Stomach cancer

Stomach cancer, also known as gastric cancer, is a growth of abnormal cells that usually begins in the tissue that lines the stomach.

Your stomach is part of your gastrointestinal system. It is a muscular organ that digests food and passes it to your small intestine.  

Most stomach cancers start in the lining of the stomach¹. These are called adenocarcinomas. Other types of stomach cancer include:

• Lymphoma Lymphomas start in cells in the lymphatic system and can develop in the stomach.
  
• Sarcomas and squamous cell cancers Sarcomas are found in the connective tissue of the stomach, such as muscle, fat or blood vessels. Squamous cell cancers develop from the flat squamous cells in the stomach.
• Metastatic cancers Tumours from melanoma, breast cancer, or other parts of the body can uncommonly metastasise and be found in the stomach.

Stomach cancer may not cause symptoms in the early stages and is often diagnosed when it’s more advanced. Symptoms may include:

• unexplained weight loss or loss of appetite
• pain or burning in the abdomen
• persistent nausea or vomiting
• swelling of the abdomen
• blood in vomit or stools
• black-coloured stools
• difficulty swallowing
• feeling full even after a small meal
• unexplained tiredness

These symptoms don’t mean you have stomach cancer, but you should see your doctor for a check-up.

There is no clear reason for stomach cancer. However, some factors appear to increase the risk. These include:

• smoking²
• infection with Helicobacter pylori³. This is a type of bacteria found in the stomach and is spread through food and water. It’s fairly common in the developed world and can be tested for with a breath test or on a gastric biopsy.
• a diet high in salted, pickled or fried foods and low in fruit and vegetables⁴
• pernicious anaemia (an autoimmune condition)⁵
• excessive alcohol consumption⁶
• chronic gastritis⁷ (inflammation of the stomach)
• being overweight⁸
• family history of stomach cancer⁹
• inherited genetic conditions such as familial adenomatous polyposis¹⁰

Having any of these risk factors doesn’t mean you will develop stomach cancer, but you could seek medical advice if you are concerned.

Your GP will probably refer you to a specialist if they are concerned about your symptoms and risk factors for stomach cancer. Tests to diagnose stomach cancer may include:

• Endoscopy This is the main test to diagnose stomach cancer. It is also known as gastroscopy. A thin, flexible tube with a camera at the end (an endoscope) is passed through your mouth into the stomach. This is usually done with a local or general anaesthetic
• Biopsy If any unusual tissue is detected during the endoscopy, a small amount of tissue will be removed so it can be examined under the microscope. This is called a biopsy and will usually be done at the same time as the endoscopy
• Endoscopic ultrasound An endoscope with an ultrasound probe is passed down through your mouth into the stomach. The ultrasound shows a picture of your stomach

If you are diagnosed with stomach cancer, your doctor will explain the staging which is how far your cancer has progressed. You may be asked to have additional tests to see if cancer has spread to other parts of your body:

• Imaging tests. These might include a PET-CT scan to give more information about size and location and to see if cancer has spread to your lymph nodes or elsewhere.
• Laparoscopy. This is a surgical procedure that doctors use to look inside your abdomen for signs cancer has spread.

The main treatment for stomach cancer is surgery. There are usually two options:

• Endoscopic resection. This can remove early-stage tumours in the stomach. It’s done using an endoscope.
• Gastrectomy. The role of surgery may be discussed by an Upper GI surgeon, with procedures either a total or partial gastrectomy, where all or part of the stomach is removed.

Other treatments before or after surgery may include:

• chemotherapy
• immunotherapy
• radiation therapy
• targeted therapy

We understand that a cancer diagnosis can be emotional and life-changing. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness. At GenesisCare, we strive to strengthen your confidence, settle your emotions and create care experiences that give you the best possible outcomes.

Our care team will know your name and get to know who you are as a person. We don’t want you to feel alone when you’re with GenesisCare. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you and help you access support from experts such as psychologists, exercise physiologists, physiotherapists and dietitians.

Please contact your local GenesisCare centre for more details on the services available. View a list of our centres here.

Whether you experience side effects and how severe they are, depends on the type and dose of chemotherapy treatment you are given and your reaction from one treatment cycle to the next. Most side effects are short-term and can be managed. These may include:

• fatigue
• nausea or vomiting
• constipation or diarrhoea
• hair loss
• easily bruising or bleeding
• weight changes
• skin changes
• mood changes
• sores and pain around the mouth

These symptoms tend to improve gradually once treatment stops. Talk to your doctor or nurse if you feel upset or anxious about how long treatment is taking or the impact of side effects.

• Get as much rest as possible
  
• Aim for a wholefood, varied diet, but we also encourage you to eat foods that interest you rather than what you think you should eat
• Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseous
• Drink lots of water
• Reach out to support groups and others who have had chemotherapy
• Ask your team about topical treatments for your skin if you get irritation or pain
• Stay out of the sun as much as possible throughout your treatment
• Record your side effects in a diary or journal
• Take some gentle exercise, such as walking, if you feel up to it. Light to moderate exercise can reduce treatment-related fatigue and improve your mood. Plan your exercise for times in the day when you know you have more energy
• It is important to acknowledge when you are fatigued and rest when you need to
• Ask for and accept help from family, friends and neighbours
• Be open with employers about your treatment and discuss flexible working options if you need them

The side effects may vary depending on the type of targeted therapy you have, and how your body reacts. These may include:

• fatigue
• bowel issues
• headaches
• fever or chills
• nausea or vomiting
• weight loss
• itching or localised rashes

General side effects include:

• soreness and swelling around the treatment area
• tiredness and lethargy for a few weeks after you finish

Specific side effects (depending on the area being treated):

• diarrhoea
• bloating
• nausea and vomiting

Most of these side effects will ease soon after treatment is finished. Your team will discuss any long-term considerations with you.

General side effects include:

• swelling and pain
• you may need a feeding tube until you’re able to eat and drink properly

• you may be given a feeding tube pre-surgery so you don’t become malnourished
• a doctor may advise liquid supplements or changing your diet

These may include:

• diarrhoea
• fatigue
• nausea
• numbness or tingling
• headaches
• skin rashes