Stomach Cancer Awareness Month: Spot the Warning Signs Early

Stomach cancer continues to be a significant health concern, with an estimated 642,000 deaths worldwide in 2024 (Source: WHO). Making the scenario more concerning is its silent nature - stomach cancer in its early stages is often asymptomatic or causes non-specific symptoms, which can delay diagnosis, at which point the treatment options are more limited. Stomach Cancer Awareness Month, observed every November, aims to address this by promoting understanding of the disease, its warning signs and the importance of timely medical consultation. In this article, we’ll take a closer look at the observation’s purpose, and explore the causes, symptoms, diagnosis and treatment pathways for stomach cancer.

About Stomach Cancer Awareness Month

Stomach Cancer Awareness Month is observed every November to raise awareness about stomach cancer. The observance gained recognition in the United States in 2010 through efforts led by the nonprofit organisation No Stomach For Cancer, which works to support stomach cancer research, education and patient advocacy. Its establishment helped bring greater attention to a disease that can be difficult to recognise in its early stages.

It highlights the importance of recognising stomach cancer symptoms, understanding risk factors and seeking timely medical advice. The observance encourages people to look beyond common digestive complaints and learn when persistent symptoms may need medical evaluation.

The month also provides an opportunity to educate people about how stomach cancer develops, the role of factors such as H. pylori infection, and the diagnostic and treatment options available. By making reliable information more accessible, the campaign aims to encourage informed health decisions and promote earlier medical evaluation when concerns arise.

Understanding Stomach Cancer

Stomach cancer, also known as gastric cancer, develops when cells in the stomach begin to grow abnormally and multiply uncontrollably. It usually starts in the stomach's inner lining and may spread into deeper layers or nearby organs as it progresses. The most common type is gastric adenocarcinoma, which develops in the cells that produce mucus and other fluids in the stomach lining. Early stomach cancer may not cause noticeable symptoms, and those that do appear can resemble common digestive problems, such as indigestion or bloating. This can make the condition difficult to recognise without medical evaluation. 

Types of Stomach Cancer

Stomach cancer can develop from different types of cells in the stomach. The main types include:

Adenocarcinoma

Adenocarcinoma is the most common type of stomach cancer, accounting for more than 90% of cases. It develops in the glandular cells lining the stomach, which produce mucus and other digestive fluids. This cancer can occur in different parts of the stomach and may grow into deeper layers or spread to other organs if left untreated. 

Gastrointestinal Stromal Tumours

Gastrointestinal stromal tumours (GISTs) develop from specialised cells in the wall of the digestive tract, most commonly in the stomach. Their behaviour varies, with some growing slowly and others being more aggressive. Treatment depends on the tumour's size, location and likelihood of spreading.

Gastric Lymphoma

Gastric lymphoma is a type of cancer that develops in the immune cells within the stomach. Some forms, including mucosa-associated lymphoid tissue (MALT) lymphoma, are associated with H. pylori infection. Treatment may involve antibiotics to eradicate the infection, medicines, radiotherapy or other cancer therapies, depending on the type and extent of the disease.

Neuroendocrine Tumours

Gastric neuroendocrine tumours develop from hormone-producing cells in the stomach. Some grow slowly, while others can be more aggressive. Their treatment depends on factors such as tumour size, grade and whether the cancer has spread.

What Increases the Risk of Stomach Cancer?

Stomach cancer does not have one single cause. Several factors can increase the likelihood of developing the disease including: 

• H. pylori Infection: Long-term infection with Helicobacter pylori, a bacterium that can cause inflammation of the stomach lining, is a major risk factor for stomach cancer. Over time, the infection may lead to changes in the stomach lining that increase cancer risk.

• Family History: Having a parent, sibling or child who has had stomach cancer can increase the risk. Certain inherited conditions, including hereditary diffuse gastric cancer, can also raise the likelihood of developing the disease.

• Dietary Habits: Regularly eating large amounts of salted, smoked or poorly preserved foods may increase the risk. Diets low in fruit and vegetables have also been associated with a higher risk.

• Smoking: Tobacco use increases the risk of stomach cancer. Quitting smoking can help reduce this risk over time and improve overall health.

• Age: The risk generally increases with age, although stomach cancer can occur in younger adults too.

• Existing Stomach Conditions: Chronic atrophic gastritis, intestinal metaplasia and pernicious anaemia are among the conditions associated with an increased risk.

• Excess Body Weight: Being overweight or obese is associated with a higher risk of cancer in the upper part of the stomach, particularly near the junction with the oesophagus.

What are the Early Signs of Stomach Cancer?

Stomach cancer may not cause noticeable symptoms in its early stages. When symptoms do appear, they can resemble common digestive conditions, which makes it important to pay attention to persistent or unusual changes. Possible signs include: 

• Persistent indigestion: Repeated indigestion or discomfort in the upper abdomen that does not settle or keeps returning.

• Bloating: Frequent bloating or a feeling of fullness after eating, even when the meal is small.

• Reduced Appetite: Eating less than usual because of a lack of appetite or discomfort after meals.

• Nausea: Recurrent nausea, sometimes accompanied by vomiting.

• Abdominal Discomfort: Persistent pain or discomfort in the upper abdomen.

• Unexplained Weight Loss: Losing weight without making changes to diet or physical activity.

• Difficulty Swallowing: Trouble swallowing food, particularly when the tumour affects the upper part of the stomach or the junction with the oesophagus.

• Unusual Fatigue: Feeling unusually tired or weak, which may occur if bleeding from the tumour leads to anaemia.

How is Stomach Cancer Diagnosed?

If stomach cancer is suspected, a doctor may recommend several tests to identify the cause of the symptoms, confirm whether cancer is present and determine how far it has spread. The diagnostic process usually involves the following steps: 

Medical Assessment

The doctor begins by asking about symptoms, how long they have been present and whether there is a family history of stomach cancer. A physical examination may follow, along with blood tests to check for anaemia or other abnormalities. These tests can provide useful clues, but they cannot confirm stomach cancer on their own.

Upper Endoscopy

An upper gastrointestinal endoscopy allows the doctor to examine the lining of the oesophagus, stomach and upper small intestine using a thin, flexible tube with a camera. If an abnormal area is found, a small tissue sample may be collected for examination.

Biopsy

A biopsy is the main way to confirm a diagnosis of stomach cancer. The tissue sample collected during endoscopy is examined under a microscope to identify cancer cells and determine the type of tumour. Additional laboratory tests may help identify characteristics that can guide treatment.

Imaging Tests

If cancer is confirmed, imaging tests such as CT scans may be used to check whether it has spread to nearby tissues, lymph nodes or other organs. In selected cases, the doctor may recommend an endoscopic ultrasound, PET scan or laparoscopy to assess the extent of the disease.

What Treatment Options are Available for Stomach Cancer?

Treatment depends on the type of stomach cancer, its stage, tumour characteristics and the person's overall health. A multidisciplinary team may include gastroenterologists, surgical oncologists, medical oncologists, radiologists and other specialists. The main treatment options include:

Surgery

Surgery may be recommended when the cancer can be removed safely. Depending on its location and extent, the surgeon may remove part of the stomach, known as a partial gastrectomy, or the entire stomach, known as a total gastrectomy. Nearby lymph nodes may also be removed to assess and treat the disease.

After surgery, eating habits and nutritional needs may change. Dietary guidance and follow-up care can help manage these changes during recovery.

Chemotherapy

Chemotherapy uses medicines to destroy cancer cells or stop them from growing. It may be given before surgery to shrink the tumour, after surgery to reduce the risk of recurrence, or as a primary treatment when surgery is not suitable. In advanced cases, it may also help control the disease and relieve symptoms.

Radiotherapy

Radiotherapy uses high-energy radiation to destroy cancer cells. It may be combined with chemotherapy in selected cases or used to relieve symptoms, depending on the location and extent of the cancer.

Targeted Therapy

Targeted therapy works on specific proteins or molecular changes that help cancer cells grow. Tests on tumour tissue may identify whether a person is likely to benefit from a particular targeted medicine.

Immunotherapy

Immunotherapy helps the immune system recognise and attack cancer cells. It may be suitable for certain stomach cancers, depending on test results, the stage of the disease and previous treatments.

Supportive Care

Supportive or palliative care helps manage symptoms, nutritional difficulties, pain and treatment side effects. It can be provided alongside cancer treatment to improve comfort and quality of life. The appropriate treatment plan should be discussed with the specialist team, including its potential benefits, side effects and expected outcomes.

Take a Step Towards Better Stomach Health

Stomach Cancer Awareness Month is a good time to pay attention to symptoms that do not go away. If you have ongoing indigestion, bloating or a loss of appetite, or you are worried about your own risk because of a family history of stomach cancer or a past H. pylori infection, do not wait for it to settle on its own. A gastroenterologist at Sterling Hospitals can review your symptoms and medical history, explain what could be causing them and advise whether you need tests such as an endoscopy. Consult a gastroenterologist at Sterling Hospitals today, so that any concern is checked early and you get clear answers.