Table of Contents<\/p>\nToggle<\/span><\/path><\/svg><\/svg><\/span><\/span><\/label>Introduction<\/a><\/li>What Is Stomach Cancer?<\/a><\/li>Early vs Advanced Symptoms of Stomach Cancer<\/a><\/li>Stomach Cancer Causes<\/a><\/li>Who Is at Risk of Developing Stomach Cancer?<\/a><\/li>Types of Stomach Cancer<\/a><\/li>Stomach Cancer Stages<\/a><\/li>How Is Stomach Cancer Diagnosed?<\/a><\/li>Stomach Cancer Treatment<\/a><\/li>Can Stomach Cancer Be Prevented?<\/a><\/li>When to Consult a Doctor?<\/a><\/li>Conclusion<\/a><\/li>Frequently Asked Questions (FAQs)<\/a><\/li>References<\/a><\/li><\/ul><\/nav><\/div>\n \n <\/span>\n \n <\/a>\n<\/span>Introduction<\/strong><\/span><\/h2>\n\n\n\nPersistent indigestion, stomach discomfort, or\u00a0unintentional weight loss\u00a0can be a cause for concern, especially if the symptoms\u00a0persist\u00a0or recur.\u00a0In many cases, these symptoms\u00a0may be caused by common digestive problems1<\/a><\/sup>. However, when such symptoms continue or become worse, they should not be ignored, as they can sometimes be linked to stomach cancer. In this blog, we will discuss stomach cancer, its stages,\u00a0symptoms, causes, treatment options, and when to seek medical attention.\u00a0<\/p>\n\n\n\n<\/p>\n\n\n\n<\/span>What Is Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nThe stomach is a muscular organ in the upper abdomen that helps break\u00a0food\u00a0down during digestion.\u00a0Stomach cancer, also known as gastric cancer,\u00a0is a type of cancer that begins when cells in the stomach start growing abnormally and uncontrollably.\u00a0The most common type\u00a0of stomach cancer\u00a0is adenocarcinoma, which develops from\u00a0the\u00a0mucus-forming cells in the\u00a0innermost lining of the\u00a0stomach2<\/a>,3<\/a><\/sup>.\u00a0Over time, abnormal cells\u00a0from this lining\u00a0can grow deeper into the stomach wall and may eventually spread to other organs2<\/a><\/sup>.\u00a0<\/p>\n\n\n\nIn the\u00a0early stages, stomach cancer may\u00a0have\u00a0mild\u00a0to no\u00a0symptoms, making it difficult to notice1<\/a><\/sup>.\u00a0This is why ongoing or unusual digestive symptoms should be\u00a0evaluated by a doctor rather than\u00a0being\u00a0treated as simple indigestion\u00a0that occurs repeatedly4<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>Early vs Advanced Symptoms of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\nStomach cancer symptoms\u00a0may\u00a0change\u00a0as the disease progresses. The table below compares symptoms that may occur in the early and advanced stages of stomach cancer.\u00a0<\/p>\n\n\n\nEarly\u00a0Symptoms<\/strong>\u00a0<\/td>Advanced Symptoms<\/strong>\u00a0<\/td><\/tr>Unexplained indigestion\u00a0<\/td>Vomiting\u00a0(often with blood)\u00a0<\/td><\/tr>Nausea (mild)\u00a0<\/td>Blood in the stool\u00a0(rarely)\u00a0<\/td><\/tr>Stomach discomfort\u00a0<\/td>Unexplained weight loss\u00a0<\/td><\/tr>Lack of appetite\u00a0<\/td>Difficulty swallowing\u00a0<\/td><\/tr>Heartburn\u00a0<\/td>Abdominal pain\u00a0or\u00a0bloating\u00a0<\/td><\/tr>\u00a0<\/td>Yellowing of skin and eyes (jaundice)\u00a0<\/td><\/tr>\u00a0<\/td>Fluid build-up in the abdomen (ascites)\u00a0<\/td><\/tr>\u00a0<\/td>Anaemia accompanied by\u00a0easy\u00a0fatigability\/generalised\u00a0weakness\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<\/span>Stomach Cancer Causes<\/strong><\/span><\/h2>\n\n\n\nStomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n\nHelicobacter Pylori (H. pylori)\u00a0Infection:<\/strong>\u00a0This bacterium can cause long-term inflammation and damage to the stomach lining, which may increase the chance of stomach cancer.\u00a0<\/li>\n\n\n\nChronic Gastritis\u00a0or Gastric\u00a0Ulcers:<\/strong>\u00a0Severe ongoing inflammation can gradually damage stomach cells and may contribute to abnormal cell changes.\u00a0<\/li>\n\n\n\nIntestinal Metaplasia:<\/strong>\u00a0Certain changes in the stomach lining can cause its usual cells to change into cells that are more\u00a0similar to\u00a0those found in the intestine.\u00a0Please note that intestinal metaplasia is not cancer, but it is considered a precancerous change because, in some people, it\u00a0may\u00a0increase the risk of developing stomach cancer over time.\u00a0<\/li>\n\n\n\nEpstein-Barr Virus (EBV)<\/strong>\u202fInfection:<\/strong>\u00a0In some people, infection with EBV may cause changes in stomach cells that are linked to the development of certain types of stomach cancer.\u00a0<\/li>\n\n\n\nInherited\u00a0Conditions:<\/strong>\u00a0Rare genetic conditions\u00a0such as Lynch syndrome\u00a0and\u00a0juvenile polyp syndrome\u00a0can affect how cells behave and may contribute to a higher chance of developing stomach cancer5<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Who Is at Risk of Developing Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nCertain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p><\/div>Show Full Article<\/button><\/div>\n\n\n\n\nAge:<\/strong>\u00a0Older people are at a higher risk of getting stomach cancer.\u00a0The greatest\u00a0number of\u00a0stomach cancer\u00a0cases\u00a0are\u00a0reported between the ages of 60 and 805<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nGender:<\/strong>\u00a0Stomach cancer\u00a0occurs\u00a0more often\u00a0in men than in women.\u00a0<\/li>\n\n\n\nFamily History:<\/strong>\u00a0Having a parent, brother, sister,\u00a0or child who has had stomach cancer can increase the risk.\u00a0<\/li>\n\n\n\nTobacco:<\/strong>\u00a0People who smoke\u00a0and chew\u00a0tobacco\u00a0have\u00a0double the\u00a0risk of stomach cancer\u00a0compared with\u00a0non-smokers6<\/a><\/sup>.<\/li>\n\n\n\nDiet:<\/strong>\u00a0Frequently eating foods that are heavily salted, smoked,\u00a0or poorly preserved may increase the risk.\u00a0\u00a0<\/li>\n\n\n\nObesity:<\/strong>\u00a0Obesity\u00a0may also\u00a0increase\u00a0the risk.\u00a0\u00a0<\/li>\n\n\n\nWorkplace\u00a0Exposures:<\/strong>\u00a0People working in industries such as rubber, metal, radiation, or coal may have an increased risk because of occupational exposures5<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nBlood Group:<\/strong>\u00a0People belonging to specific\u00a0blood groups, such as\u00a0type A, are at higher risk5<\/a><\/sup>.<\/li>\n\n\n\nGeographical and\u00a0Population\u00a0Differences:<\/strong>\u00a0Stomach cancer is more common in certain populations and regions, particularly in parts of East Asia, Eastern Europe, and Central and South America6<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
Persistent indigestion, stomach discomfort, or\u00a0unintentional weight loss\u00a0can be a cause for concern, especially if the symptoms\u00a0persist\u00a0or recur.\u00a0In many cases, these symptoms\u00a0may be caused by common digestive problems1<\/a><\/sup>. However, when such symptoms continue or become worse, they should not be ignored, as they can sometimes be linked to stomach cancer. In this blog, we will discuss stomach cancer, its stages,\u00a0symptoms, causes, treatment options, and when to seek medical attention.\u00a0<\/p>\n\n\n\n<\/p>\n\n\n\n<\/span>What Is Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nThe stomach is a muscular organ in the upper abdomen that helps break\u00a0food\u00a0down during digestion.\u00a0Stomach cancer, also known as gastric cancer,\u00a0is a type of cancer that begins when cells in the stomach start growing abnormally and uncontrollably.\u00a0The most common type\u00a0of stomach cancer\u00a0is adenocarcinoma, which develops from\u00a0the\u00a0mucus-forming cells in the\u00a0innermost lining of the\u00a0stomach2<\/a>,3<\/a><\/sup>.\u00a0Over time, abnormal cells\u00a0from this lining\u00a0can grow deeper into the stomach wall and may eventually spread to other organs2<\/a><\/sup>.\u00a0<\/p>\n\n\n\nIn the\u00a0early stages, stomach cancer may\u00a0have\u00a0mild\u00a0to no\u00a0symptoms, making it difficult to notice1<\/a><\/sup>.\u00a0This is why ongoing or unusual digestive symptoms should be\u00a0evaluated by a doctor rather than\u00a0being\u00a0treated as simple indigestion\u00a0that occurs repeatedly4<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>Early vs Advanced Symptoms of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\nStomach cancer symptoms\u00a0may\u00a0change\u00a0as the disease progresses. The table below compares symptoms that may occur in the early and advanced stages of stomach cancer.\u00a0<\/p>\n\n\n\nEarly\u00a0Symptoms<\/strong>\u00a0<\/td>Advanced Symptoms<\/strong>\u00a0<\/td><\/tr>Unexplained indigestion\u00a0<\/td>Vomiting\u00a0(often with blood)\u00a0<\/td><\/tr>Nausea (mild)\u00a0<\/td>Blood in the stool\u00a0(rarely)\u00a0<\/td><\/tr>Stomach discomfort\u00a0<\/td>Unexplained weight loss\u00a0<\/td><\/tr>Lack of appetite\u00a0<\/td>Difficulty swallowing\u00a0<\/td><\/tr>Heartburn\u00a0<\/td>Abdominal pain\u00a0or\u00a0bloating\u00a0<\/td><\/tr>\u00a0<\/td>Yellowing of skin and eyes (jaundice)\u00a0<\/td><\/tr>\u00a0<\/td>Fluid build-up in the abdomen (ascites)\u00a0<\/td><\/tr>\u00a0<\/td>Anaemia accompanied by\u00a0easy\u00a0fatigability\/generalised\u00a0weakness\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<\/span>Stomach Cancer Causes<\/strong><\/span><\/h2>\n\n\n\nStomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n\nHelicobacter Pylori (H. pylori)\u00a0Infection:<\/strong>\u00a0This bacterium can cause long-term inflammation and damage to the stomach lining, which may increase the chance of stomach cancer.\u00a0<\/li>\n\n\n\nChronic Gastritis\u00a0or Gastric\u00a0Ulcers:<\/strong>\u00a0Severe ongoing inflammation can gradually damage stomach cells and may contribute to abnormal cell changes.\u00a0<\/li>\n\n\n\nIntestinal Metaplasia:<\/strong>\u00a0Certain changes in the stomach lining can cause its usual cells to change into cells that are more\u00a0similar to\u00a0those found in the intestine.\u00a0Please note that intestinal metaplasia is not cancer, but it is considered a precancerous change because, in some people, it\u00a0may\u00a0increase the risk of developing stomach cancer over time.\u00a0<\/li>\n\n\n\nEpstein-Barr Virus (EBV)<\/strong>\u202fInfection:<\/strong>\u00a0In some people, infection with EBV may cause changes in stomach cells that are linked to the development of certain types of stomach cancer.\u00a0<\/li>\n\n\n\nInherited\u00a0Conditions:<\/strong>\u00a0Rare genetic conditions\u00a0such as Lynch syndrome\u00a0and\u00a0juvenile polyp syndrome\u00a0can affect how cells behave and may contribute to a higher chance of developing stomach cancer5<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Who Is at Risk of Developing Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nCertain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p><\/div>Show Full Article<\/button><\/div>\n\n\n\n\nAge:<\/strong>\u00a0Older people are at a higher risk of getting stomach cancer.\u00a0The greatest\u00a0number of\u00a0stomach cancer\u00a0cases\u00a0are\u00a0reported between the ages of 60 and 805<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nGender:<\/strong>\u00a0Stomach cancer\u00a0occurs\u00a0more often\u00a0in men than in women.\u00a0<\/li>\n\n\n\nFamily History:<\/strong>\u00a0Having a parent, brother, sister,\u00a0or child who has had stomach cancer can increase the risk.\u00a0<\/li>\n\n\n\nTobacco:<\/strong>\u00a0People who smoke\u00a0and chew\u00a0tobacco\u00a0have\u00a0double the\u00a0risk of stomach cancer\u00a0compared with\u00a0non-smokers6<\/a><\/sup>.<\/li>\n\n\n\nDiet:<\/strong>\u00a0Frequently eating foods that are heavily salted, smoked,\u00a0or poorly preserved may increase the risk.\u00a0\u00a0<\/li>\n\n\n\nObesity:<\/strong>\u00a0Obesity\u00a0may also\u00a0increase\u00a0the risk.\u00a0\u00a0<\/li>\n\n\n\nWorkplace\u00a0Exposures:<\/strong>\u00a0People working in industries such as rubber, metal, radiation, or coal may have an increased risk because of occupational exposures5<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nBlood Group:<\/strong>\u00a0People belonging to specific\u00a0blood groups, such as\u00a0type A, are at higher risk5<\/a><\/sup>.<\/li>\n\n\n\nGeographical and\u00a0Population\u00a0Differences:<\/strong>\u00a0Stomach cancer is more common in certain populations and regions, particularly in parts of East Asia, Eastern Europe, and Central and South America6<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
<\/p>\n\n\n\n
The stomach is a muscular organ in the upper abdomen that helps break\u00a0food\u00a0down during digestion.\u00a0Stomach cancer, also known as gastric cancer,\u00a0is a type of cancer that begins when cells in the stomach start growing abnormally and uncontrollably.\u00a0The most common type\u00a0of stomach cancer\u00a0is adenocarcinoma, which develops from\u00a0the\u00a0mucus-forming cells in the\u00a0innermost lining of the\u00a0stomach2<\/a>,3<\/a><\/sup>.\u00a0Over time, abnormal cells\u00a0from this lining\u00a0can grow deeper into the stomach wall and may eventually spread to other organs2<\/a><\/sup>.\u00a0<\/p>\n\n\n\nIn the\u00a0early stages, stomach cancer may\u00a0have\u00a0mild\u00a0to no\u00a0symptoms, making it difficult to notice1<\/a><\/sup>.\u00a0This is why ongoing or unusual digestive symptoms should be\u00a0evaluated by a doctor rather than\u00a0being\u00a0treated as simple indigestion\u00a0that occurs repeatedly4<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>Early vs Advanced Symptoms of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\nStomach cancer symptoms\u00a0may\u00a0change\u00a0as the disease progresses. The table below compares symptoms that may occur in the early and advanced stages of stomach cancer.\u00a0<\/p>\n\n\n\nEarly\u00a0Symptoms<\/strong>\u00a0<\/td>Advanced Symptoms<\/strong>\u00a0<\/td><\/tr>Unexplained indigestion\u00a0<\/td>Vomiting\u00a0(often with blood)\u00a0<\/td><\/tr>Nausea (mild)\u00a0<\/td>Blood in the stool\u00a0(rarely)\u00a0<\/td><\/tr>Stomach discomfort\u00a0<\/td>Unexplained weight loss\u00a0<\/td><\/tr>Lack of appetite\u00a0<\/td>Difficulty swallowing\u00a0<\/td><\/tr>Heartburn\u00a0<\/td>Abdominal pain\u00a0or\u00a0bloating\u00a0<\/td><\/tr>\u00a0<\/td>Yellowing of skin and eyes (jaundice)\u00a0<\/td><\/tr>\u00a0<\/td>Fluid build-up in the abdomen (ascites)\u00a0<\/td><\/tr>\u00a0<\/td>Anaemia accompanied by\u00a0easy\u00a0fatigability\/generalised\u00a0weakness\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<\/span>Stomach Cancer Causes<\/strong><\/span><\/h2>\n\n\n\nStomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n\nHelicobacter Pylori (H. pylori)\u00a0Infection:<\/strong>\u00a0This bacterium can cause long-term inflammation and damage to the stomach lining, which may increase the chance of stomach cancer.\u00a0<\/li>\n\n\n\nChronic Gastritis\u00a0or Gastric\u00a0Ulcers:<\/strong>\u00a0Severe ongoing inflammation can gradually damage stomach cells and may contribute to abnormal cell changes.\u00a0<\/li>\n\n\n\nIntestinal Metaplasia:<\/strong>\u00a0Certain changes in the stomach lining can cause its usual cells to change into cells that are more\u00a0similar to\u00a0those found in the intestine.\u00a0Please note that intestinal metaplasia is not cancer, but it is considered a precancerous change because, in some people, it\u00a0may\u00a0increase the risk of developing stomach cancer over time.\u00a0<\/li>\n\n\n\nEpstein-Barr Virus (EBV)<\/strong>\u202fInfection:<\/strong>\u00a0In some people, infection with EBV may cause changes in stomach cells that are linked to the development of certain types of stomach cancer.\u00a0<\/li>\n\n\n\nInherited\u00a0Conditions:<\/strong>\u00a0Rare genetic conditions\u00a0such as Lynch syndrome\u00a0and\u00a0juvenile polyp syndrome\u00a0can affect how cells behave and may contribute to a higher chance of developing stomach cancer5<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Who Is at Risk of Developing Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nCertain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p><\/div>Show Full Article<\/button><\/div>\n\n\n\n\nAge:<\/strong>\u00a0Older people are at a higher risk of getting stomach cancer.\u00a0The greatest\u00a0number of\u00a0stomach cancer\u00a0cases\u00a0are\u00a0reported between the ages of 60 and 805<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nGender:<\/strong>\u00a0Stomach cancer\u00a0occurs\u00a0more often\u00a0in men than in women.\u00a0<\/li>\n\n\n\nFamily History:<\/strong>\u00a0Having a parent, brother, sister,\u00a0or child who has had stomach cancer can increase the risk.\u00a0<\/li>\n\n\n\nTobacco:<\/strong>\u00a0People who smoke\u00a0and chew\u00a0tobacco\u00a0have\u00a0double the\u00a0risk of stomach cancer\u00a0compared with\u00a0non-smokers6<\/a><\/sup>.<\/li>\n\n\n\nDiet:<\/strong>\u00a0Frequently eating foods that are heavily salted, smoked,\u00a0or poorly preserved may increase the risk.\u00a0\u00a0<\/li>\n\n\n\nObesity:<\/strong>\u00a0Obesity\u00a0may also\u00a0increase\u00a0the risk.\u00a0\u00a0<\/li>\n\n\n\nWorkplace\u00a0Exposures:<\/strong>\u00a0People working in industries such as rubber, metal, radiation, or coal may have an increased risk because of occupational exposures5<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nBlood Group:<\/strong>\u00a0People belonging to specific\u00a0blood groups, such as\u00a0type A, are at higher risk5<\/a><\/sup>.<\/li>\n\n\n\nGeographical and\u00a0Population\u00a0Differences:<\/strong>\u00a0Stomach cancer is more common in certain populations and regions, particularly in parts of East Asia, Eastern Europe, and Central and South America6<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
In the\u00a0early stages, stomach cancer may\u00a0have\u00a0mild\u00a0to no\u00a0symptoms, making it difficult to notice1<\/a><\/sup>.\u00a0This is why ongoing or unusual digestive symptoms should be\u00a0evaluated by a doctor rather than\u00a0being\u00a0treated as simple indigestion\u00a0that occurs repeatedly4<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>Early vs Advanced Symptoms of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\nStomach cancer symptoms\u00a0may\u00a0change\u00a0as the disease progresses. The table below compares symptoms that may occur in the early and advanced stages of stomach cancer.\u00a0<\/p>\n\n\n\nEarly\u00a0Symptoms<\/strong>\u00a0<\/td>Advanced Symptoms<\/strong>\u00a0<\/td><\/tr>Unexplained indigestion\u00a0<\/td>Vomiting\u00a0(often with blood)\u00a0<\/td><\/tr>Nausea (mild)\u00a0<\/td>Blood in the stool\u00a0(rarely)\u00a0<\/td><\/tr>Stomach discomfort\u00a0<\/td>Unexplained weight loss\u00a0<\/td><\/tr>Lack of appetite\u00a0<\/td>Difficulty swallowing\u00a0<\/td><\/tr>Heartburn\u00a0<\/td>Abdominal pain\u00a0or\u00a0bloating\u00a0<\/td><\/tr>\u00a0<\/td>Yellowing of skin and eyes (jaundice)\u00a0<\/td><\/tr>\u00a0<\/td>Fluid build-up in the abdomen (ascites)\u00a0<\/td><\/tr>\u00a0<\/td>Anaemia accompanied by\u00a0easy\u00a0fatigability\/generalised\u00a0weakness\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<\/span>Stomach Cancer Causes<\/strong><\/span><\/h2>\n\n\n\nStomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n\nHelicobacter Pylori (H. pylori)\u00a0Infection:<\/strong>\u00a0This bacterium can cause long-term inflammation and damage to the stomach lining, which may increase the chance of stomach cancer.\u00a0<\/li>\n\n\n\nChronic Gastritis\u00a0or Gastric\u00a0Ulcers:<\/strong>\u00a0Severe ongoing inflammation can gradually damage stomach cells and may contribute to abnormal cell changes.\u00a0<\/li>\n\n\n\nIntestinal Metaplasia:<\/strong>\u00a0Certain changes in the stomach lining can cause its usual cells to change into cells that are more\u00a0similar to\u00a0those found in the intestine.\u00a0Please note that intestinal metaplasia is not cancer, but it is considered a precancerous change because, in some people, it\u00a0may\u00a0increase the risk of developing stomach cancer over time.\u00a0<\/li>\n\n\n\nEpstein-Barr Virus (EBV)<\/strong>\u202fInfection:<\/strong>\u00a0In some people, infection with EBV may cause changes in stomach cells that are linked to the development of certain types of stomach cancer.\u00a0<\/li>\n\n\n\nInherited\u00a0Conditions:<\/strong>\u00a0Rare genetic conditions\u00a0such as Lynch syndrome\u00a0and\u00a0juvenile polyp syndrome\u00a0can affect how cells behave and may contribute to a higher chance of developing stomach cancer5<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Who Is at Risk of Developing Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nCertain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p><\/div>Show Full Article<\/button><\/div>\n\n\n\n\nAge:<\/strong>\u00a0Older people are at a higher risk of getting stomach cancer.\u00a0The greatest\u00a0number of\u00a0stomach cancer\u00a0cases\u00a0are\u00a0reported between the ages of 60 and 805<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nGender:<\/strong>\u00a0Stomach cancer\u00a0occurs\u00a0more often\u00a0in men than in women.\u00a0<\/li>\n\n\n\nFamily History:<\/strong>\u00a0Having a parent, brother, sister,\u00a0or child who has had stomach cancer can increase the risk.\u00a0<\/li>\n\n\n\nTobacco:<\/strong>\u00a0People who smoke\u00a0and chew\u00a0tobacco\u00a0have\u00a0double the\u00a0risk of stomach cancer\u00a0compared with\u00a0non-smokers6<\/a><\/sup>.<\/li>\n\n\n\nDiet:<\/strong>\u00a0Frequently eating foods that are heavily salted, smoked,\u00a0or poorly preserved may increase the risk.\u00a0\u00a0<\/li>\n\n\n\nObesity:<\/strong>\u00a0Obesity\u00a0may also\u00a0increase\u00a0the risk.\u00a0\u00a0<\/li>\n\n\n\nWorkplace\u00a0Exposures:<\/strong>\u00a0People working in industries such as rubber, metal, radiation, or coal may have an increased risk because of occupational exposures5<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nBlood Group:<\/strong>\u00a0People belonging to specific\u00a0blood groups, such as\u00a0type A, are at higher risk5<\/a><\/sup>.<\/li>\n\n\n\nGeographical and\u00a0Population\u00a0Differences:<\/strong>\u00a0Stomach cancer is more common in certain populations and regions, particularly in parts of East Asia, Eastern Europe, and Central and South America6<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
Stomach cancer symptoms\u00a0may\u00a0change\u00a0as the disease progresses. The table below compares symptoms that may occur in the early and advanced stages of stomach cancer.\u00a0<\/p>\n\n\n\nEarly\u00a0Symptoms<\/strong>\u00a0<\/td>Advanced Symptoms<\/strong>\u00a0<\/td><\/tr>Unexplained indigestion\u00a0<\/td>Vomiting\u00a0(often with blood)\u00a0<\/td><\/tr>Nausea (mild)\u00a0<\/td>Blood in the stool\u00a0(rarely)\u00a0<\/td><\/tr>Stomach discomfort\u00a0<\/td>Unexplained weight loss\u00a0<\/td><\/tr>Lack of appetite\u00a0<\/td>Difficulty swallowing\u00a0<\/td><\/tr>Heartburn\u00a0<\/td>Abdominal pain\u00a0or\u00a0bloating\u00a0<\/td><\/tr>\u00a0<\/td>Yellowing of skin and eyes (jaundice)\u00a0<\/td><\/tr>\u00a0<\/td>Fluid build-up in the abdomen (ascites)\u00a0<\/td><\/tr>\u00a0<\/td>Anaemia accompanied by\u00a0easy\u00a0fatigability\/generalised\u00a0weakness\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<\/span>Stomach Cancer Causes<\/strong><\/span><\/h2>\n\n\n\nStomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n\nHelicobacter Pylori (H. pylori)\u00a0Infection:<\/strong>\u00a0This bacterium can cause long-term inflammation and damage to the stomach lining, which may increase the chance of stomach cancer.\u00a0<\/li>\n\n\n\nChronic Gastritis\u00a0or Gastric\u00a0Ulcers:<\/strong>\u00a0Severe ongoing inflammation can gradually damage stomach cells and may contribute to abnormal cell changes.\u00a0<\/li>\n\n\n\nIntestinal Metaplasia:<\/strong>\u00a0Certain changes in the stomach lining can cause its usual cells to change into cells that are more\u00a0similar to\u00a0those found in the intestine.\u00a0Please note that intestinal metaplasia is not cancer, but it is considered a precancerous change because, in some people, it\u00a0may\u00a0increase the risk of developing stomach cancer over time.\u00a0<\/li>\n\n\n\nEpstein-Barr Virus (EBV)<\/strong>\u202fInfection:<\/strong>\u00a0In some people, infection with EBV may cause changes in stomach cells that are linked to the development of certain types of stomach cancer.\u00a0<\/li>\n\n\n\nInherited\u00a0Conditions:<\/strong>\u00a0Rare genetic conditions\u00a0such as Lynch syndrome\u00a0and\u00a0juvenile polyp syndrome\u00a0can affect how cells behave and may contribute to a higher chance of developing stomach cancer5<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Who Is at Risk of Developing Stomach Cancer?<\/strong><\/span><\/h2>\n\n\n\nCertain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p><\/div>Show Full Article<\/button><\/div>\n\n\n\n\nAge:<\/strong>\u00a0Older people are at a higher risk of getting stomach cancer.\u00a0The greatest\u00a0number of\u00a0stomach cancer\u00a0cases\u00a0are\u00a0reported between the ages of 60 and 805<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nGender:<\/strong>\u00a0Stomach cancer\u00a0occurs\u00a0more often\u00a0in men than in women.\u00a0<\/li>\n\n\n\nFamily History:<\/strong>\u00a0Having a parent, brother, sister,\u00a0or child who has had stomach cancer can increase the risk.\u00a0<\/li>\n\n\n\nTobacco:<\/strong>\u00a0People who smoke\u00a0and chew\u00a0tobacco\u00a0have\u00a0double the\u00a0risk of stomach cancer\u00a0compared with\u00a0non-smokers6<\/a><\/sup>.<\/li>\n\n\n\nDiet:<\/strong>\u00a0Frequently eating foods that are heavily salted, smoked,\u00a0or poorly preserved may increase the risk.\u00a0\u00a0<\/li>\n\n\n\nObesity:<\/strong>\u00a0Obesity\u00a0may also\u00a0increase\u00a0the risk.\u00a0\u00a0<\/li>\n\n\n\nWorkplace\u00a0Exposures:<\/strong>\u00a0People working in industries such as rubber, metal, radiation, or coal may have an increased risk because of occupational exposures5<\/a>,6<\/a><\/sup>.\u00a0<\/li>\n\n\n\nBlood Group:<\/strong>\u00a0People belonging to specific\u00a0blood groups, such as\u00a0type A, are at higher risk5<\/a><\/sup>.<\/li>\n\n\n\nGeographical and\u00a0Population\u00a0Differences:<\/strong>\u00a0Stomach cancer is more common in certain populations and regions, particularly in parts of East Asia, Eastern Europe, and Central and South America6<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
Stomach cancer does not usually have\u00a0a single cause. It\u00a0develops when changes in the cells of the stomach cause them to grow and multiply abnormally.\u00a0Factors that may\u00a0increase the\u00a0chance\u00a0of\u00a0these changes include:\u00a0<\/p>\n\n\n\n
Certain factors can make a person more likely to develop stomach cancer.\u00a0These\u00a0include:\u00a0<\/p>
Note:<\/strong>\u00a0Having any of these risk factors does not mean that a person will\u00a0develop stomach cancer. These factors only\u00a0indicate\u00a0that the likelihood\u00a0of stomach cancer\u00a0may be higher. If you have concerns about your risk or experience persistent digestive symptoms, speak with your doctor\u00a0for\u00a0appropriate advice\u00a0and evaluation.\u00a0<\/em><\/p>\n\n\n\n<\/span>Types of Stomach Cancer<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nThere are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n\nAdenocarcinoma:<\/strong>\u00a0This is the most common type of stomach cancer. It starts in the gland-forming cells that produce mucus and other digestive fluids in the stomach lining.\u00a0Stomach adenocarcinoma can be further divided into two main forms:\u00a0\n\nIntestinal\u00a0type:<\/strong>\u00a0The cancer cells look more\u00a0similar to\u00a0normal stomach cells and often grow in gland-like or tube-like patterns.\u00a0This type\u00a0may\u00a0have\u00a0a\u00a0slightly\u00a0better\u00a0prognosis.\u00a0<\/li>\n\n\n\nDiffuse type:<\/strong>\u00a0The cancer cells look more unusual and do not form clear patterns. This type is less common, more aggressive,\u00a0and may be\u00a0difficult\u00a0to treat.\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\nGastrointestinal stromal tumour (GIST):<\/strong>\u00a0GIST develops\u00a0in\u00a0certain\u00a0cells in the\u00a0stomach\u00a0wall\u00a0called interstitial cells\u00a0of Cajal.\u00a0GISTs\u00a0can occur anywhere along the digestive system but mostly\u00a0begin\u00a0in the stomach.\u00a0<\/li>\n\n\n\nNeuroendocrine\u00a0Tumours\u00a0(NETs):\u00a0<\/strong>These cancers develop from special cells in the stomach that have features of both nerve cells and hormone-producing cells. Many NETs grow slowly and may remain limited to the stomach, while some can grow faster and spread to other parts of the body.\u00a0<\/li>\n\n\n\nLymphoma:<\/strong>\u00a0This type of cancer begins in\u00a0the\u00a0lymphocytes, which are white blood cells that help the body fight infections. Although lymphoma usually starts in other parts of the body, it can sometimes develop in the stomach.\u00a0Note that a\u00a0type called gastric MALT lymphoma is strongly linked to H. pylori infection7<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\nNote:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
There are\u00a0different\u00a0types\u00a0of stomach\u00a0cancer\u00a0based on the\u00a0type\u00a0of cells they\u00a0originate in.\u00a0<\/p>\n\n\n\n
Note:<\/strong>\u00a0There are certain other types of cancers,\u00a0such as\u00a0squamous cell carcinoma, small cell carcinoma,\u00a0and leiomyosarcoma,\u00a0that\u00a0can develop in the stomach. However, these forms are uncommon.<\/em>\u00a0<\/p>\n\n\n\n<\/span>Stomach Cancer Stages<\/strong><\/span><\/h2>\n\n\n\nStomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n1.<\/strong> Stage 0<\/strong><\/h3>\n\n\n\nDuring this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n2.<\/strong> Stage I<\/strong><\/h3>\n\n\n\nStage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IA:<\/strong>\u00a0The cancer is found in the\u00a0mucosa\u00a0and may have grown into the layer just beneath it\u00a0(submucosa).\u00a0<\/li>\n\n\n\nS<\/strong>tage\u00a0IB:<\/strong>\u00a0The cancer may have\u00a0affected the mucosa and submucosa and may have\u00a0reached 1 or 2 nearby lymph\u00a0nodes\u00a0or it may have\u00a0affected the mucosa and\u00a0grown into the muscle layer.\u00a0<\/li>\n<\/ul>\n\n\n\n3. Stage II<\/strong><\/h3>\n\n\n\nStage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n\nStage IIA:<\/strong>\u00a0The cancer may have reached the\u00a0submucosa\u00a0and spread to 3-6 nearby lymph nodes or it may have grown into the muscle layer and affected 1-2 nearby lymph nodes\u00a0or\u00a0it may\u00a0have spread to\u00a0the\u00a0tissue between the muscle layer and the\u00a0outer covering\u00a0of the stomach\u00a0(subserosa).\u00a0<\/li>\n\n\n\nStage IIB:<\/strong>\u00a0The cancer may have\u00a0affected the submucosa\u00a0and spread to 7-15 nearby lymph\u00a0nodes\u00a0or it may have grown into the muscle layer and affected 3-6 lymph nodes.\u00a0It\u00a0may\u00a0even\u00a0have spread to the subserosa\u00a0along with 1-2 nearby lymph nodes or it may have reached the stomach\u2019s outermost covering\u00a0(serosa).\u00a0<\/li>\n<\/ul>\n\n\n\n4. Stage\u00a0III<\/strong><\/h3>\n\n\n\nStage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n\nStage IIIA:<\/strong>\u00a0The cancer may have grown into\u00a0the\u00a0muscle\u00a0layer of the stomach and spread to\u00a07-15 nearby lymph nodes\u00a0or spread to the subserosa and 3-6 nearby lymph nodes or spread to the serosa and 1-6 nearby lymph nodes.\u00a0It may have reached nearby organs, such as the liver, pancreas, spleen, colon, kidney,\u00a0small intestine\u00a0or back of the abdomen.\u00a0<\/li>\n\n\n\nStage IIIB:<\/strong>\u00a0The cancer may have spread to\u00a0the submucosa and affected\u00a016 or more nearby lymph nodes. It may\u00a0also\u00a0have\u00a0spread to the subserosa and\u00a0affected 7-15\u00a0nearby\u00a0lymph\u00a0nodes or\u00a0reached nearby organs,\u00a0such as\u00a0the\u00a0adrenal gland, kidney, or\u202fsmall intestine\u00a0or\u00a0spread to 1-6 lymph nodes.\u00a0<\/li>\n\n\n\nStage IIIC:<\/strong>\u00a0The cancer has grown\u00a0into the subserosa or serosa\u00a0and spread to 16 or more nearby lymph nodes\u00a0or\u00a0to\u00a0organs such as\u00a0the\u00a0spleen, liver,\u00a0colon,\u00a0or\u00a0diaphragm\u00a0and\u00a0affected 7 or more\u00a0nearby\u00a0lymph nodes.\u00a0<\/li>\n<\/ul>\n\n\n\n5.<\/strong> Stage IV<\/strong><\/h3>\n\n\n\nThe cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
Stomach cancer can be divided into\u00a0different stages:\u00a0<\/p>\n\n\n\n
During this stage, abnormal or cancerous cells are limited to the innermost layer of the stomach lining\u00a0(mucosa)\u00a0and have not invaded deeper\u00a0tissues\u00a0but\u00a0can spread to nearby parts.\u00a0This is also called carcinoma in situ.\u00a0<\/p>\n\n\n\n
Stage I stomach cancer is divided into Stage IA and Stage IB, depending on\u00a0the spread of the\u00a0cancer and whether nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n
Stage II stomach cancer is divided into Stage IIA and Stage IIB\u00a0based on\u00a0how deeply the cancer has grown into the stomach wall and how many nearby lymph nodes are affected.\u00a0<\/p>\n\n\n\n
Stage III stomach cancer is divided into Stages\u00a0IIIA, IIIB and IIIC. At this stage, the cancer has grown deeper into the stomach wall and may have spread to several nearby lymph nodes or surrounding organs.\u00a0<\/p>\n\n\n\n
The cancer at this stage has\u00a0spread from the stomach to\u00a0other\u00a0distant\u00a0parts of the body, such as the liver, lungs, distant lymph nodes or the lining of the abdomen. This\u00a0stage\u00a0is\u00a0also\u00a0known as metastatic stomach cancer. The cancer\u00a0that has spread to other organs\u00a0is the same type as the original tumour.\u00a0For example, stomach cancer that spreads to the lungs\u00a0will\u00a0still\u00a0have\u00a0stomach cancer\u00a0cells\u00a0and it will be called metastatic stomach cancer8<\/a><\/sup>.\u00a0<\/p>\n\n\n\n<\/span>How Is Stomach Cancer Diagnosed?<\/strong><\/span><\/h2>\n\n\n\nIf stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n\nClinical Evaluation:<\/strong>\u00a0The doctor will ask about symptoms such as ongoing indigestion, stomach pain, reduced\u00a0appetite\u00a0or unexplained weight loss. They\u00a0will\u00a0review your\u00a0personal or\u00a0family history\u00a0of cancer or any disease\u00a0and perform a physical examination.\u00a0<\/li>\n\n\n\nUpper endoscopy:<\/strong>\u00a0A thin, flexible tube with a small camera is passed through the mouth into the stomach. This allows the doctor to examine the stomach lining for unusual areas.\u00a0<\/li>\n\n\n\nBiopsy:<\/strong>\u00a0If a suspicious area is found during endoscopy, small pieces of tissue may be removed and examined under a microscope to check for cancer cells (the\u00a0endoscopy device usually has a tool to take the sample for biopsy). A biopsy\u00a0may help to identify infections such as those caused by H.\u00a0pylori.\u00a0<\/li>\n\n\n\nImaging tests:<\/strong>\u00a0Imaging tests such as\u00a0positron emission tomography-computed\u00a0tomography (PET-CT),\u00a0magnetic resonance imaging (MRI)\u00a0and endoscopic ultrasound (EUS) may be used to examine the stomach and surrounding tissues. PET\u00a0scan\u00a0uses a small amount of radioactive glucose to highlight areas of increased activity, while CT provides detailed images to help identify cancer and possible spread. MRI uses magnets and radio waves to create detailed images, and EUS uses ultrasound waves, passed via an endoscope,\u00a0to show the stomach wall and help doctors assess how the cancer has grown.\u00a0<\/li>\n\n\n\nLaparoscopy:<\/strong>\u00a0In some cases, doctors use a small camera inserted through a tiny cut in the abdomen to examine the stomach and nearby areas. This can help identify cancer that may not be clearly visible on imaging scans. They usually collect\u00a0a\u00a0sample\u00a0to check for cancer.\u00a0<\/li>\n\n\n\nBiomarker testing:\u00a0<\/strong>Tests may be performed on the tumour tissue to look for specific markers or genetic changes.\u00a0They\u00a0may\u00a0look for markers such as\u00a0HER2, PD-L1,\u00a0and\u00a0NTRK,\u00a0among others9<\/a><\/sup>.\u00a0<\/li>\n\n\n\nOther Laboratory Tests:\u00a0<\/strong>The doctor may recommend blood tests, such as a complete blood count (CBC)<\/a><\/strong>, to check for signs of anaemia caused by stomach bleeding. Liver and kidney function tests may also be performed to assess\u00a0the baseline wellbeing. A stool test may be done to detect hidden blood in the stool9<\/a>,10<\/a><\/sup>.<\/li>\n<\/ul>\n\n\n\n<\/span>Stomach Cancer Treatment<\/strong><\/span><\/h2>\n\n\n\n<\/figure><\/div>\n\n\nStomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n\nSurgery:<\/strong>\u00a0Surgery may be recommended to remove the tumour along with some surrounding healthy tissue. In some cases, part of the stomach is removed, while advanced tumours may require removal of the entire stomach, followed by reconstruction of the lumen to\u00a0maintain\u00a0continuity of the digestive tract.\u00a0The decision of surgery\u00a0depends\u00a0on the severity and type\u00a0of cancer.\u00a0<\/li>\n\n\n\nChemotherapy:<\/strong>\u00a0This\u00a0approach uses medicines that destroy cancer cells or slow their growth.\u00a0It may be given as an injection or as oral medicine.\u00a0,\u00a0Depending on the\u00a0oncologist\u2019s\u00a0decision, it may be used before or after surgery at any stage\u00a0of\u00a0stomach cancer to\u00a0help\u00a0control the disease.\u00a0Examples\u00a0of routinely used drugs: Capecitabine<\/a><\/strong>,\u00a0cisplatin<\/a><\/strong>,\u00a0and\u00a0docetaxel<\/a><\/strong>.\u00a0<\/li>\n\n\n\nRadiation Therapy:<\/strong>\u00a0This treatment uses\u00a0localised\u00a0high-energy radiation to damage cancer cells\u00a0or restrict them from growing. It may be used along with chemotherapy\u00a0before or after surgery for some\u00a0stage II and\u00a0stage III cancers. In\u00a0stage IV disease, it may also be used\u00a0for palliative symptom relief\u00a0such as pain, bleeding or blockage.\u00a0<\/li>\n\n\n\nTargeted Therapy:<\/strong>\u00a0This uses\u00a0medicines\u00a0or drugs to\u00a0act on specific\u00a0types of\u00a0cancer cells\u00a0to restrict their growth. For example, some patients whose tumours have certain markers, such as HER2, may benefit from HER2-targeted treatment.\u00a0It is mainly used for advanced or\u00a0stage IV stomach cancer.\u00a0Examples: Trastuzumab<\/a><\/strong>\u00a0and\u00a0trastuzumab deruxtecan, in\u00a0cases\u00a0of\u00a0HER2-positive tumours.\u00a0<\/li>\n\n\n\nImmunotherapy:<\/strong>\u00a0This\u00a0treatment uses drugs that help\u00a0the immune system recognise and attack cancer cells.\u00a0They\u00a0use more than one way to\u00a0destroy cancer cells.\u00a0It is mainly considered for advanced or\u00a0stage IV stomach cancer\u00a0and may be combined with chemotherapy.\u00a0Examples: Nivolumab<\/a><\/strong>\u00a0and\u00a0pembrolizumab<\/strong><\/a>11<\/a>,12<\/a><\/sup>.\u00a0<\/li>\n<\/ul>\n\n\n\n<\/span>Can Stomach Cancer Be Prevented?<\/strong>
If stomach cancer is suspected, doctors\u00a0may use a combination of tests to confirm the diagnosis, determine the extent of the disease and choose the most appropriate treatment. The common\u00a0diagnostic tests\u00a0include:\u00a0<\/p>\n\n\n\n
Stomach cancer treatment\u00a0depends on factors such as the cancer stage, its location,\u00a0the individual\u2019s\u00a0overall health,\u00a0and whether\u00a0the cancer\u00a0has spread to other parts of the body. Doctors may use one treatment or combine several approaches\u00a0as needed.\u00a0<\/p>\n\n\n\n