Stomach cancer Cancerbackup There are about 8,200 new cases of stomach cancer diagnosed every year and it's more common in men, particularly in late middle age.

In this article

What is stomach cancer? Symptoms

Causes and risk factors Treatment and recovery

Further information

As with colorectal (bowel) cancer, the embarrassment of talking about the symptoms often puts people off seeking medical help. But late diagnosis leads to a low survival rate, so the sooner it gets treated the better.

The stomach lies between the lower end of the gullet (oesophagus) and the beginning of the intestine.

Although incidences of stomach cancer in the UK have been decreasing, cancers at the junction (GoJ) of the stomach and the oesophagus are rising and many of the symptoms and the investigations and treatments are same.

This rise in cancers of the GoJ has been linked to:

• Obesity
• An increase in rates of infection with an organism called helicobacter pylori
• Barrett’s oesophagus (where abnormal cells develop in the lining of the lower oesophagus)

The following symptoms are common to other conditions other than stomach cancer, so it's vital to get them checked by your GP:

• Indigestion that won't go away
• Loss of appetite
• A bloated feeling after eating
• Vomiting
• Tiredness
• Blood in bowel motions or black stools
• Weight loss
• Difficulty swallowing

The exact cause of stomach cancer is still not known, although it's thought that diet may play an important part.

There's every reason to believe that a healthy diet will reduce your risk of cancer. Diets containing plenty of fruit and vegetables appear to protect against all cancers - and in particular cancers of the stomach and bowel.

People who have pernicious anaemia (an autoimmune condition where the lining of the stomach becomes thin, less acid is produced and anaemia develops due to lack of vitamin B12), atrophic gastritis, or a hereditary condition of growths in the stomach are at a higher risk of developing this type of cancer.

Infection with the bacteria Helicobacter pylori, usually linked to stomach ulcers, may increase the risk of stomach cancer in the lower part of the stomach by up to three times.

Your GP will listen to your symptoms and examine you, referring you to a specialist hospital team if needed, where you’ll be seen within two weeks.

The hospital team will arrange for you to have a gastroscopy - a look inside your stomach using a flexible telescope that's passed into your mouth and down the gullet. During a gastroscopy, tiny samples of abnormal tissues, called biopsies, can be taken to be examined under the microscope in the laboratory.

If the gastroscopy shows a stomach cancer then a CT scan will be arranged to look for spread of the cancer to other organs. If there is no sign of spread you may go on to have a PET scan and a laparoscopy, where a telescope is placed into the belly under anaesthetic in order to look directly at the internal organs, to double-check.

If all these tests are clear with no sign of the cancer spreading, then most patients will be offered chemotherapy treatment for three months, then surgery to remove the affected part of the stomach. If the surgery is successful then the operation is usually followed by a further three months of chemotherapy.

If patients have persistent vomiting or significant bleeding then they will often have immediate surgery without chemotherapy first.

Patients who are found to have a stomach cancer that has spread to other organs may not benefit from surgery but, depending on their general health, may be offered chemotherapy. Radiotherapy may also be recommended, depending on the exact location of the cancer and symptoms.

Cancerbackup
Website: www.cancerbackup.org

CORE - Digestive Disorders Foundation
Website: www.digestivedisorders.org.uk

This article was last medically reviewed by Dr David Smith, Medical Oncologist, Clatterbridge Centre for Oncology in March 2009.
First published in February 1999.