Stomach cancer is the fifth most common cancer in India, with an estimated 70,000 new cases every year. The prevalence of stomach cancer varies from region to region because of differences in diet and lifestyle.
Globally, the number of people getting it has been steadily decreasing.
Early symptoms of stomach cancer may be quite vague and similar to indigestion. This means that many people with stomach cancer don’t find out until the cancer is quite advanced. Without treatment, stomach cancer can spread to other parts of your body including organs such as your liver. When cancer spreads through the body, the process is called metastasis.
Most (more than nine out of 10) stomach cancers start in gland cells in the lining of your stomach. These are called adenocarcinomas. Our information here is about this type of stomach cancer.
Stomach cancer is likely to be due to a combination of different factors. But it’s often linked to lifestyle, including diet. Although it’s possible to develop it at a younger age, stomach cancer is more common in older people – most people who get it are over 55. It’s also more common in men than women.
You're also more likely to develop stomach cancer if you:
A small number of people who develop stomach cancer also have a family history of the disease.
Having any of these risk factors doesn’t mean that you will definitely get stomach cancer – but they increase your chances of developing it. Similarly, you can still develop stomach cancer without having any of these risk factors.
Symptoms of stomach cancer can be quite vague in the early stages. For many people, indigestion is one of the first symptoms.
Other symptoms of stomach cancer may begin to happen as the cancer advances. These can include:
Many of these symptoms are often caused by other less serious problems or conditions such as gallstones, ulcers or reflux. Contact your doctor if you have new, unusual symptoms for you – or if they don’t go away after three weeks. You should also contact your doctor if you regularly take indigestion medicines but they seem to have stopped working. You should always seek medical help if you have difficulty swallowing.
Your doctor will ask about your symptoms and examine you. They’ll also ask you about your medical history and will arrange for you to have blood tests.
If your doctor thinks you need further investigations, they may refer you for a test called a gastrointestinal endoscopy (also called a gastroscopy). The test involves passing a narrow, flexible, tube-like telescopic camera called an endoscope down your throat to look inside your stomach. The endoscopist who carries out the test may remove small samples of tissue (biopsies) from any abnormal areas of your stomach at the same time. Any samples are sent to a laboratory to look for cancer cells.
If you're found to have stomach cancer, you’ll be referred to a specialist cancer doctor (oncologist) or surgeon. You’ll need further tests to find out how advanced your cancer is and if it’s spread. This process is known as staging. Tests may include:
Your treatment and care will be managed by a team of doctors and other cancer specialists. They will discuss with you what treatments they recommend in your particular circumstances. Treatment will depend on the size and position of your stomach cancer, if it has spread, and if you’ve had previous surgery to your stomach. Your general health and fitness will also be taken into account, along with your own wishes about your treatment.
If you’re diagnosed with stomach cancer early, it can be easier to treat and possible to cure. Many people with stomach cancer don’t find out until it’s at a late stage and it may not be possible to cure it. If this is the case, your treatment will focus on easing your symptoms, controlling the cancer and improving your quality of life.
Surgery is the main treatment for early-stage stomach cancer because it may cure your cancer. If your cancer is very small and just in the stomach lining, you may be able to have an operation called endoscopic mucosal resection. This is when the affected areas of your stomach lining are removed through a tube passed down your throat, called an endoscope. You won’t need any cuts to your tummy for this.
For larger cancers, you may have an operation to remove part of your stomach (partial or subtotal gastrectomy) or all of your stomach (total gastrectomy). You might be able to have keyhole (laparoscopic) surgery rather than open surgery. This means your surgeon will make several smaller cuts in your abdomen to reach your stomach, instead of one larger one.
If your surgeon recommends you have surgery, they’ll explain what will happen before, during and after your operation – including potential side-effects. For more information, see our FAQs on dumping syndrome and on what you can eat and drink after surgery below.
Your doctor may offer you one of the following treatments as well as or instead of surgery.
Over half of stomach cancers are preventable. You can control some of the risk factors for stomach cancer by making changes to your lifestyle. This may reduce your risk of getting stomach cancer and bring many other health benefits too. Changes you can make include the following.
Being diagnosed with stomach cancer and facing treatment can be distressing for you and your family. An important part of cancer treatment is having support to deal with the emotional aspects and practical issues, as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need – make sure you talk to them if you have any concerns.
Weight loss is a very common problem for people with stomach cancer. This is because the side-effects of the cancer and treatment can make it difficult to eat enough. Speak to your doctor, nurse or dietitian about how to make sure you’re eating well and getting any help you need.
Talking to your family and friends can help them to understand what you’re going through and how you’re feeling. Organisations and support groups that specialise in helping people with cancer can be a great source of information and support.
Dumping syndrome is a side-effect of some forms of stomach surgery. It's caused by food moving from your stomach into your small bowel more quickly than before your surgery. This can cause unpleasant symptoms straight after eating a meal (early dumping syndrome) or a few hours later (late dumping syndrome).
Early dumping syndrome is due to your bowel drawing in more water quickly to dilute your food. This causes a sudden drop in your blood pressure which can make you feel faint and dizzy. You might have abdominal symptoms too, with stomach cramps, feeling bloated or sick, and diarrhoea.
Late dumping syndrome is due to a rapid change in your blood sugar levels. This can make you feel very shaky and you may faint.
Most people find that their symptoms are relatively mild, and they can manage them quite easily by making some changes to how they eat. You can try:
It will take time for your body to recover after stomach cancer surgery. You’ll see a dietitian while you’re in hospital, who will go through with you what you’ll be able to eat and when. You’ll be able to contact them when you get home too.
In the first day or so after your operation, you won’t be able to eat or drink at all. You’ll have a drip to give you fluids and sometimes a feeding tube into your bowel to help you get the right nutrition. You’ll usually be able to start having sips of water within a day or two, and can start building up to eating small amounts within a week or so.
As you recover, you may feel full after small amounts of food, and it’s likely that you’ll lose some weight. Some foods may make you feel sick or give you diarrhoea or indigestion. Try to keep track of what foods cause you problems, so you know to avoid these. Your nurse or dietitian may be able to give you medication to help with these problems too. Over time, your body will start to adjust so that you may be able to manage bigger portions and different types of food.
After stomach cancer surgery, you may not be able to absorb certain vitamins and minerals, such as iron, folate and calcium, as well as before. Your doctor will keep an eye on whether you’re getting enough of these, and if necessary, you may need to take supplements. If you’ve had all or part of your stomach removed (a total gastrectomy), you’ll need regular injections of vitamin B12 (usually every three months).
It’s important that you eat well during and after treatment for cancer. If you have any concerns, talk to your doctor, nurse or dietitian.
www.macmillan.org.uk
www.cancerresearchuk.org
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