Stomach Cancer

Overview

What is stomach cancer?

In stomach cancer (also called gastric cancer), cancer cells usually begin on the inner lining of stomach walls and then penetrate deeper into the stomach walls as the cancer develops. The tumor may grow to involve nearby organs like the liver and pancreas.

Stomach cancer is one of the most common cancers worldwide, but is seen less often in the United States. The number of stomach cancer cases has been steadily declining over the last few decades, possibly because of widespread use of refrigeration that increased access to fresh food without preservatives and bacterial contamination.

Symptoms and Causes

What are the causes of stomach cancer?

The main cause of stomach cancer is a genetic mutation (change) in the cells of the stomach, which causes the cells to grow rapidly and eventually form a tumor. Risk factors that can increase a person’s chance of getting stomach cancer include:

What are the symptoms of stomach cancer?

  • Nausea and vomiting
  • Difficulty swallowing
  • Heartburn
  • Loss of appetite
  • Weight loss
  • Feeling tired
  • Bloating
  • Vomiting blood (in advanced stages)

Diagnosis and Tests

How is stomach cancer diagnosed?

Several different tests can be used to help diagnose stomach cancer.

  • Radiologic tests like a CT scan, barium swallow and MRI can help identify a problem in the stomach if the tumor is large enough.
  • An upper endoscopy is used to take a biopsy (sample) of the lesion to make the diagnosis or to detect early cancer before a mass is large enough to be seen on radiologic tests. An upper endoscopy is performed by inserting a thin tube with a tiny camera through the mouth and into the stomach, where biopsies are obtained from the tumor.
  • To find out how much of the stomach wall a tumor involves and to help assess the “stage” of the cancer, a doctor will order an endoscopic ultrasound, which uses a special type of endoscope that has an ultrasound probe. The endoscope is placed in the stomach through the mouth. The ultrasound probe is able to look through the surface of the stomach lining to the stomach wall beyond and see how much of the stomach is involved by the tumor.

Management and Treatment

How is stomach cancer treated?

There are several approaches to treating stomach cancer. In many cases, surgery can be avoided.

In the early stages when the cancer is limited to the superficial (uppermost) layers of the stomach, the cancer can be removed through an upper endoscopy performed by a gastroenterologist. In this procedure (endoscopic submucosal dissection, or ESD), the tumor is dissected from the rest of the gastric wall and removed through the mouth.

Once the tumor invades beyond the superficial layers of the stomach, surgery will be required to remove the stomach and connect the esophagus (the tube through which food passes) to the small intestines to allow for digestion.

Radiation therapy uses high-powered beams of energy to kill cancer cells. Chemotherapy uses chemicals to kill the cancer cells. These treatments are generally combined.

There are also several drugs to treat stomach cancer. Treatment depends on how severe the cancer is and is decided upon by a doctor after diagnosis.

Prevention

How can stomach cancer be prevented?

Stomach cancer can be prevented with the following practices:

  • The best way to prevent stomach cancer is by eating a healthy diet that is high in fruits and vegetables and low in salts and red meats.
  • Maintain a healthy weight and practice good exercise habits.
  • Avoid smoking, because it increases the risk for stomach cancer and many other cancers.

Outlook / Prognosis

What is the prognosis (outlook) for people who have stomach cancer?

The outlook for stomach cancer depends on the stage of the cancer. People in the early stages of stomach cancer have a much greater rate of survival than those at a later stage:

  • If stomach cancer is found in its earliest stage and can be removed with an endoscope, the five-year survival rate is higher than 90 percent.
  • If the cancer is found after it has spread to areas surrounding the stomach, the five-year survival rate is 28 percent.
  • If the cancer has spread to areas beyond those surrounding the stomach, the five-year survival rate is 4 percent.

Last reviewed by a Cleveland Clinic medical professional on 02/17/2019.

References

  • American Cancer Society. What Is Stomach Cancer? (https://www.cancer.org/cancer/stomach-cancer/about/what-is-stomach-cancer.html) Accessed 2/18/2019.
  • National Cancer Institute. Gastric Cancer Treatment (PDQ®)–Patient Version. (https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq) Accessed 2/18/2019.
  • Bhatt A, Abe S, Kumaravel A et al, Indications and Techniques for Endoscopic Submucosal Dissection. Am J Gastroenterol. 2015 Jun;110(6):784-91.

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