Stomach cancer is an abnormal growth of cells that begins in the stomach. The stomach is a muscular sac located in the upper middle of your abdomen, just below your ribs. Your stomach receives and holds the food you eat and then helps to break down and digest it.
Stomach cancer, also known as gastric cancer, can affect any part of the stomach. In most of the world, stomach cancers form in the main part of the stomach (stomach body).
But in the United States, stomach cancer is more likely to affect the area where the long tube (esophagus) that carries food you swallow meets the stomach. This area is called the gastroesophageal junction.
Where the cancer occurs in the stomach is one factor doctors consider when determining your treatment options. Treatment usually includes surgery to remove the stomach cancer. Other treatments may be recommended before and after surgery.
Signs and symptoms of stomach cancer may include:
When to see a doctor
If you have signs and symptoms that worry you, make an appointment with your doctor. Your doctor will likely investigate more-common causes of these signs and symptoms first.
It's not clear what causes stomach cancer, though research has identified many factors that can increase the risk.
Doctors know that stomach cancer begins when a cell in the stomach develops changes in its DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes tell the cell to grow quickly and to continue living when healthy cells would die. The accumulating cells form a tumor that can invade and destroy healthy tissue. With time, cells can break off and spread (metastasize) to other areas of the body.
Factors that increase the risk of stomach cancer include:
To reduce the risk of stomach cancer, you can:
ests and procedures used to diagnose stomach cancer include:
Determining the extent (stage) of stomach cancer
The stage of your stomach cancer helps your doctor decide which treatments may be best for you. Tests and procedures used to determine the stage of cancer include:
Other staging tests may be used, depending on your situation.
Your doctor uses the information from these procedures to assign a stage to your cancer. The stages of stomach cancer are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating that the cancer is small and affects only the inner layers of your stomach. By stage IV, the cancer is considered advanced and may have spread to other areas of the body.
Treatment options for stomach cancer depend on the cancer's location, stage and aggressiveness. Your doctor also considers your overall health and your preferences when creating a treatment plan.
The goal of surgery is to remove all of the cancer and some of the healthy tissue around it.
Operations used for stomach cancer include:
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach.
Chemotherapy can be given before surgery to help shrink the cancer so that it can be more easily removed. Chemotherapy is also used after surgery to kill any cancer cells that might remain in the body. Chemotherapy is often combined with radiation therapy.
Chemotherapy may be used alone or with targeted drug therapy in people with advanced stomach cancer.
Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. The energy beams come from a machine that moves around you as you lie on a table.
For stomach cancer, radiation therapy can be used before surgery to shrink the cancer so that it's more easily removed. Radiation therapy can also be used after surgery to kill any cancer cells that might remain. Radiation therapy is often combined with chemotherapy.
For advanced stomach cancer that can't be removed with surgery, radiation therapy may be used to relieve side effects, such as pain or bleeding, caused by a growing cancer.
Targeted drug therapy
Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. For stomach cancer, targeted drugs are usually combined with chemotherapy for advanced cancers or cancer that comes back after treatment.
Your doctor may test your cancer cells to see which targeted drugs are most likely to work for you.
Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make it hard for the immune system cells to recognize the cancer cells as dangerous. Immunotherapy works by interfering with that process.
For stomach cancer, immunotherapy might be used when the cancer is advanced, if it comes back or if it spreads to other parts of the body.
Supportive (palliative) care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
Coping and support
A cancer diagnosis can be overwhelming and frightening. Once you start to adjust after the initial shock of your diagnosis, you may find that it helps to stay focused on tasks that help you cope. For example, try to:
Preparing for your appointment
Start by seeing your family doctor if you have signs or symptoms that worry you. If your doctor suspects that you may have a stomach problem, you may be referred to a doctor who specializes in conditions that affect the digestive system (gastroenterologist). Once stomach cancer is diagnosed, you may be referred to a cancer specialist (oncologist) or a surgeon who specializes in operating on the digestive tract.
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions can help you cover all your concerns. List your questions from most important to least important in case time runs out. For stomach cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions as they occur to you during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask: