Stomach Cancer Symptoms

What Is Stomach Cancer?

Stomach cancer, also labeled gastric cancer, grows within the stomach. This is one of the most prevalent types of cancer globally. Approximately 1.5% of all newly diagnosed cancers in the United States are identified as stomach cancers every year.

Adenocarcinoma is the most common type of stomach cancer that grows within the stomach's inner lining. [1] Other rare types of cancers include gastrointestinal stromal tumors (GIST), neuroendocrine (carcinoid), and Lymphomas.

Types of Stomach Cancer

Stomach cancer is divided into four molecular subtypes [2], including:

  • Epstein-Barr virus (EBV)
  • Microsatellite instability (MSI)
  • Genomically stable (GS)
  • Chromosomal instability (CIN)

Medical health professionals focus on the type of cell that stomach cancer originates from to determine which type of stomach cancer an individual might have. These include:

Adenocarcinoma develops in the Mucosa (the innermost lining of the stomach) gland cells. [3] Three of its major subtypes include:

  • Mucinous adenocarcinoma (MAC)
  • Classical adenocarcinoma (CA)
  • Signet-ring cell carcinoma (SRCC)

Lymphomas of the stomach can originate in any location within the stomach where with lymph tissues. [4] Two of its major subtypes include:

  • Extranodal marginal zone B-cell
  • Diffuse large B-cell lymphoma (DLBCL)

Carcinoid tumors originate in the cells within the stomach that are in charge of producing hormones. [5] Stomach Carcinoids are typically separated into three categories based on their histological and clinical characteristics:

  • Carcinoid tumors linked with MEN-1 or Zollinger-Ellison syndrome (ZES)
  • Carcinoid tumors linked with chronic atrophic gastritis type A (CAG-A)
  • Carcinoid tumors that develop sporadically

Gastrointestinal stromal tumors lead to abnormal cell proliferation within the tissues of the gastrointestinal tract. Its subtypes include sarcomatoid, diffuse hypercellular, palisaded, vacuolated, sclerosing, features with substantial mitotic activity, and nuclear atypia. [6]

How Is Stomach Cancer Diagnosed?

In most cases, stomach cancer is diagnosed when an individual goes to a medical health professional complaining about symptoms that are considered a sign of stomach cancer, e.g., heartburn, bloating, or difficulty swallowing. If medical health practitioners suspect an individual has stomach cancer, they will run certain tests or procedures to rule out the disease, including:

Upper Endoscopy

Upper endoscopy is one of the most common tests doctors resort to when they suspect an individual has stomach cancer. This test involves health practitioners passing an endoscope down the throat. An endoscope is a flexible, thin tube attached to a camera. This allows doctors to examine the stomach and esophagus's inner lining and a section of the small intestine.

Imaging Tests

Imagining tests utilize sound waves, radioactive substances, X-rays, or magnetic fields to generate pictures of the insides of a body. Imaging tests are conducted due to several reasons, including:

  • To determine the severity of cancer and its stage
  • To determine if any abnormal tissues might be a result of cancer
  • To determine the efficiency of a cancer treatment

Biopsy

Doctors may conduct a biopsy if they notice any abnormalities during the endoscopy. During a biopsy, the doctors take samples of the tissues from the abnormal area by passing instruments through the endoscope.

Computed Tomography (CAT or CT) Scan

A CT scan machine utilizes X-ray technology to generate detailed images of the soft tissues in the body. CT scans can help doctors determine if an individual has cancer and also pinpoint its location. Doctors also recommend CT scans for patients diagnosed with cancer to locate the parts of the body where cancer may have spread. [7]

Stomach Cancer Staging

Stomach cancer is divided into the following stages:

Stage 0: This stage is considered the early stage of cancer and is also called carcinoma in situ. In this stage, cancer has yet to spread to the nearby tissues or the stomach's innermost lining.

Stage 1: The malignancy has spread to the submucosa (the stomach's second layer). This stage is divided into two categories, Stage 1A and 1B, with 1B being the more severe stage.

Stage 2: The cancerous cells have developed in the submucosa and are visible in 7 to 15 lymph nodes. This stage is also divided into two stages.

Stage 3: The cancerous cells have invaded the subserosa (outer lining of the stomach) and spread to nearby organs. Depending on the severity level, this stage is divided into three categories, 3 A, B, and C. [8]

Stage 4: The malignancy has spread to nearby or distant organs, affecting over 15 lymph nodes. This is the most severe stage of stomach cancer.

Is Stomach Cancer Hereditary?

Some individuals develop stomach cancer due to inherited gene mutation from their birth parents. However, this occurs rarely, and most individuals diagnosed with cancer don't have a family history of the disease. [9]

Stomach Cancer Symptoms

Some people may experience stomach cancer symptoms if they have early or advanced stages of the disease. However, symptoms usually occur when the stomach cancer has progressed to the advanced stages. If you experience unusual cancer symptoms, consult your healthcare provider for an immediate diagnosis and treatment recommendation.

What Are The Symptoms of Stomach Cancer?

If you experience the following symptoms for over 14 days [10], it is advisable to consult a gastroenterologist. A gastroenterologist is a physician with education and training in treating and managing diseases linked with the liver and gastrointestinal tract.

  • Unexplained pain in the stomach area
  • Headache and weight loss
  • Frequent burping
  • Bloating after meals
  • Pain or difficulty swallowing
  • Nausea
  • Vomiting, with or without blood
  • Tarry stool
  • Appetite loss

What Are Some Signs of Stomach Cancer?

If you have a family history of stomach cancer or suspect you have the disease, look for the following seven warning signs of stomach cancer:

  • Changes in bladder or bowel habits: An increase or decrease in bowel movements or the frequency of urination.
  • A sore that does not heal: A wound in any part of the body that is taking a while to heal or is reoccurring.
  • Hoarseness or cough: Persistent cough or hoarseness that carries on for weeks and does not go away with treatment.
  • Lump on the body: A lump anywhere on the body can signal cancer growth. Consult a medical health professional immediately to determine whether it is cancerous.
  • Unusual discharge or bleeding: Individuals with advanced stages of stomach cancer may experience unusual discharge or bleeding in the stool. These symptoms should never be taken lightly.
  • Indigestion: Persistent indigestion accompanied by heartburn is a common symptom of stomach cancer.
  • Changes in mole or wart: Changes in the color or size of a wart or mole may signal cancerous growth.

Symptoms of Stomach Cancer in Women vs. Symptoms of Stomach Cancer in Men

The stomach cancer symptoms in men and women are typically the same. Both men and women will experience symptoms like fatigue, bloody stools, stomach discomfort, sense of fullness, nausea, vomiting, or Pallor, etc. Individuals experiencing these symptoms may not necessarily have stomach cancer. These symptoms can also signal other health conditions. This is why a proper diagnosis is critical to rule out the cause of the symptoms. [11]

1 Note that here, we are using the terms ‘men’ and ‘women’ to refer to male and female biological sex at birth, respectively.

Risk Factors for Stomach Cancer

Risk factors refer to anything that increases your likelihood of developing stomach cancer. Although we can change or eliminate certain risk factors, such as smoking, others, like a family history or old age, cannot be altered.

However, having the risk factors of stomach cancer does not mean that one will necessarily develop the disease. It just increases their likelihood of developing the illness. Common risk factors for stomach cancer include:

  • Old age: Although stomach cancer may occur in younger individuals, its risks increase. Therefore, individuals in their 60s or above are more at risk of developing this condition.
  • Smoking habit: The risk of stomach cancer is almost double in individuals who smoke. Smoking can lead to stomach cancer of the stomach's upper half, which is connected to the esophagus.
  • Family history: Individuals with immediate relatives (parents, children, siblings) who might have had a history of cancer may be more at risk of developing the disease.
  • Geography: Data suggests stomach cancer is more common in Central and South America, East Asia, and Eastern Europe.
  • Obesity: Obesity has been linked with an increased risk of cancer of the upper stomach region, also known as cardia.
  • Ethnicity: In the US, stomach cancer is more prevalent in African Americans, Pacific/Asian Islanders, Hispanic Americans, and Native Americans than non-Hispanic individuals.
  • Gender: Men may be more prone to developing stomach cancer compared to women. [12]

Stomach Cancer Prevention

Avoiding habits like smoking or increased alcohol intake can help you reduce your likelihood of developing stomach cancer. Moreover, since obesity can increase an individual's chances of developing stomach cancer, exercising and focusing on weight loss can also be a great preventative measure to avoid stomach cancer. You can also consult your doctor or any other healthcare professional for advice on reducing your risk of developing stomach cancer. [13]

Stomach Cancer Prognosis and Treatment

The prognosis and treatment of stomach cancer depend entirely on factors like the stage of the disease. Individuals with early stages of the disease have better prognoses than individuals with advanced stages.

Stomach Cancer Survival Rate

The 5-year survival rate for individuals with early stages of stomach cancer is 32%, whereas the 5 years survival rate can be 6% for individuals with advanced stages of the disease. Around 36% of individuals with stomach cancer are diagnosed in the advanced stages. [14]

Stomach Cancer Treatment Options

Treatment options for stomach cancer include [15]:

  • Target drug therapy
  • Surgery
  • Chemotherapy
  • Radiation Therapy
  • Immunotherapy

Conclusion

Takeaway

Although in most cases, stomach cancer may not display a sign or symptom until it has progressed to the advanced stage, detecting the early warning signals of cancer may allow you to get treatment before the disease worsens. Contacting your healthcare provider when you notice unusual cancer symptoms can significantly help improve your survival rates.