Stomach cancer
Overview
Stomach cancer, also called gastric cancer, is a growth of cells that starts in the stomach. It is a type of gastrointestinal cancer. The stomach is in the upper middle part of the belly, just below the ribs. The stomach helps to break down and digest food.
If you've been diagnosed with stomach cancer, there are several factors that affect treatment options. These include where the cancer started, how far it has grown or spread, and the type of cell involved.
When stomach cancer occurs in people in the United States, it tends to start in a different part of the stomach than it does in other areas of the world. In the U.S., stomach cancer often happens in the part of the stomach closest to the esophagus. The esophagus is the tube that carries food you swallow to the stomach. The area where the esophagus and stomach meet is called the gastroesophageal junction. In places where stomach cancer is common, it's more likely to start in other parts of the stomach. Stomach cancer isn't common in the United States. It happens much more often in certain parts of the world, such as East Asia, Eastern Europe and South America.
Treatment can sometimes cure stomach cancer. A cure is most likely when the cancer is found before it spreads beyond the stomach. When stomach cancer has grown through the stomach wall or spread to other parts of the body, treatment is aimed at controlling the cancer, relieving symptoms and helping people live longer. Advances in research continue to improve stomach cancer treatment.
The type of stomach cancer you have is based on the type of cell where the cancer began. Examples of stomach cancer types include:
In diffuse stomach cancers, the cancer cells don't form a mass. They spread throughout the stomach wall. Some diffuse stomach adenocarcinomas can form cells filled with mucus. That makes them look like a ring when viewed through a microscope. Those are called signet ring cells.
There are no well-established differences in stomach cancer symptoms between men and women. But the type of stomach cancer can differ by sex. For example, cancers that begin in the upper part of the stomach near the esophagus tend to be more common in men. Also, stomach cancer in general is more common in men. Among people with stomach cancer, women may be more likely than men to have a cancer that starts in the lower part of the stomach. Signet ring cell cancers also may be more common in women.
Symptoms
Signs and symptoms of stomach cancer may include:
Stomach cancer doesn't always cause symptoms in its early stages. Also, symptoms don't seem to differ between women and men. When stomach cancer symptoms appear, they may include indigestion and pain in the upper part of the belly. Symptoms can feel mild or vague. Or you may feel full after eating just a small amount. But there's no single way stomach cancer feels. Also, most of the time mild symptoms like these that come and go aren't caused by stomach cancer.
Symptoms might not happen until the cancer is advanced. Later stages of stomach cancer might cause symptoms such as feeling very tired, losing weight without trying and vomiting blood.
Stomach cancer that spreads to other parts of the body is called metastatic stomach cancer. It causes symptoms specific to where it spreads. For example, when cancer spreads to the lymph nodes it might cause lumps you can feel through the skin. Cancer that spreads to the liver may block the bile ducts and cause yellowing of the skin and whites of the eyes. This condition is known as jaundice, and it may cause itching or other skin reactions. If cancer spreads within the belly, it might cause fluid to fill the belly. The belly might look swollen.
If you have symptoms that worry you, make an appointment with a doctor or other healthcare professional. Many conditions can cause symptoms that are like the ones caused by stomach cancer. Your healthcare professional might test for those other causes first before testing for stomach cancer.
Causes
It's not clear what causes stomach cancer. Healthcare professionals believe most stomach cancers start when something hurts the inside lining of the stomach. Examples include having an infection in the stomach and eating a lot of salty foods. Not everyone with these risk factors gets stomach cancer, though. So more research is needed to find out exactly what causes it.
A long-lasting infection with bacteria called H. pylori can be linked to some types of stomach cancer. But not everyone with H. pylori gets stomach cancer.
Stomach cancer starts when cells in the stomach get changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time.
In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.
The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. It might start to grow deeper into the wall of the stomach. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.
Risk factors
Factors that increase the risk of stomach cancer include:
Heavy alcohol use may increase the risk of stomach cancer. Research hasn't clearly linked light or moderate alcohol use with stomach cancer, but alcohol is known to cause many other cancers and guidelines recommend limiting alcohol intake.
Prevention
There's no sure way to prevent stomach cancer. Some risk factors, such as inherited gene changes, can't be changed. But there are steps you can take to lower the risk of stomach cancer.
To lower the risk of stomach cancer:
Diagnosis
To diagnose stomach cancer, a healthcare professional might ask about your symptoms and order a test to look inside the stomach, called an upper endoscopy. Other tests might include a biopsy procedure to get some stomach tissue for testing, blood tests and imaging tests. If you have a strong family history of stomach cancer, you might have screening tests to look for stomach cancer before it causes any symptoms.
Sometimes tests are used to look for stomach cancer in people who don't have symptoms. This is called stomach cancer screening. The goal of screening is to detect stomach cancer when it's small and more likely to be cured.
In some parts of the world where stomach cancer is common, stomach cancer screening is standard. In the United States, stomach cancer screening is only for people with a high risk, such as those with a strong family history of stomach cancer.
Stomach cancer screening often involves upper endoscopy exams to detect the cancer.
Tests and procedures used to diagnose and detect stomach cancer include:
Once you're found to have stomach cancer, the next step often is to have imaging tests to see if the cancer has spread. This information is used to give the cancer a stage, which the healthcare team uses to make a treatment plan.
Tests and procedures used to find the stage of stomach cancer include:
Other tests may be used in certain situations.
Treatment
Stomach cancer treatments include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy and palliative care. Treatment options for stomach cancer, also called gastric cancer, may depend on the cancer's location within the stomach and its stage. Your healthcare team also thinks about your overall health and your preferences when making a treatment plan.
The goal of surgery for stomach cancer is to remove all of the cancer. For small stomach cancers, surgery might be the first treatment. Other treatments might be used first if the stomach cancer grows deeper into the stomach wall or spreads to the lymph nodes.
Operations used to treat stomach cancer include:
Small stage 1 stomach cancers often can be cut away from the inner lining of the stomach. But if the cancer grows into the muscle layer of the stomach wall, this might not be an option. Some stage 1 cancers may need surgery to remove all or some of the stomach.
For stage 2 and stage 3 stomach cancers, surgery might not be the first treatment. Instead, treatment might start with other options to shrink the cancer and make it easier to remove completely. Treatment might start with chemotherapy, immunotherapy, or a combination of chemotherapy and radiation therapy. Surgery for stage 2 and stage 3 stomach cancers often involves removing some or all of the stomach and also some lymph nodes.
If stage 4 stomach cancer grows through the stomach and into nearby organs, surgery is sometimes used to help control symptoms.
Chemotherapy treats cancer with strong medicines. Types of chemotherapy used for stomach cancer include:
Chemotherapy might not be needed for stage 1 stomach cancer. It might not be needed if surgery removed all of the cancer and there's a low risk of cancer coming back.
Systemic chemotherapy is often used before surgery to treat stage 2 and stage 3 stomach cancers. It might help shrink the cancer so that it's easier to remove.
Systemic chemotherapy might continue after surgery to lower the risk that the cancer may come back. The risk of cancer coming back after surgery is higher if the cancer cells are found deep within the stomach wall or if the cancer spreads to the lymph nodes.
Chemotherapy can be used alone or it can be combined with radiation therapy.
If surgery isn't an option, systemic chemotherapy might be recommended instead. It might be used if the cancer is too advanced or if you're not healthy enough to have surgery. Chemotherapy might help control cancer symptoms.
Localized chemotherapy with HIPEC or PIPAC might be an option for advanced stomach cancer that spreads to the peritoneum. These treatments are experimental and may be available through clinical trials.
Radiation therapy treats cancer with powerful energy beams. The beams can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine gives the radiation treatment to precise points on your body.
Radiation therapy is often done at the same time as chemotherapy. Sometimes healthcare professionals call this chemoradiation.
Radiation therapy might not be needed for stage 1 stomach cancer. It might not be needed if surgery removed all of the cancer and there's a low risk that the cancer will come back.
Radiation is sometimes used before surgery to treat stage 2 and stage 3 stomach cancers. It can shrink the cancer so that it's easier to remove. Sometimes radiation is used after surgery if the cancer wasn't removed completely.
Radiation can help relieve stomach cancer symptoms if the cancer is advanced or surgery isn't possible.
Targeted therapy for cancer is a treatment that uses medicines that attack specific molecules in the cancer cells. By blocking these molecules, targeted treatments can cause cancer cells to die. Your healthcare team might test your cancer cells to see if they have the molecules that the medicine targets.
For stomach cancer, targeted therapy is often used with systemic chemotherapy. Targeted therapy is typically used for advanced stomach cancer. This might include stage 4 stomach cancer and cancer that comes back after treatment.
Immunotherapy for cancer is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Your healthcare team may test your cancer cells to see if they're likely to respond to this treatment.
Immunotherapy might be used before surgery for stage 2 and stage 3 cancers. The treatment can help shrink the cancer to make it easier to remove. Sometimes immunotherapy kills all of the cancer and surgery may not be needed.
Immunotherapy also may help treat advanced stomach cancers, such as stage 4 stomach cancers and cancers that come back after treatment.
Palliative care is a special type of healthcare that helps people with serious illnesses feel better. If you have cancer, palliative care can help relieve pain and other symptoms. Healthcare professionals work as a team to give palliative care. This can include doctors, nurses and other specially trained professionals. Their goal is to improve the quality of life for you and your family.
Palliative care specialists work with you, your family and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with other treatments, people with cancer may feel better and live longer.
Coping and support
A stomach cancer diagnosis can be overwhelming and frightening. It may take time to adjust to the initial shock of your diagnosis. In time you'll find ways to cope. Until then, it might help to:
Preparing for an appointment
Start by making an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If your healthcare professional thinks that you may have a condition that affects the stomach, you may be referred to a gastroenterologist. This is a doctor who diagnoses and treats digestive system conditions.
Once stomach cancer is diagnosed, you may be referred to other specialists. This might be a cancer doctor, also called an oncologist, or a surgeon who specializes in operating on the digestive tract.
It's a good idea to be prepared for your appointment. Here's some information to help you get ready, and what to expect.
Your time with your healthcare professional is limited, so prepare a list of questions. List your questions from most important to least important in case time runs out. For stomach cancer, some basic questions to ask include:
In addition to the questions that you've prepared, don't hesitate to ask other questions you think of during your appointment.
Your healthcare professional is likely to ask you questions. Being ready to answer them may allow more time later to cover other points you want to address. Your health professional may ask:
Diagnosis
After a stomach cancer diagnosis, other tests might be needed to find out how far the cancer has spread. This is called staging. Tests may include blood tests, endoscopic ultrasound, CT or PET imaging, or laparoscopy. Staging tells the healthcare team about the size of the cancer and whether it has spread to nearby lymph nodes or to other parts of the body. The care team uses the stage to decide on treatment and get an idea of your outcome.
For the most common type of stomach cancer, called adenocarcinoma, the stages range from 0 to 4. Higher numbers mean the cancer has grown farther through the stomach, spread to nearby lymph nodes or spread to other parts of the body. Different stages may be used after the first treatment.
The stages also are different for other types of stomach cancer, including gastric lymphomas, neuroendocrine tumors and gastrointestinal stromal tumors.
This is the earliest stage of stomach cancer. Cancer cells or cells that are likely to become cancer are found only in the innermost lining of the stomach. The cells have not grown deeper into the layers of the stomach or spread to other parts of the body.
At this stage, the treatment is often aimed at removing the cells completely with a procedure or surgery.
In this stage, the cancer has grown into the layers of the stomach wall. The cancer may have spread to one or two nearby lymph nodes. The cancer has not spread to distant parts of the body.
Stage 1 is an early stage of stomach cancer. The cancer cells often can be cut away from the inner lining of the stomach. But if the cancer grows into the muscle layer of the stomach wall, this may not be an option. Some stage 1 cancers need surgery to remove all or some of the stomach. Chemotherapy and radiation may not be needed if surgery can remove all the cancer and there's a low risk of cancer coming back.
In this stage, the cancer has grown into the inner layers of the stomach wall, spread to nearby lymph nodes or both. Or the cancer has grown deeper into or through the stomach wall but hasn't spread to lymph nodes. At this stage, the cancer has not spread to distant parts of the body.
For stage 2 stomach cancers, surgery may not be the first treatment. Instead, treatment to shrink the cancer may be done first. This makes it easier to remove the cancer completely. Treatment options may include chemotherapy, immunotherapy, or a combination of chemotherapy and radiation therapy. Surgery often involves removing all or some of the stomach and some lymph nodes.
In stage 3, the cancer has grown deeper into or through the stomach wall and has spread to nearby lymph nodes. It hasn't spread to other parts of the body.
Surgery often involves removing all or some of the stomach and some lymph nodes. Immunotherapy may be used before surgery. This treatment can help shrink the cancer to make it easier to remove. Sometimes immunotherapy kills all the cancer cells, and surgery may not be needed.
Systemic chemotherapy is often used before surgery. Chemotherapy may help shrink the cancer so that it's easier to remove. Radiation also may be used before surgery to shrink the cancer. Sometimes it is used after surgery if the cancer wasn't removed completely.
Stage 4 means the stomach cancer has spread to distant parts of the body. It also is called metastatic stomach cancer. At this stage, the cancer may have spread to the lining of the abdomen, liver, lungs or lymph nodes outside the local area of the stomach. Because the cancer has spread to another part of the body, surgery often cannot remove it completely. But surgery is sometimes used to help control symptoms. Targeted therapy may be used with systemic chemotherapy for cancer that has spread to distant parts of the body or has come back after treatment.
To describe each stage in more detail, healthcare professionals commonly use the TNM system. This system looks at three key factors:
Staging can be complex. If you're not sure what something means, ask your healthcare team to explain it in a way that makes sense to you.
How quickly a cancer grows or spreads varies from person to person. Some types of stomach cancer may be more aggressive than others. Staging for stomach cancer is a way to describe the extent of the cancer at diagnosis. But it does not tell you how quickly the cancer is growing or spreading. Different types of stomach cancer can spread in different ways. For example, cancer cells that form a mass versus ones that are more diffuse spread at different rates. Your healthcare team can tell you more about what the features of your cancer may mean for you.
After a diagnosis of stomach cancer, the outlook is different for everyone. Treatment for stomach cancer continues to improve. Your healthcare team can help you identify options for your care. The options and goals of treatment depend on the stage and type of cancer, your health and how well the treatment kills the cancer cells.
Your experience with cancer is unique, and your care team supports you through each step. After treatment, regular follow-up with your care team can help manage your health and check for any signs that the cancer has come back.
Survival rates
Your healthcare team uses your cancer's stage and other factors to estimate your prognosis. The prognosis is how likely it is that the cancer will be cured. Prognosis sometimes is referred to as outlook or likely outcome. For stomach cancer, the prognosis for early-stage cancer is good. As the stage gets higher, the chances of a cure get lower. Even when stomach cancer can't be cured, treatments may slow the cancer's growth, help you live longer and make you more comfortable.
Stomach cancer survival rates are based on large groups of people. They don't take into account your specific situation, and they can't predict what will happen to you.
For all people diagnosed with stomach cancer, the five-year survival rate is about 40%.
Survival rates five years and 10 years after diagnosis vary based on how far the cancer has spread:
Many factors can affect your prognosis. If you like, ask your healthcare team about your outlook and how serious your cancer is. Your care team understands your overall health and may be able to give a more personal prognosis.
Cancer survival rates may cause worry, but these rates vary widely. And the rates don't tell the whole story for each person. Talk to your care team about your specific factors. Your care team can help you learn what factors affect your outlook and what you can do to support your health during treatment.
Updated on Aug 22, 2026
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