blood tests
• Stool sample
• X-ray

Tests to diagnose stomach cancer include:

• Endoscopy – such as a gastroscopy, using a long, thin instrument (an endoscope) with a video camera to see inside your stomach and upper intestine
• Barium swallow – where you drink a contrast agent which makes your stomach show up on an X-ray

If you’ve been diagnosed with stomach cancer, further tests may be needed to assess the best treatment. These include:

• Laparoscopy – an endoscope is inserted into your stomach through a small cut in your abdomen to see your stomach
• CT or PET scans to create detailed images of your body
• Ultrasound scans – to check if it’s spread to your liver

The exact cause of stomach cancer is unknown. However, lifestyle factors are linked to three in four stomach cancers. These include:

• Being overweight
• Diet – a diet high in pickled vegetables, smoked meats and salt can increase your risk, whereas a high fibre diet can help protect you
• Smoking

Other factors that increase your chances of getting it include:

• Aging
• Bacterial infection with H. pylori – can also cause stomach ulcers, indigestion and inflammation
• Being male – men are twice as likely to develop stomach cancer than women
• Family history
• Having another type of cancer or certain conditions – such as pernicious anaemia (which causes a lack of vitamin B12)
• Stomach surgery

Treatment options vary depending on the stage of the stomach cancer, whether it’s spread and your general health. Treatment may aim to:

• Cure the cancer
• Control the cancer and prevent it from spreading
• Ease symptoms and prolong life if it’s spread

The main treatments for stomach cancer are:

• Surgery – removing the affected part of the stomach or the whole stomach can cure the cancer if it’s diagnosed early
• Chemotherapy – to prevent advanced cancer from developing further or to shrink a tumour before surgery and prevent it from coming back afterwards
• Radiotherapy – used if you have advanced stomach cancer to help relieve symptoms

You may have a combination of these treatments. For example, chemoradiotherapy – a combination of chemotherapy and radiotherapy. Even if it’s not possible to cure your tumour, treatment can help control the growth and ease your symptoms.