The multi-disciplinary team at Saint Luke’s Cancer Institute provides specialized stomach cancer treatment designed to provide optimum results and recovery.   

What Is Stomach Cancer?

What Is Stomach (Gastric) Cancer?

Outline of human figure showing esophagus, stomach, and small intestine.

Cancer happens when cells in the body begin changing and multiplying out of control. These cells can form lumps of tissue called tumors. Cancer that forms in the stomach is called stomach or gastric cancer.

Understanding the stomach

The stomach helps the body digest food. When food is swallowed, it travels down a tube called the esophagus. The esophagus ends in the stomach. The stomach adds chemicals and fluids to food that help begin the process of digestion. There is a strong muscle layer of the stomach that mixes the contents to make it soft. Food then leaves the stomach and enters the small intestine.

When stomach cancer forms

In most cases, stomach cancer starts in the stomach’s inner lining, the mucosa. Cancer cells can then spread through the other layers of the stomach. If cancer cells reach the stomach’s outer layer, they can invade nearby organs. Stomach cancer can also spread from the stomach to other parts of the body. This spread is called metastasis. The more cancer spreads, the harder it is to treat.

Treatment choices for stomach cancer

You and your healthcare provider will discuss a treatment plan that’s best for your needs. Treatment choices may include:

  • Surgery to remove the cancerous part of the stomach and some surrounding tissue.

  • Chemotherapy, which uses strong medicines to kill cancer cells.

  • Radiation therapy, which uses directed rays of energy to kill cancer cells.

Symptoms

Stomach Cancer: Symptoms

What are the symptoms of stomach cancer?

The symptoms of stomach cancer vary from person to person. Cancer in early stages may have mild or no symptoms. The symptoms may also be like those of other diseases or conditions.

The most common symptoms of stomach cancer include:

  • Indigestion or heartburn

  • Feeling like food gets stuck in your throat when eating

  • Pain in your stomach

  • Feeling of fullness or bloating after eating even small amounts of food

  • Nausea and vomiting. This often happens soon after eating.

  • Vomiting blood

  • Diarrhea or constipation

  • Blood in your stool

  • Loss of appetite

  • Unexplained weight loss

  • Weakness and tiredness

Stomach cancer that’s more advanced can block your stomach or intestines. This can cause vomiting that doesn’t go away. Stomach cancer can also spread to your liver. If this happens, it can cause yellowing of your skin and the white part of your eyes (jaundice). Or fluid build-up in your belly (ascites).

When to see your healthcare provider

Many of these symptoms may be caused by other health problems. But it is important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

Diagnosis

Stomach Cancer: Diagnosis

How is stomach cancer diagnosed?

If your healthcare provider thinks you might have stomach cancer, you’ll need certain exams and tests to be sure. Diagnosing stomach cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam.

What tests might I need?

You may have one or more of the following tests:

  • Fecal occult blood test (FOBT)

  • Blood tests

  • Upper endoscopy

  • Upper GI series

  • Biopsy

Lab tests

Fecal occult blood test (FOBT)

This testis used to check for hidden blood in your stool. Your healthcare provider may place a small amount of your stool on a plastic slide or a special type of paper. Or you may do this test at home. Stomach cancer can sometimes cause small amounts of bleeding. This can be hard to see. However, other conditions that aren’t cancer can also cause this. Even if the test shows blood in your stool, you’ll likely need other tests to tell whether or not it’s due to cancer.

Blood tests

Blood tests can check if you have low red blood cell counts. This could be due to bleeding in your stomach. Blood tests can also be used to see how well certain organs are working and what overall health is like.

Endoscopic tests

Upper endoscopy

This test is also called an esophagogastroduodenoscopy (EGD). This procedure helps find most stomach cancers. It’s often the first test done. During this test, a healthcare provider looks at the inside of your stomach with a thin, flexible, lighted tube. This is called an endoscope. He or she guides the scope through your throat and down into your stomach. You’re sedated during this test.

An upper endoscopy also checks your esophagus and part of your duodenum, which is the first section of your small intestine. If your healthcare provider sees tissue that’s abnormal, he or she takes a small sample of the changed tissue out through the scope. This is done to check for cancer cells. This is called an endoscopic biopsy. 

Your healthcare provider may do an upper endoscopy with an endoscopic ultrasound (EUS) exam. The EUS uses sound waves to make a better picture of your stomach wall, nearby tissues, and lymph nodes.

Imaging tests

Upper GI series

This is also called a barium swallow. During this test, your healthcare provider can see even small abnormalities in your stomach lining. For this test, you’ll drink a thick, chalky fluid with barium in it. This fluid lines your stomach. This makes it easier to see on an X-ray. To see very early cancers, your healthcare provider may use a double contrast technique. For this, a small tube is placed in your stomach after drinking the barium. Air is then pumped through the tube into your stomach. This makes the barium coating thinner around the inside of your stomach. This helps your healthcare provider see small changes in your stomach.

Biopsy

A biopsy is when your healthcare provider removes a small sample of abnormal tissue from your stomach. A pathologist looks at the sample under a microscope. In addition to checking for stomach cancer, a biopsy can also show other conditions. These can include H. pylori bacterial infection, noncancerous diseases, or another type of cancer called a lymphoma.  A biopsy can show changes on the lining of your stomach.

A biopsy is needed to confirm a diagnosis of stomach cancer.

Laparoscopic surgery

This surgery is done by making a small incision in your skin. Then your healthcare provider puts an instrument in it to look at the inside of your abdomen. If he or she sees any suspicious areas, your healthcare provider can remove them and look at them under the microscope. This is called a laparoscopic biopsy.

Endoscopic stomach biopsy

This is the most common type of biopsy used. This is a procedure that uses an endoscope. During the procedure, you’ll receive medicine to help you relax. You’ll also receive a numbing medicine sprayed into your throat. This is to help prevent gagging. Once you’re relaxed, your healthcare provider puts the endoscope into your mouth and guides it down your throat and into your stomach. He or she looks at the lining of your stomach with the scope. Tools can be passed through the scope to take tissue samples from any abnormal areas.

Endoscopic ultrasound-guided needle biopsy 

This test also uses an endoscope. The scope has a special ultrasound tool at the tip. The ultrasound tip is put against your stomach walls to create images. This procedure may be used if a healthcare provider thinks the cancer is deeper in the wall of your stomach. You’ll receive medicine to help you relax. You’ll also receive a numbing medicine sprayed into your throat. This is to help prevent gagging. The endoscope is then put into your mouth and guided into your stomach.

The ultrasound tip is placed against your stomach walls. Your healthcare provider looks at the lining of your stomach with the scope. He or she can view images of the layers of your stomach, lymph nodes, and other nearby tissues. If he or she sees suspicious areas, your healthcare provider will pass a thin, hollow needle through the scope and into your stomach wall. This needle is used to take the tiny pieces of tissue to test in the lab.

Getting your test results

When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if stomach cancer is found. Make sure you understand the results and what follow-up you need.

Treatment

Stomach Cancer: Treatment Introduction

Learning about your treatment options

There are different treatment choices for stomach cancer. Which may work best for you? It depends on a number of factors. These include:

  • Type, size, and location of the tumor

  • Results of lab tests

  • Stage of the disease

  • Your overall health

  • Your age

  • Your personal needs and concerns

  • What side effects you’ll find acceptable.

You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It’s important to take the time you need to make the best decision.

Types of treatment for stomach cancer

Here is an overview of the treatment options for stomach cancer:

Surgery

This is the most common treatment for stomach cancer. The goal of this treatment is to remove the entire tumor and any cancer cells that may have spread to nearby tissue. Depending on the stage of the cancer, surgery may be all that you need. Or you may have surgery before or after another treatment.

Radiation therapy

This treatment uses high-energy X-rays or particles. The main goal of radiation is to kill cancer cells and reduce the chance the cancer will come back. This is called recurrence. Sometimes it’s used to reduce the symptoms of cancer. These can include pain or bleeding.

Chemotherapy

The goal of chemotherapy is to shrink a tumor, destroy cancer cells, relieve symptoms from the cancer, or help prevent recurrence of the cancer. Chemotherapy is rarely used for early-stage stomach cancer, which has not spread. But it may be the main treatment if the cancer has spread beyond the stomach to other parts of the body. Chemotherapy can be used before surgery. This is called neoadjuvant therapy. Or it may be done after surgery. This is called adjuvant therapy.

Targeted therapy

These are medicines that target specific parts of stomach cancer cells to kill the cells or slow their growth. These medicines work differently from regular chemotherapy medicines. They’re used to treat certain types of stomach cancer and advanced stomach cancer that's not responding to other treatments.

Your healthcare provider may suggest that you have more than 1 of these types of treatment. This is sometimes called combination therapy. Newer types of treatment may be available only through a research study. This is called a clinical trial. Talk with your healthcare provider about what clinical trials may be an option for you.

Making treatment decisions 

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may require a second opinion. You may also want to involve your family and friends in this process.

 

 

News

Thumbnail
MEDIA COVERAGE: Saint Luke's Announces Center for Precision Oncology
Our precision oncology experts treat your tumor’s mutation, not just your cancer’s location. It’s the only program within 450 miles that offers this level of expertise in clinical oncology, tumor genomics, and computational biology.
Thumbnail
MEDIA COVERAGE: Saint Luke's signs cancer trial agreement with hospital with National Cancer Institute designation
Saint Luke’s Health System has signed an agreement with Washington University’s Alvin J. Siteman Cancer Center that will give its patients access to National Cancer Institute trials for new treatments.

Providers

Mark H DeWolfe, MD

Oncology / Hematology

Timothy J Pluard, MD

Oncology / Hematology

Shahzad Raza, MD

Oncology / Hematology

Jamie P Rigden, MD

Oncology / Hematology

Ali Shwaiki, MD

Oncology / Hematology

Jacob P Smeltzer, MD

Oncology / Hematology

Janakiraman Subramanian, MD

Oncology / Hematology

Addison R Tolentino, MD

Oncology / Hematology

Saint Luke’s Cancer Institute

Saint Luke's provides comprehensive cancer care, from expert diagnosis and personalized treatment plans to survivorship support.