Stomach Cancer Symptoms, Risk Factors, and When to See a Doctor for a Diagnosis

Stomach cancer, also referred to as gastric cancer, is cancer cell growth in the wall and lining of your stomach. While its case numbers have dropped¹ over the past couple of decades, it's still one of the most deadly and prevalent cancers² worldwide; and men have twice the risk as women³ of receiving a stomach cancer diagnosis.

According to the National Cancer Institute⁴, the five-year relative survival rate between 2011 and 2017 was 32.4%. For 2021, the estimated new cases are 26,560 (1.4%).

Adenocarcinoma is the most common type and begins in your stomach's inner lining. Other types can start from the outer parts or middle of the stomach, but they're relatively rare.

What are the signs of each stage of stomach cancer?

There are different stages of stomach cancer; you may feel specific symptoms, depending on the stage.⁵

In its earlier stages, stomach cancer may not cause any noticeable symptoms. Some stomach cancer symptoms, like mild belly pain, early satiety (sense of feeling full), and fatigue, are common. They're also similar to the non-specific symptoms of other less severe conditions.

In earlier stages, signs of stomach cancer might include:

• Stomach discomfort and indigestion

• Mild nausea

• A bloated feeling after eating

• Heartburn

• Loss of appetite

In more advanced gastric cancer stages, you might experience the following symptoms:

• Vomiting

• Blood in your stool

• Stomach pain

• Trouble swallowing

• Jaundice (yellowing of your skin and eyes)

• Weight loss for no apparent reason

• Ascites (fluid build-up in your abdomen)

If you experience any of these symptoms, consult with your doctor.

When and what type of doctor you should see 

If you're worried about any changes you're experiencing, it's important you speak with your doctor. They will want to know how often and how long you've been experiencing the symptoms, along with other questions regarding family history and other possible links. This will help them determine what's causing the issue and assist in making a diagnosis.

If the doctor does diagnose you with stomach cancer, an essential part of treatment and care is centered around managing your symptoms. Symptom relief will likely start soon after receiving your diagnosis and continue throughout your treatment. This might require supportive or palliative care. You should consult your health care team about any changes in your symptoms, including any new symptoms.

Doctors and specialists

Different doctors⁶ frequently work together in cancer care to create an overall treatment plan tailored for the patient, combining various treatments. This is known as a multidisciplinary team.

When it comes to gastric cancer, this team might include doctors, such as:

• Gastroenterologists: specialize in the gastrointestinal tract, which includes the stomach.

• Surgeons or surgical oncologists: specialize in performing surgery to treat cancer.

• Medical Oncologists: specialize in cancer treatment using medication.

• Radiation Oncologists: specialize in treating cancer with radiation therapy.

• Pathologists: specialize in assessing tissues, organs, and cells and interpreting lab tests to diagnose disease.

• Radiologists: They specialize in diagnosing disease through the use of imaging tests.

Other health care professionals that are members of a cancer care team may include:

• Oncology nurses

• Nurse practitioners

• Physician assistants

• Pharmacists

• Social workers

• Dietitians

• Counselors

• Others

Learn more about how stomach cancer is treated and the kinds of doctors and specialists involved.

What are the risk factors for stomach cancer?

There are a number of risk factors for stomach cancer. However, individuals might not develop this cancer even if they have a certain risk factor. Also, some individuals might have few or no risks but still, get stomach cancer.⁷

Stomach cancer risk factors include:

Age

There's a higher risk of stomach cancer in people over 50. Most individuals with gastric cancer receive a diagnosis while they're in their late 60s to 80s.

Gender

Men have a higher risk than women of stomach cancer.

Tobacco use

People have two times the risk of stomach cancer if they smoke.

Family history

Those with a family history of gastric cancer are at a higher risk. Anyone who has a history of gastric cancer in a first-degree relative (children, parents, siblings) will have an increased risk of this cancer.

Race and ethnicity

Gastric cancer in the U.S. is more common in African Americans, Hispanic Americans, Asian/Pacific Islanders, and Native Americans.

Diet

You may be at an increased risk of stomach cancer if you consume a diet rich in salted fish, smoked foods, and pickled vegetables. Cancer-causing substances like nitrites and nitrates are found in cured meats. A diet rich in fresh vegetables and fruits might lower your stomach cancer risk.

Helicobacter Pylori Infection

This bacteria, also referred to as H. pylori, can be a significant risk factor for stomach cancer. It's typically linked to cancer in the distal or lower part of the stomach.

Post stomach surgery

Post-surgery can increase your risk of gastric cancer. It may be due to less acid production that leads to multiplying nitrite-producing bacteria in the stomach. Stomach cancer can also be caused by bile reflux, which happens when bile is pushed up or held in the stomach following surgery.

Stomach lymphoma

Your risk for stomach cancer increases if you have mucosa-associated lymphoid tissue (MALT) lymphoma.

Being obese or overweight

Excess weight might increase your stomach cancer risk, particularly in the upper part (cardia) of your stomach.

Pernicious anemia

This is a form of anemia caused by the stomach's failure to make a special protein, called intrinsic factor (IF), that binds vitamin B12 so that it can be absorbed in the intestines. 

Lynch syndrome

This genetic disorder increases your risk of some cancers, including gastric cancer.

Type A blood group

Individuals with type A blood have a higher risk of developing stomach cancer.

Certain professions

Individuals who work in the metal, coal, and rubber industries might have a higher risk of stomach cancer.

There's no way of preventing this cancer. However, you can help decrease your risk by limiting how much alcohol you drink, not smoking, eating a diet rich in fresh vegetables and fruits, and maintaining a healthy weight.

How is stomach cancer diagnosed?

If your doctor thinks you may have stomach cancer, they'll perform a comprehensive physical exam and review your medical history. They'll also request stool and blood samples which provide them with many essential details and help guide the clinical decision.

They may request imaging tests like:

• Magnetic Resonance Imaging (MRI)

• Computed axial tomography (CAT or CT) scans

• Upper gastrointestinal endoscopy (EGD)

• Positron emission tomography (PET) scans

They might also order other diagnostic procedures such as endoscopy with biopsy and endoscopic ultrasound.

Endoscopy with biopsy

When it comes to gastrointestinal conditions, endoscopy is the most accurate and reliable test, particularly ones in the inner stomach lining and small intestines. Innovative endoscopic techniques often lead to earlier detection of stomach cancers, resulting in more treatment options.

An endoscope is a thin tube with a small camera attached at the end. This enables the doctor to see the back of your throat and mouth, stomach, esophagus, and parts of your small intestine on a computer screen.

During an endoscopy with biopsy:

• You'll lie down on your left side.

• You'll receive anesthesia, so you'll be asleep or extremely relaxed throughout the procedure.

• The doctor will guide the endoscope through your mouth and throat and down into your stomach.

• The doctor can see your stomach's inner lining with the endoscope, as well as your mouth, voice box (pharynx), and esophagus.

• The doctor will perform a biopsy. This is where they remove a small part of tissue and send it to the lab for testing. The results from the biopsy will help your doctor make a diagnosis.

In some circumstances, you may need another endoscopy after you receive your diagnosis so the doctor can determine the extent of your cancer. This will help them determine which treatments and follow-ups are best for you.

Endoscopic ultrasound

With this test, the endoscope is combined with ultrasound. The ultrasound uses a probe that generates soundwave imaging and detailed information and images about your digestive tract. It's particularly helpful in seeing the outer and middle layers beyond your inner lining. Endoscopic ultrasound will help your doctor gauge the depth of your tumor and if it has metastasized (spread).

The lowdown

Remember, early-stage stomach cancer doesn't usually present symptoms. In fact, countries where routine screening isn't available for stomach cancer, like in the U.S., result in the majority of cases not being diagnosed until they've begun spreading outside the stomach or have grown relatively large. That is why it's crucial to understand the signs of stomach cancer and your personal risk factors. If you have any of the risk factors mentioned above, talk with your doctor about screening tests that may be available.

Most of the symptoms associated with stomach cancer are often caused by other ailments, like an ulcer or viral infection. Some of the symptoms may be signs of other forms of cancer. Regardless, if you're experiencing any of these symptoms, particularly if they persist or become worse, you'll want to see a doctor so they can determine the cause and provide treatment if required.