Gastric cancer: symptoms, diagnosis and treatment

What is gastric cancer?

Gastric cancer, also known as stomach cancer, develops in the stomach's inner lining and can spread through the body if untreated. The predominant form is adenocarcinoma, originating in glandular cells, though rarer variants include lymphomas and gastrointestinal stromal tumours.

What are the symptoms?

Early-stage disease typically produces no warning signs. As it advances, patients may experience:

• Persistent indigestion or heartburn.
• Loss of appetite or unintentional weight loss.
• Nausea or vomiting, sometimes with blood.
• Abdominal pain or discomfort.
• Feeling full quickly after eating small amounts.
• Black, tarry stools indicating bleeding.

What causes it, and what are the risk factors?

• Helicobacter pylori infection.
• High intake of salted or smoked foods.
• Tobacco and alcohol consumption.
• Family history.
• Chronic inflammatory conditions of the stomach.
• Previous stomach surgery.

How is it diagnosed?

• Endoscopy with tissue sampling — the definitive test.
• Imaging: CT and PET scans to assess spread.
• Blood tests measuring tumour markers such as CEA and CA 19-9.

What are the treatment options?

• Surgery: subtotal gastrectomy, total gastrectomy, or lymphadenectomy.
• Chemotherapy: administered before or after surgery.
• Radiation therapy: often combined with chemotherapy.
• Targeted therapy: including trastuzumab for HER2-positive cases.
• Immunotherapy: to strengthen the immune response in advanced disease.

Surgery becomes necessary when the cancer is localised and can be completely removed, or to address symptoms in advanced cases.

What is recovery like?

Hospital stays typically last 7–10 days. Patients progress from liquids to soft foods and will need permanent dietary modification. Light activity is encouraged while strenuous exercise is avoided for several weeks. Ongoing monitoring through imaging and endoscopy remains essential.

What are the potential complications?

• Bleeding and infection.
• Anastomotic leakage at the surgical join.
• Nutritional deficiencies, particularly iron and vitamin B12.
• Dumping syndrome — rapid gastric emptying causing nausea and diarrhoea.

Can gastric cancer be cured, and can it be prevented?

Yes — early detection and treatment offer curative potential. Prognosis depends on the stage at diagnosis, the patient's general health, response to treatment and whether the disease has spread.

• Testing for and treating H. pylori.
• Eating fresh produce and whole grains while limiting processed food.
• Avoiding smoking and alcohol.
• Maintaining a healthy weight.
• Regular screening for high-risk groups.