Cancer that starts in the stomach can cause pain, weight loss, and difficulty eating. Early detection is key.
What is stomach cancer?
Stomach cancer is a disease that occurs when cancer cells form in the lining of the stomach. The stomach is a hollow muscular organ located in the upper abdomen, just below your ribs. It receives and digests food from the esophagus. Treatment for this type of cancer takes into consideration the function of the stomach and its importance in digestion.
Stomach cancer is relatively rare and is often detected in later stages. Most stomach cancers are adenocarcinomas, which develop from the cells that form the innermost lining of the stomach (the mucosa). Other types of stomach cancers include lymphomas, gastrointestinal stromal tumors (GISTs), and carcinoid tumors. Given the rarity and potential complexity of this disease, getting care from experienced, highly specialized health care providers, like those found at AHN, is critical.
Our stomach cancer team has devoted their careers to studying gastrointestinal cancers. This exclusive focus gives our team a depth of expertise in developing an individualized treatment plan for each patient.
Esophageal and Gastric Center of Excellence
At the Esophageal and Gastric Center of Excellence, our expert team provides a quick and accurate diagnosis. When it comes to stomach cancer, a quick and accurate diagnosis is critical so we can begin treatment as soon as possible.
Our team is dedicated to continual advancement in treating stomach cancer. Our dedicated research team is working on developing new treatments that provide new care options for our patients. Our physicians deploy the most up-to-date diagnostic and therapeutic tools available. Features of our program include:
- Advanced technology: We use innovative and advanced technology to provide patients with minimally invasive techniques that allow for a quicker and easier recovery.
- Collaborative care: At our stomach cancer tumor board (cancer care meeting), we review our patients’ cases in a collaborative setting. Physicians, surgeons, medical oncologists, radiologists, and researchers work together to develop individualized treatment plans.
- Convenient services: We designed clinics to meet the diverse needs of our patients. You can often coordinate tests, appointments, and treatment at the same facility. If you're having pain or other side effects, you'll get prompt treatment from one of our specialists at our convenient After Hours Oncology Clinic instead of waiting in an emergency room.
- Research-driven treatment: As a patient, you have access to the clinical trials offered at AHN as well as coordinated access to the clinical trials of our distinguished partners, if your provider feels like these would be good treatment options for you. This amounts to more than 500 active clinical trials. You can take part in the latest medical research that may help discover new, effective approaches to treatment. Learn more about our clinical trials program.
Stomach cancer symptoms and signs
Sometimes, early stomach cancer doesn't cause any symptoms. That's why it is important to talk with your doctor about the changes you notice in your body. Stomach cancer symptoms can be mistaken for other gastrointestinal issues or other common illnesses. If you notice the following symptoms, talk with your doctor:
- Persistent indigestion or heartburn: Feeling like you have a stomachache that just won't go away.
- Loss of appetite: Not feeling hungry, even when you normally would.
- Unexplained weight loss: Losing weight without trying.
- Feeling full quickly: Feeling like you've eaten a lot only after eating a small amount of food.
- Nausea and vomiting: Feeling nauseated and/or vomiting.
- Stomach pain: This could be a general ache or a sharp pain.
- Blood in your stool: Black, tarry, or bloody stool.
- Fatigue: Feeling very tired even with regular sleep or rest.
- Anemia: Low blood counts (hemogloblin or hematocrit).
Causes and risk factors
There are various risk factors and causes of stomach cancer. These include:
- Helicobacter pylori (H. pylori) infection: This is a common bacteria that can infect the stomach.
- Diet high in salt, smoked processed foods, red meat, alcohol, and low-fiber food: Eating a lot of these foods over a long time can increase the risk.
- Smoking: Increases the risk of many cancers, including stomach cancer.
- Family history/genetics: Having a close relative (parent, sibling, or child) who had stomach cancer.
- Age: Stomach cancer is more common in older people (over 50).
- Gender: It's more common in men than in women.
- Certain medical conditions: Such as pernicious anemia or atrophic gastritis.
It’s important to know that while these can be causes or risk factors, they do not always lead to stomach cancer. Regular checkups and discussions with your doctor are important in all instances, but if you have a combination of these risk factors or causes, be sure to talk with your doctor about potential screening options.
Stomach cancer screening and diagnosis
At AHN Cancer Institute, we work to get you a quick and accurate diagnosis. As soon as we confirm the diagnosis and the stage of the cancer, our highly experienced tumor board discusses personalized treatment recommendations for you.
You will meet your team in the clinic, where you will undergo an evaluation and a plan will be developed. After you are diagnosed with stomach cancer, your team will coordinate a comprehensive evaluation to complete staging. The staging of cancer is important to help your team develop a treatment plan.
Key components of our evaluations include:
- Minimally invasive: Most of our diagnostic tests use sophisticated technology that keeps you as comfortable as possible. Many tests do not even require an incision.
- Expert: Our stomach cancer specialists use the latest research, so you receive the most precise diagnosis. A precise diagnosis helps us create a more effective treatment plan for you.
- Convenient: Most of our tests can often be done during one visit. We provide a quick turnaround time for results to reduce your wait time.
At AHN, we expedite appointments so you can quickly meet your treatment team after being diagnosed with cancer. Your team reviews your case and makes recommendations. Our advanced diagnostic tests include:
- Sedated endoscopy: This procedure uses a flexible tube with a light and camera to visually inspect your stomach. We pass the camera into the digestive tract through your mouth. If we see abnormal areas, we can easily take a tissue sample (biopsy) using instruments passed through the endoscope.
- Biopsy: As part of a standard endoscopy, we collect cells from any suspicious areas. A specially trained physician, called a pathologist, examines the cells to determine if they are cancerous.
- Endoscopic ultrasound: The physician inserts a flexible tube with an ultrasound into your mouth and down to your stomach. The ultrasound provides images that help us to measure the tumor and look for any spread of disease (e.g., lymph nodes).
- Computed tomography (CT) scans: The technician takes multiple images of your body. A computer combines them to form one 3D picture that shows more information about the location of tumor and other internal structures.
- Positron emission tomography (PET) scan: We inject a small, safe amount of a radioactive sugar substance into your arm before the test. The substance collects in cancerous areas, so we can clearly see where the cancer is located.
- Molecular staging of tumors: This procedure identifies the unique molecular makeup of a specific tumor. Using that information, we can select targeted, effective treatment options.
- Staging laparoscopy: After we have diagnosed the cancer, we often perform this procedure so we can complete the staging of the cancer. We insert a thin, flexible tube with a video camera attached into the abdomen. The surgeon can see inside the abdomen and determine if the cancer has spread to other organs.
Types and stages of stomach cancer
The type of stomach cancer refers to the kind of cells that are cancerous.
Adenocarcinoma
The most common type at approximately 90 – 95% of stomach cancers. This type originates in the gland cells that line the stomach's inner lining (mucosa). These cells normally produce mucus and other fluids that protect the stomach.
Subtypes of adenocarcinoma include:
- Intestinal type: Often forms gland-like structures, similar to those in the intestine. Tends to be more localized and have a slightly better prognosis. Can be associated with H. pylori infection.
- Diffuse type: Cancer cells grow individually or in small groups, infiltrating the stomach wall. Can be more aggressive and spread more easily. Less associated with H. pylori. Often related to a mutation in the CDH1 gene.
- Mixed type: Has features of both intestinal and diffuse types.
- Tubular, papillary, mucinous, signet ring cell: These are other, less common subtypes described by their microscopic appearance.
Lymphoma
Accounting for about 4% of stomach cancer diagnoses, this is a cancer of the lymphatic system, which is part of the immune system. Lymphomas can occur in the stomach. The most common type of lymphoma in the stomach is mucosal associated lymphoid tissue (MALT), which is associated with H. pylori infection.
Gastrointestinal stromal tumor (GIST)
Less than 2 – 3% of stomach cancers, GISTs arise from specialized nerve cells in the stomach wall called interstitial cells of Cajal (ICCs). GISTs can be benign (noncancerous) or malignant (cancerous). Often driven by mutations in the KIT or PDGFRA genes.
Carcinoid tumor
These tumors arise from neuroendocrine cells, which are specialized cells that produce hormones. Most carcinoid tumors in the stomach grow slowly. Sometimes associated with a condition called atrophic gastritis (chronic inflammation of the stomach lining) or Zollinger-Ellison syndrome (causes excess stomach acid production).
Stomach cancer stages
Staging helps doctors understand how far the cancer has spread. It's usually described using numbers from 0 to 4, with higher numbers indicating more advanced cancer. Early-stage stomach cancer generally refers to cancer that is confined to the inner layers of the stomach. It hasn't spread to distant organs or lymph nodes (or has only spread to a few lymph nodes near the stomach). The most common stages considered "early" are Stage 0, Stage 1, and sometimes Stage 2.
- Stage 0 (Carcinoma in situ): Cancer cells are only found in the innermost layer of the stomach lining (mucosa).
- Stage 1: The cancer has grown deeper into the stomach wall but hasn't spread far. Stage 1 is often further divided into:
- Stage 1A: Cancer is in the inner layers of the stomach wall and has not have spread to nearby lymph nodes.
- Stage 1B: Cancer has grown into the muscle layer of the stomach and may or may not have spread to nearby lymph nodes.
- Stage 2: Cancer has grown further into the stomach wall and may have spread to lymph nodes. The cancer has not spread to distant organs.
- Stage 3: Cancer has grown more deeply into the stomach wall and has spread to more lymph nodes. The cancer has not spread to distant organs.
- Stage 4: This is the most advanced stage of stomach cancer. It means the cancer has spread (metastasized) to distant organs, such as the liver, lungs, or bones, or to distant lymph nodes.
Stomach cancer treatment
Our highly trained teams of specialists work together to determine the most effective treatment plan. We discuss all the details of the plan with you and your family, so you feel informed and confident about your care. Our whole-person approach includes robust services such as support groups, palliative care, and mental health support.
Depending on the stage of the cancer, we may use a single treatment technique, or we may combine therapy options to give you the best results. Our stomach cancer specialists can treat stomach cancer using surgery, radiation therapy, chemotherapy, and clinical trials. At every step of the way, we discuss your options and consider your personal preferences and needs.
Stomach cancer surgery
Surgeons at the Cancer Institute use the latest techniques and technology. Their expertise ensures that you receive the most thorough treatment plan with the best possible results. We may use surgery to remove the cancer and part or all of the stomach, depending on the type and stage of the cancer. The surgeon will try to leave as much of the stomach intact as possible so you can have a functional digestive system. We will discuss a comprehensive treatment plan that focuses on quick recovery, reducing pain, and return to daily activities.
Our advanced surgical options include:
- Ablation: This procedure uses either electrical current or extreme cold to burn or freeze a part of a cancerous lesion for removal.
- Endoscopic mucosal resection (EMR): We pass a long, narrow tube (endoscope) down your throat and use small tools to remove the cancerous cells in your stomach.
- Minimally invasive gastrectomy: This procedure uses small incisions to remove part or all of the stomach. We reconnect your intestines to allow food and drink to pass through your digestive system.
- Feeding tube: Some patients may need a feeding tube either for a short time or permanently. If so, we perform this minimally invasive procedure. We insert an endoscope with a small camera attached through the mouth and into the stomach. Then, the surgeon numbs an area on your abdomen and makes a small incision to insert the feeding tube. Alternatively, a tube may be placed into the small intestine through small incisions on the abdomen.
Radiation therapy
You may need radiation therapy (high-dose radiation beams directed at the tumor) before or after surgery. Our radiation oncologists use their expertise and innovative technologies to provide leading-edge cancer care. Our advanced radiation therapies include:
- External beam radiation: We direct beams of radiation at the area where the cancer is located or was located before surgery. Our sophisticated technology allows us to direct the intensity of the radiation dose to a precise location. This process prevents radiation from affecting normal tissue and reduces side effects.
- Internal radiation: Instead of aiming radiation beams from outside the body, we place radioactive seeds near areas of cancer. This site can be used to boost or further treatment an area of cancer. This process ensures we can give the maximum radiation dose to cancerous tissues while minimizing exposure to the surrounding healthy tissue.
Medical oncology
Our expert medical oncologists treat patients using a variety of medications. You may receive these treatments before or after surgery or on their own. Our advanced medical oncology therapies include:
- Chemotherapy: These are powerful drugs that can kill cancer cells. The medications may cause side effects, such as nausea or hair loss. Our team works with you to minimize the side effects as much as possible.
- Hyperthermic intraperitoneal chemotherapy (HIPEC): This is a highly concentrated, heated chemotherapy treatment for late-stage abdominal cancers. Doctors deliver chemotherapy directly to cancer cells in the abdomen during surgery.
- Targeted therapy: This therapy works by attacking specific genes within the surrounding blood vessels to stop cancer from growing.
- Immunotherapy: This therapy helps your own immune system to better fight the cancer.
Clinical trials for stomach cancer
Through our partnership with AHN’s Esophageal Institute, we have a robust clinical trials program that is one of the most comprehensive in the nation. Our program is known for:
- Patient-centered care: On the day you enter our facility, a member of our clinical trials team determines if you are a candidate for a clinical trial. You can see all your options before you begin treatment.
- Renowned partnerships: If you meet the eligibility criteria, you have access to the clinical trials we have here. We are also a site for federally funded trials through the National Cancer Institute, the country’s leader in cancer research.
- Expert staff: Our research coordinators are experts in treating stomach cancer. They focus 100% of their time and effort on the study and treatment of cancer. We are at the forefront of stomach cancer research and have the expertise to match the right person to the right trial.
Palliative care for stomach cancer
When stomach cancer is in an advanced stage, surgery may not be an effective treatment option. Palliative care cannot cure the disease, but it helps to relieve the symptoms and improve your quality of life. Palliative care options include:
- Stent placement: For this procedure, we use an endoscope to prevent the tumor from blocking the opening or end of the stomach. This procedure helps you eat and digest food.
- Cryoablation: This procedure uses extreme cold to reduce the size of a stomach tumor to prevent a blockage, allowing you to eat and digest food more comfortably.
Rehabilitation after stomach cancer treatment
After certain types of stomach cancer treatment, such as gastrectomy (removal of the stomach), rehabilitation may be necessary. Our highly trained and compassionate team helps you resume a full life post-cancer. You have access to:
- Nutrition counselors
- Physical therapists
- Gastroenterologists
- Gastrointestinal nurses
Stomach cancer FAQs
With a stomach cancer diagnosis, you likely have questions and may feel a sense of overwhelm. Your AHN Care Team is here to help you navigate your diagnosis and understand your options. We’ve included some frequently asked questions about stomach cancer to provide you with some background knowledge that may aid in productive conversations with your care team. They are available to discuss, in more detail, anything having to do with your stomach cancer diagnosis or treatment.
What causes stomach cancer?
Researchers don't know exactly what causes stomach cancer in every case. But it's like a puzzle with many pieces. Certain things can increase your chances of getting it, like:
- Helicobacter pylori (H. pylori) infection: This is a common bacteria that can infect the stomach.
- Diet high in salty, smoked processed foods, red meat, alcohol, and low-fiber foods: Eating a lot of these foods over a long time can increase the risk.
- Smoking: Increases the risk of many cancers, including stomach cancer.
- Family history: Having a close relative (parent, sibling, or child) who had stomach cancer.
- Age: Stomach cancer is more common in older people (over 50).
- Gender: It's more common in men than in women.
- Certain medical conditions: Such as pernicious anemia or atrophic gastritis.
What is the survival rate for stomach cancer?
Survival rates are tricky because they're based on large groups of people and may not predict what will happen in your specific case. Also, survival rates have improved over time with better treatments. Generally, it depends on what stage the cancer is when it's found. Early-stage cancers (Stage 1) that are treated have a much higher survival rates than cancers that have spread to other parts of the body (Stage 4). Newer diagnostic tools and treatments further improve survival by individualizing treatment to your specific cancer.
It's best to discuss your specific situation with your doctor. They can give you a better idea of what to expect based on the stage of your cancer, your overall health, and the treatments available.
Where is the first place stomach cancer spreads to?
When stomach cancer spreads, it usually goes to the nearby lymph nodes first. Lymph nodes are like small filters that are part of your immune system. They're connected by a network of vessels, and cancer cells can travel through these vessels to reach the lymph nodes. This is why doctors often remove lymph nodes during surgery to see if they contain cancer cells.
What does Stage 1 stomach cancer feel like?
This is the tricky part: Stage 1 stomach cancer often doesn't cause any symptoms. This is why it's so important to get regular checkups and be aware of any changes in your body. If symptoms do occur in Stage 1, they're usually mild and can be easily mistaken for other things, such as:
- Indigestion or heartburn: Feeling like you have an upset stomach.
- Loss of appetite: Not feeling hungry.
- Feeling full quickly: Feeling like you've eaten a lot after only eating a small amount of food.
Contact us
Call the Hope Line at (412) 578-HOPE (412) 578-4673 to connect with a nurse navigator or schedule an appointment.
Second opinions
If you have cancer, you have a team of oncology specialists ready to review your medical records and offer you a second opinion. After completing their review, they’ll talk with you about your goals to determine a course of treatment that’s right for you. To get started, fill out our Second Opinion Request form. A nurse navigator will contact you within the next 24 to 48 hours to discuss next steps and schedule.