Stomach cancer

There are four types of stomach cancer:

• Gastric adenocarcinoma (also known as gastric cancer) – the most common type of stomach cancer in Australia – starts in the glandular cells that line the inner layer of the stomach wall (called the mucosa)^2,4
• Gastrointestinal stromal tumours (GIST) are regarded as being rare cancers that start in the connective (interstitial) tissue in the stomach wall⁵
• Lymphomas are regarded as being rare cancers of the lymph system that can be found in the wall of the stomach⁶
• Carcinoid tumours are regarded as being rare cancers that start in the hormone-making cells of the stomach⁷

Stomach cancer may not cause symptoms in the early stages and is often diagnosed when it’s more advanced. Common stomach cancer symptoms may include:^1,2

• Indigestion or heartburn, particularly if it gets worse
• Difficulty or pain when swallowing, including a sense of choking when swallowing, which is called dysphagia
• Feeling full or bloated, especially after only eating a small amount
• Loss of appetite
• Unexplained weight loss
• Nausea or vomiting, with or without blood
• Black or bloody stools
• Pain in the upper abdomen, which may occur when eating
• Swollen abdomen caused by a build-up of fluid
• Feeling tired for no clear reason
• Anaemia

It's important to note that these symptoms do not necessarily mean that you have stomach cancer. If you are concerned or have further questions, please make an appointment with your GP or specialist.

There are no clear causes for stomach cancer, however there are a range of factors that may increase the potential risk of diagnosis. These risk factors may include:^1,2

• Having a chronic stomach condition, such as Helicobacter pylori infection, chronic gastritis (stomach inflammation), or gastric polyps (non-cancerous growths on the inner lining of the stomach)
• Being older
• Low levels of red blood cells (anaemia)
• A partial gastrectomy (stomach removal) to treat non-cancerous conditions
• Eating a high-salt diet that includes smoked or pickled foods, and is low in fruit and vegetables
• Smoking tobacco
• Drinking excessive amounts of alcohol
• Being overweight or obese
• Family history of stomach cancer or gastrointestinal disorders

It is recommended to make an appointment with your GP or specialist if you are concerned or have any questions about risk factors for stomach cancer.

There are a few different tests that may be undertaken to diagnose stomach cancer, including:1,2

• Physical examination
• Endoscopy: this is an examination of the inside of the stomach and other parts of the upper digestive system, performed using an endoscope
• Biopsy: this involves a tissue sample being taken from the stomach wall for further examination under a microscope. Generally, a biopsy is taken during an endoscopy

If you are diagnosed with stomach cancer, you may have further tests to help determine how far the cancer has progressed. These are called staging tests and may include:^1,2,8

• Imaging tests: such tests may include an endoscopic ultrasound, computed tomography (CT) scan, positron emission tomography (PET-CT) scan, or magnetic resonance imaging (MRI). The objective of imaging-based tests is to understand more about the size and location of the tumour. Imaging tests may also help determine if the cancer has spread to your lymph nodes or elsewhere
• Laparoscopy: this is a surgical procedure that may be used to look inside the abdomen to detect if the tumour has spread

One of the treatment options suggested to treat stomach cancer may be surgery, with usually two types of surgical treatment suggested:_^9,10

Endoscopic resection - This can remove early-stage tumours in the stomach. It is done using an endoscope.

Gastrectomy - Surgery to remove all or part of the stomach is called a gastrectomy. The surgeon aims to remove as much of the tumour as possible, including some healthy tissue and lymph nodes, to help reduce the risk of the cancer recurring. 

There are two types of gastrectomy: partial gastrectomy and total gastrectomy.

Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.

Targeted therapy refers to treatment with medicines that are designed to specifically attack cancer cells without harming normal cells. These types of medicines affect the way that cancer cells grow, divide, repair themselves or interact with other cells.

Radiation therapy may be offered in the early stages of cancer treatment, or after it has started to spread. There are different radiation therapy techniques which may be suitable for different cancer types at different stages.

Immunotherapy is a type of treatment that is intended to help your own immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.