Understanding this cancer
Gastric cancer starts in the stomach. Most cases are adenocarcinomas, but pathology must distinguish these from lymphoma, gastrointestinal stromal tumour and other diseases. Tumour location, stage and biomarkers shape treatment.
Signs to discuss with a doctor
Persistent indigestion, difficulty swallowing, early fullness, vomiting, upper abdominal pain, black stools, anaemia or unexplained weight loss require assessment, especially when new or worsening.
Risk factors
Helicobacter pylori infection, tobacco, high-salt preserved foods, certain inherited syndromes, chronic gastric inflammation and family history can increase risk.
Tests and diagnosis
Upper endoscopy with biopsy is central. CT and sometimes endoscopic ultrasound, PET or staging laparoscopy help determine extent. Biomarker testing may include HER2, mismatch-repair or PD-L1 depending on the clinical setting.
Treatment approaches
Treatment may combine surgery, chemotherapy, radiotherapy, targeted therapy or immunotherapy. The order and intent depend on resectability, stage, biomarkers, nutrition and fitness.
Prevention and screening
Treating H. pylori when clinically diagnosed, avoiding tobacco, reducing heavily salted preserved foods and eating a balanced diet may reduce risk. Population screening is used in some high-incidence countries but is not universal.
Questions for your care team
What is the exact pathology, location and stage? Is the tumour operable? Which biomarkers were tested? How will nutrition be supported before and after treatment?