Stomach cancer

This factsheet is for people who have stomach cancer, or who would like information about it.

Stomach cancer is a lump (tumour) created by an abnormal and uncontrolled growth of cells in your stomach. It’s also known as gastric cancer.

How cancer develops

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About stomach cancer

Your stomach is a muscular bag in your abdomen (tummy) that digests the food you eat. The lining of your stomach produces a strong acid to help break down food and protect you from harmful bacteria.

In the early stages, stomach cancer only develops within your stomach lining or stomach wall. If it becomes more advanced, the cancer cells can spread into neighbouring organs. This is called localised spread. Sometimes the cancer cells can break away and spread to other parts of your body (this is known as metastasis) in your blood or lymphatic system. Your lymphatic system is made up of tissues and organs – including the bone marrow, spleen, thymus, and lymph nodes – that produce and store cells that fight infection and disease.

About 7,800 people get stomach cancer each year in the UK. It mostly affects people over 55 and is more common in men.

Types of stomach cancer

About nine in 10 stomach cancers are adenocarcinomas. This type of stomach cancer starts in the glandular cells that produce mucus and stomach juices.

Other, rarer, types of stomach cancer include:

• squamous cell carcinomas, where the cancer starts in squamous cells (skin-like cells that make up part of your stomach lining)
• soft tissue sarcomas, where the cancer starts in the muscle layer of your stomach wall
• lymphomas, where the cancer starts in your lymphatic system
• carcinoid tumours, where the cancer starts in your neuroendocrine system (the system of glands throughout your body that produce hormones)

Symptoms of stomach cancer

The symptoms of stomach cancer can include:

• indigestion, heartburn and burping
• feeling bloated
• loss of appetite
• persistent stomach pain
• feeling sick or vomiting

As the cancer grows, other symptoms you may have include:

• weight loss
• vomiting blood
• blood in your faeces, which can look black
• tiredness and anaemia (when you have too few red blood cells or not enough haemoglobin in your blood), caused by blood loss
• a swelling or lump in your stomach area

These symptoms aren't always caused by stomach cancer but if you have them, see your GP.

Causes of stomach cancer

The exact reasons why you may develop stomach cancer aren't fully understood at present. However, certain factors may increase your risk – these are listed below.

• Age. Stomach cancer is most common in people aged 55 and over.
• Gender. Men are twice as likely to develop stomach cancer as women.
• Helicobacter pylori. This is a bacterium that causes infection of your stomach and duodenum, which can double your risk of stomach cancer.
• Acid reflux, also known as gastro-oesophageal reflux disease (GORD).
• Pernicious anaemia. This is a condition where your body doesn't absorb enough vitamin B12 from your diet.
• Family history. You’re more likely to get stomach cancer if your brother, sister or one of your parents has had it.
• Diet. Too much salt, red meat and foods that are smoked or that contain preservatives may increase your risk of stomach cancer.
• Smoking and drinking too much alcohol.Being overweight.

Diagnosis of stomach cancer

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history and organise for you to have the following tests.

• Blood tests. These are done to assess your general health.
• Gastroscopy. This is a test that allows your doctor to look at the inside of your stomach and is done using a narrow, flexible, tube-like telescopic camera called an endoscope.

You will usually be referred to a doctor who specialises in diseases of the stomach (a gastroenterologist or surgeon) for tests, which may include the following.

• Biopsy. This is when a small sample of tissue may be removed from your stomach during the gastroscopy and sent to a laboratory for testing.
• Barium swallow and meal. If you have this test, you will be asked to swallow a liquid containing a special dye (barium) that shows up on X-rays. Barium will show up any unusual growths in your stomach lining.

If these tests indicate that you have stomach cancer, you may need to have other tests to find out if the cancer has spread. You will usually need to have scans, including ultrasound, MRI or CT scan, to check your stomach, liver and surrounding lymphatic system.

Treatment of stomach cancer

Your treatment will depend on the type of stomach cancer you have and how far it has spread. Your doctor will discuss your treatment options with you.

Surgery

Surgery involves removing the affected tissue from your stomach and usually a small amount of the surrounding healthy tissue. You may have a partial gastrectomy, which means that part of your stomach is removed, or a total gastrectomy meaning that all of your stomach is removed. The lymph nodes (glands that are part of your immune system) around your stomach may also be removed to check whether the cancer has spread to them.

It may be possible for you to have laparoscopic (keyhole) surgery rather than open surgery, which means that several smaller cuts are made into your abdomen instead of one larger one. Speak to your surgeon for more information.

Surgery is sometimes followed by chemotherapy or radiotherapy treatment to make sure all the cancer cells are destroyed.

Non-surgical treatment

Your doctor may advise you to have one of the following treatments.

• Chemotherapy. This treatment uses medicines to destroy cancer cells. Most commonly chemotherapy is given through a drip into your bloodstream (intravenous chemotherapy) or as tablets or capsules that you swallow.
• Radiotherapy. This uses a targeted beam of radiation to kill cancer cells. It’s only very rarely used to treat stomach cancer.
• Biological therapy. This treatment uses a substance that stimulates your body to attack or control the growth of cancer cells. If your stomach cancer has spread, you may be offered a medicine called trastuzumab (Herceptin) alongside chemotherapy. It works by targeting cancer cells that have a particular protein on their surface, so isn’t suitable for everyone.

You may be offered entry into a clinical trial of a new treatment. Ask your doctor for advice and further information.

Prevention of stomach cancer

Some simple dietary changes can reduce your risk of stomach cancer. For example, you should:

• eat a healthy diet with at least five portions of fruit and vegetables a day
• cut down on processed and pickled foods
• reduce your intake of salt and red meat
• not smoke or chew tobacco
• only drink alcohol in moderation
• maintain a healthy weight

Getting enough vitamin D may reduce your risk of developing a number of cancers, including stomach cancer – although more research needs to be done to be certain. Vitamin D is also well known to be important for bone health.

Talk to your GP if you need further advice and information.

Help and support

Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need, and may also visit you at home. If you have more advanced cancer, further support is available to you in hospices or at home, and this is called palliative care.
 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.