Having stomach cancer may be overwhelming, but a community of family, friends, counselors, support groups, and your healthcare team can give you and your caregiver emotional and practical support during treatment. This section contains information to help you understand what to expect.
About your Stomach
Your stomach is a hollow organ that has an important role in the digestion of food. After food moves from your mouth into the esophagus (the tube that runs from the back of your throat to your stomach), it then passes into your stomach where it is broken down by digestive juices. From there, it moves into the small intestine.
Symptoms of Stomach Cancer
Early-stage stomach cancer may not cause symptoms, but as the cancer grows, some of the most common issues include:
- Stomach pain or discomfort
- Weight loss
- Feeling full or bloated after a small meal
- Having blood in your stool (may appear black and tarry and have a foul smell)
- Vomiting blood
These symptoms also may be caused by other medical conditions, so a doctor will need to perform tests to confirm a stomach cancer diagnosis. Please talk to your doctor about any symptoms you may be having.
How Stomach Cancer is Diagnosed
Several tests and procedures are used to diagnose stomach cancer and may include:
A general examination is performed to check for signs of disease and to record overall health.
How Stomach Cancer is Staged
After stomach cancer is diagnosed, the next step is to determine the stage, or extent, of the disease. There are five stages ranging from 0 to IV (4). The higher the stage, the more advanced the cancer. The stage number is used to help determine how your stomach cancer should be treated. Tumor staging is determined using the TNM classification.
Describes the size of the original tumor. A T1 tumor is smaller, while a T3 tumor is larger
Tells whether the cancer has spread to your lymph nodes. N0 means there is no cancer in your lymph nodes. N1, N2, and N3 mean it has spread to your lymph nodes.
Tells whether the cancer has spread (metastasized) to other parts of your body. M0 means it hasn’t spread far from its original site, while M1 means the cancer has spread to more distant locations
Part of the classification is based on how far the cancer has spread through the stomach wall. The stomach wall has five layers:
- Mucosa: Innermost layer (contains three parts: epithelial cells, tissue called lamina propria, and a thin muscle layer called muscularis mucosa)
- Submucosa: Support tissue for the inner layer
- Muscularis propria: Thick layer of muscle
- Subserosa: Support tissue for the outer layer
- Serosa: Outer layer that covers the stomach
As the cancer grows deeper into the stomach layers, the staging advances.
How Stomach Cancer is Treated
Treatment recommendations for stomach cancer can be unique for each person based on the stage of the disease, its location, and information learned during discussions with your doctor. Some options may include surgery, radiation therapy, chemotherapy, biologic therapy, or a combination of these options.
Part or all of the stomach and possibly some lymph nodes are removed. Surgical options include:
Endoscopic mucosal resection
This procedure is used only for some very early-stage cancers, where the chance of spreading to the lymph nodes is very low. For this procedure, your skin is not cut. An endoscope is inserted through your mouth, down the throat, and into your stomach. The tumor is removed using surgical tools that are passed through the endoscope.
Subtotal (partial) gastrectomy
An operation removes the part of the stomach where the cancer is located.
This is usually the recommended procedure if the cancer has spread through the entire stomach. The stomach is removed along with some surrounding tissue. The end of your esophagus is then attached to the small intestine, allowing food to move through the digestive system.
Lymph node removal
During subtotal or total gastrectomy operations, the nearby lymph nodes are also removed.
This operation helps people with advanced stomach cancer control their symptoms and makes them more comfortable.
A machine outside the body directs high-powered beams of energy into the tumor to kill the cancer cells. Radiation may be used before surgery to shrink a tumor, after surgery to kill cancer cells that may remain, or to relieve symptoms in people with advanced cancer. Radiation also may be combined with chemotherapy.
Drugs are either injected into a vein or taken by mouth, as a pill, to kill cancer cells. These chemicals travel and act throughout the body, so it is the main treatment for people whose stomach cancer has spread to distant organs. Chemotherapy may be used before surgery to shrink a tumor, after surgery to kill cancer cells that may remain, or to relieve symptoms in patients with advanced cancer. Chemotherapy also may be combined with radiation therapy.
This type of treatment uses substances made from living organisms to treat disease.
Plan: What’s Next?
With any type of cancer diagnosis, there is likely a need to adapt and plan for many areas in life—from organizing financial and legal affairs to rearranging your daily schedule around treatments. With stomach cancer there are considerations and decisions to be made with your care team and loved ones. Playing an active role in your health and treatment may help you feel more in control and confident in the decisions you are making together. Due to the nature of treatment and possible surgical side effects, maintaining proper nutrition is a very important planning consideration when living with stomach cancer or caring for someone who is.
Why a healthy diet is important
When stomach cancer is diagnosed, good nutrition becomes essential, especially taking in enough calories to maintain a healthy weight. However, that can be difficult if you’re too tired to eat or just not interested in food. You may be experiencing side effects from treatment, like nausea or mouth sores, that also may cause you to lose your appetite.
Talk to your doctor or a nutritionist to understand how diet might be important to you.
What does eating healthier mean?
Healthier eating means consuming a variety of foods that give the body the nutrients it needs. These include protein, fat, carbohydrates, water, vitamins, and minerals. Talk with your doctor about how you can incorporate healthier eating into your diet.
Needed for growth, to heal tissue, and to keep the body’s immune system healthy. When the body does not get enough protein, it may get the fuel it needs somewhere else, like breaking down muscle. Being low in protein can slow healing and lower the body’s defenses against infection. People undergoing cancer treatment may need more protein than others. Good sources include fish, chicken, eggs, lean red meat, nuts, low-fat dairy products, dried beans, and soy foods.
Provides a rich source of energy, helps transport certain vitamins through the blood, and insulates the body. Some types of fat are better than others.
When considering the effect of fat on cholesterol and the heart, better choices include:
- Monounsaturated fats
Found in vegetable and other types of oils (olive, canola, peanut, sunflower, and sesame), avocados, peanut butter, and many nuts and seeds.
- Polyunsaturated fats
Found in some oils (safflower, sunflower, corn, flaxseed, and soybean), certain fish (such as salmon, trout, mackerel, and herring), and some nuts and seeds (including walnuts and sunflower seeds).
These types of fats may raise cholesterol and increase the risk of heart disease:
- Saturated fats
Found in animal sources like meat (fatty beef, lamb, pork, and chicken with the skin) and dairy products (butter, cheese, and whole or reduced-fat [2%] milk). They are also found in some baked goods, fried foods, and some oils (coconut, palm kernel, and palm).
- Trans fats
Found in certain snacks and preserved baked goods (such as pastries, pie crusts, cookies, and pizza dough) and in fried foods (like doughnuts and french fries).
- Monounsaturated fats
Important for energy. Carbohydrates give the body the fuel it needs for physical activity and proper organ function. Good sources include fruits, vegetables, and whole grains. Other sources include bread, potatoes, rice, pasta, corn, peas, and beans.
Needed for cells to function. You should drink about eight 8-oz glasses of liquid each day, which can include items like soup and milk. If you are experiencing side effects such as diarrhea or vomiting, you may require more fluids to prevent dehydration. Talk to your doctor about all of your symptoms and ask about ways to help manage them.
Needed for proper bodily function. Most are found naturally in food, but pill and liquid supplements are available, if needed. Large doses of some vitamins and minerals may change the effectiveness of certain treatments, so talk with your doctor before taking any supplements.
If you’re losing weight or having difficulty digesting certain foods, be sure to tell your nutritionist. If you don’t have one, ask your doctor if working with a nutritionist might help you. Each person is different, and a nutritionist can recommend a diet that meets your specific needs.
Support for those with Stomach Cancer
A stomach cancer diagnosis can be frightening. It brings on a wide range of emotional reactions that differ from person to person. Some experience anger, depression, anxiety, and fear as they face the “what ifs.” As treatment begins, these emotions may come and go, so it’s important to know that you’re not alone. You have your healthcare team, support groups, and loved ones right beside you. Let them help in whatever way they can.
Stomach cancer also can be a significant physical challenge because it alters a very fundamental aspect of life—eating. So you may have additional moments of stress as you adapt to following a new diet, dealing with the side effects of very complex surgery, and even facing self-image issues that may arise from weight loss or surgical scars.
If you or someone you love is faced with a stomach cancer diagnosis and the challenges it may bring, please talk with your healthcare team members. They may know of resources in your area that can help. You and those who surround you also may find comfort and support through this organization dedicated solely to stomach cancer:Visit Debbie's Dream Foundation®
New Normal: Life’s Different.
From the moment stomach cancer is diagnosed, you become a survivor—whether you’re the one fighting the disease or the one fighting for the person who is. Each day can bring new challenges as you work with your healthcare team and loved ones to make difficult treatment decisions and learn how to live with the changes they bring.
If you go through surgery: You may have to learn to eat smaller meals, manage potential side effects like heartburn, nausea, and abdominal pain, and take supplements to ensure you are getting the vitamins your body needs, including the possibility of having to take vitamin B12 injections. Chemotherapy and radiation also may cause side effects that can make it even more difficult to maintain proper nutrition. Your healthcare team can have you meet with a dietitian who can recommend foods and give you tips that may help you feel better. So don’t hesitate to talk about any problems you experience.
During and after treatment: It can be a relief to finish treatment, but then you may worry about the cancer coming back. It may help you to know that others have lived with the same fears. For some people, their cancer may never go away completely, so they may receive ongoing treatment to help keep it under control for as long as possible. This can be a very stressful situation for anyone with stomach cancer and their loved ones. That’s why it’s important to seek out emotional and social support through friends, family, church or spiritual groups, private counselors, and cancer support groups. Staying hopeful and positive is important, too.
Share your story and get involved: Sharing experiences can help raise awareness of stomach cancer and may empower others to do the same. If you choose to share your story or join a support community, you may consider: