What Are Stomach Cancer Symptoms? What Should I Ask and Know About Diagnosis and Treatment?

Stomach cancer rarely causes early symptoms, so more than half of patients are diagnosed at an advanced (metastatic) stage. Early cancers treated surgically are often found incidentally or through screening endoscopy without symptoms. Cancer screening testsinvestigate cancer in people without symptoms. Although not routine for stomach cancer in Western societies or our country, they are important in programs in high-incidence countries such as Japan, Venezuela and Chile. Officially, stomach cancer ranks 5. in men and 6. in women in our country. This article shares what to know about diagnosis and treatment, particularly symptoms and risks.

What Are Stomach Cancer Symptoms?

Unexplained weight loss and chronic abdominal pain are commonest. Weight loss often results from reduced calories due to appetite loss, nausea, abdominal pain, early fullness and/or swallowing difficulty.

• Loss of appetite
• Pain around the stomach
• Vague abdominal aching, particularly around the navel
• Fullness after small meals
• Heartburn or indigestion
• Nausea 
• Vomiting with or without blood
• Abdominal swelling or fluid accumulation

These symptoms can arise from stomach canceror milder conditions such as gastritis, ulcers or reflux. Seek medical advice if one or more symptoms persist or worsen.

Does Everyone Have the Same Risk? What Should I Ask and Know About Risk Factors?

Risk is not the same for everyone. Factors increasing the likelihood of cancer are called risk factors as their designation.

Stomach Cancer Risk Factors Include:

• Sex: Stomach cancer is more common in men.
• Age: Most patients are between 60 and 80.
• Location and Ethnicity: Highest rates occur in Japan, China, Southern and Eastern Europe, South and Central America. It is rarer in North and West Africa, South Central Asia and North America. 
• Certain Infectious Organisms:
  • Helicobacter pylori (H. pylori): infection with this bacterium is the main cause of stomach cancer. Long-term infection can cause precancerous changes and inflammation of the stomach lining and is associated with ulcers and some lymphomas. Recent studies also show EBV virus infection accounts for approximately %10 of stomach cancers.
    - Related topic: Preventing Stomach Cancer by Treating Helicobacter Pylori Infection
  • Epstein-Barr Virus (EBV): It causes infectious mononucleosis, or “mono”, also called glandular fever. Almost all adults encounter it, but why it triggers stomach cancer in some remains unclear. It has been found in stomach cancer cells. 
• Diet: Risk rises with heavy consumption of pickled vegetables, salted fish and meats, and smoked foods. Conversely, plentiful fresh fruit and vegetables reduce risk.
• Tobacco Use: Smoking approximately doubles stomach cancer risk. 
• Being Overweight or Obese: Being overweight or obesemay cause cancer in the upper stomach. However, the weight-related association remains unclear.
• Previous Stomach Surgery: People with partial stomach removal for problems such as ulcers may develop stomach cancer, even years later.
• Pernicious Anemia: This results when the stomach produces insufficient protein for vitamin B12 absorption. It can cause red blood cell deficiency (anemia) and other problems. Affected individuals have increased stomach cancer risk.
• Menetrier Disease: This rare disease may produce cancer-causing stomach changes.
• Blood Group: For unknown reasons, people with blood group A have higher risk.
• Hereditary Cancer Syndrome: A syndrome is a group of signs indicating a disease or condition. Inherited gene changes (mutations) produce several syndromes increasing stomach cancer risk:
  • Hereditary diffuse gastric cancer
  • Hereditary nonpolyposis colorectal cancer (HNPCC)
  • Familial adenomatous polyposis (FAP)
  • Hereditary breast and ovarian cancer syndrome
  • Li-Fraumeni syndrome
  • Peutz-Jeghers syndrome
• Family History: People with affected parents, siblings or children have a higher likelihood of stomach cancer.
• Certain Stomach Polyps: Polyps develop in the stomach wall and are benign. Most do not increase cancer risk, but adenomatous polyps or adenomas sometimes become malignant.
• Certain Occupations: Coal, metal and rubber industry workers have higher risk.

What Should I Do If High-Risk or Suspicious of Stomach Cancer?

Consult a gastroenterologist, a digestive disease specialist, if there is reason for suspicion. Following examination and assessment, endoscopy is the first recommendation if cancer is suspected.

• Upper Endoscopy: Medication induces sleep through sedation. A thin, flexible, illuminated tube with a small camera enters through the throat, examining the esophagus, stomach and beginning of the small intestine. Abnormal areas are sampled through the tube (biopsy). Laboratory examination determines whether cancer exists.

- Related topic: What Is Stomach Biopsy, How Is It Performed and How Are Results Interpreted? (Detailed)

What Should I Ask and Know First If Biopsy Confirms Stomach Cancer?

Ask about stage, the most important treatment determinant. Stomach cancers are even divided into operable or inoperable as 2 groups.

Spread to lymph nodes, nearby organs, major vessels or distant sites, or poor general health, can prevent complete surgical removal. Early cancers are generally operable. 

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