Medical advice

Does early diagnosis make a difference?

The earlier a diagnosis can be made, the more likely it is that the problem can be cured. The longer a cancer is present in the stomach, the more likely it is that it will spread to other parts of the body such as lymph glands and the liver.

What are the symptoms of stomach cancer?

Stomach cancer can present in many different ways depending on which part of the stomach is involved. Indigestion (pain or discomfort in the upper abdomen related to eating or drinking), and loss of appetite are common, and associated with weight loss. If the cancer is at the top of the stomach near the gullet, it may cause difficulty with swallowing food. If it is at the bottom of the stomach, it may cause vomiting of food. Cancers can sometimes bleed, leading to symptoms of anaemia such as tiredness and shortness of breath.

Aren’t some symptoms similar to those of a peptic ulcer?

Many of the symptoms of stomach cancer are similar to those of a benign ulcer. It is very important that any new occurrences of the symptoms listed above are reported to your doctor if you are over 40.

How is the diagnosis made?

Occasionally a lump can be felt in the abdomen, but other tests are always needed.

• Endoscopy (video examination of the stomach). This is a simple test carried out under local anaesthetic. A small sample of tissue is taken for examination under a microscope (histology) and a test is taken for Helicobacter pylori, a bacterium which can infect the stomach and is thought to increase the risk of stomach cancer.

• CT scan – this is an X-Ray which takes 3 dimensional pictures of the chest, abdomen and pelvis areas. It gives information about the stomach itself, and also about other areas that disease may have spread to. 

What happens once cancer is diagnosed?

If the tests show that you have stomach cancer, you will be referred to a cancer specialist – usually a surgeon – for further assessment. It is likely that you will have a staging laparoscopy. Under a general anaesthetic, a small telescope is passed through the belly button into the abdomen to examine the stomach and other areas closely. The results of your tests will then be discussed by a group of cancer experts, and a decision will be made on the best form of treatment.

How are cancers of the stomach treated?

Once checks have been made that it has not spread anywhere else, most stomach cancers will be removed by surgery. Either a part of the stomach or the whole stomach is removed, with lymph glands that are close by. The stomach or gullet is then joined to the bowel (anastomosis). Once the cancer has been removed it is examined closely under the microscope to decide exactly what stage it is at. If the cancer is an early one that has not spread through the stomach wall, then no further treatment may be necessary. If the cancer has spread through the wall, or involved lymph glands you may be offered further treatment such as chemotherapy, radiotherapy or a combination of both. Sometimes chemotherapy is given before surgery.

What happens after surgery?

You will stay in hospital for about 10 days after your operation. You will take 6 to 8 weeks to recover fully. You will see a dietician who will advise you on the best foods to eat. The main advice will be to eat a balanced diet, little and often. All the test results will be discussed to decide if any further treatment is necessary. You will be told the results when you come back to see your surgeon about a month after surgery. You will be seen regularly in clinic over the months and years after your treatment, and will be offered regular blood tests. Sometimes further scans and endoscopies are needed to see if the cancer has come back. If the problem does recur, it can be treated again, usually with chemotherapy or radiotherapy.