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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 2, 2021.

About stomach cancer

Stomach cancer shares many risk factors with other organs of the digestive tract, especially risk factors that involve diet, tobacco use and obesity. The stomach is near the midway point of the digestive tract, with the mouth, throat and esophagus above it and the small intestines, colon and anus below it.

About 26,560 new cases of stomach cancer are expected to be diagnosed in the United States in 2021, according to the American Cancer Society. However, the number of new cases and stomach cancer deaths have declined dramatically since the early 1990s.

Stomach cancer, also called gastric cancer, may spread beyond the wall of the stomach, metastasizing to another part of the body such as the lungs, pancreas or liver.

What causes stomach cancer?

While cancer research has not yet identified the cause of stomach cancer, the risk of developing stomach cancer is known to increase with age. People with a family history of cancers may also be at higher risk.

Common stomach cancer risk factors include:

  • Inherited mutations on breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2)
  • Inherited mutation E-cadherin/CDH1, a tumor suppressor gene
  • Lynch syndrome, also called hereditary non-polyposis colorectal cancer (HNPCC)
  • Familial adenomatous polyposis (FAP), which causes polyps, including stomach polyps
  • Tobacco smoking
  • Diet high in processed foods, smoked foods, salted fish and meat, and/or pickled vegetables
  • Obesity
  • Chemical exposure from working in the coal, metal or rubber industries
  • Helicobacter pylori (H-pylori infection)
  • Chronic gastritis
  • Pernicious anemia, a medical condition linked to a vitamin B12 deficiency, which sometimes produces gastric polyps
  • A medical history that includes the Epstein-Barr virus (EBV), the virus that causes “mono” (mononucleosis)

Who gets stomach cancer?

Men are twice as likely to get stomach cancer as women. The disease occurs most often in people over the age of 55. People with Type A blood are also at higher risk of stomach cancer.

Stomach cancer is more common in African Americans than in whites.

The disease is also more common in some parts of the world, including Japan, Korea, parts of Eastern Europe and Latin America. People in these areas eat many foods that are preserved by drying, smoking, salting or pickling, placing the individuals at increased risk of stomach cancer.

Types of stomach cancer

Almost all stomach cancers are adenocarcinomas of the stomach. These types of cancer cells are common in many tumors, including in breast cancer, colorectal cancer and prostate cancer. Stomach adenocarcinomas form in glandular cells in the inner lining of the stomach, also known as the mucosa.

Besides an adenocarcinoma, other types of stomach cancer include:

  • Lymphomas, cancers of the immune system, which may start anywhere lymph tissues, including lymph nodes, are found
  • Gastrointestinal stromal tumors (GISTs), which are found in the lining of the stomach, called interstitial cells of Cajal (ICCs)
  • Carcinoid tumors, which typically start in the hormone-producing cells of the stomach

Stomach cancer symptoms

Most patients with early-stage stomach cancer have no symptoms of the disease. The cancer often reaches an advanced stage before a diagnosis is made and gastric cancer treatment can begin. Individuals may mistake their symptoms for a common stomach virus.

Symptoms of stomach cancer may include:

  • A feeling of fullness after eating small meals
  • Heartburn, indigestion or symptoms similar to having an ulcer
  • Nausea and vomiting, which may contain blood
  • Unexplained weight loss
  • Loss of appetite
  • Stomach pain above the navel
  • Abdominal swelling or fluid build-up

In some cases, doctors may identify symptoms of stomach cancer during a routine physical exam.

Diagnosing stomach cancer

The following diagnostic tools and techniques may be used to reach a stomach cancer diagnosis:

  • Esophagogastroduodenoscopy (EGD), also called an upper endoscopy, which uses an endoscope to examine the esophagus, stomach and duodenum
  • Endoscopic ultrasound (EUS)
  • Biopsy
  • Advanced genomic testing
  • Blood tests, such as a complete blood count (CBC) test
  • Liver function tests, to determine whether a cancer has spread
  • Nutritional panel
  • Computed tomography scan (CT scan)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)/CT scan
  • Upper gastrointestinal series (upper GI series), also called a barium swallow X-ray

Stomach cancer treatments

Treatment options may include:

  • Gastrectomy (total or subtotal), stomach surgery that removes the stomach or part of the stomach
  • Liver resection, if stomach cancer metastasizes to the liver
  • Gastroenterology procedures, such as those used to place stents and insert tubes, as well as balloon dilation to relieve obstructions

Our clinical oncology team may also recommend:

  • Chemotherapy
  • Hyperthermic intraperitoneal chemotherapy (HIPEC), which delivers chemotherapy drugs directly to the abdomen during surgery
  • Intensity modulated radiation therapy (IMRT)
  • Trilogy®
  • TomoTherapy®
  • Interventional radiology, if stomach cancer spreads to the liver
  • Immunotherapy
  • Targeted therapy