Stomach Cancer: Let’s Talk Risk Factors, Treatment, and Support

Until the late 1930s, stomach cancer (also known as gastric cancer) was the leading cause of cancer death in the United States. Today the number of people diagnosed with stomach cancer is declining each year. It's estimated that, in 2022, stomach cancer will account for 1.4% of all new cancer diagnoses. In addition to being much less common, the disease is much more treatable today thanks to improvements in public health, screening, and treatments over the past 50 years.

In 2005, chef Hans Rueffert was diagnosed with stage 3 stomach cancer. His cancer journey has included 11 surgeries, chemotherapy, radiation, and the removal of his stomach and 95% of his esophagus. Known as the chef without a stomach, Hans is the author of the cookbook "Eat Like There’s No Tomorrow." In a 2017 podcast interview with CSC, Rueffert discussed his story and shared some practical tips that have helped him.

Listen to Our Conversation With Hans Rueffert

In recognition of Stomach Cancer Awareness Month, we share key things to know about the disease, including resources to help people navigate a stomach cancer diagnosis.

Risk Factors 

As more is known about gastric cancer, risk factors have been identified. The bacteria helicobacter pylori (H. pylori) commonly infects the inner lining of the stomach during childhood and may increase the risk for stomach cancer. H. pylori infection often isn’t found unless it causes stomach inflammation and sores (called peptic ulcers) later on. Treatment for H. pylori lowers the risk of developing stomach cancer. H. pylori infections have become less common in the United States over the past 50 years, but they remain high in some other parts of the world.

Other common risk factors for the disease include:

• Family history: Patients who have parents, brothers, sisters, or children with a history of stomach cancer are somewhat more likely to develop the disease.
• Long-term inflammation of the stomach: People who have conditions associated with long-term stomach inflammation (such as the blood disease pernicious anemia) have an increased risk of stomach cancer.
• Nutrition/physical activity/tobacco use: Studies suggest that diets high in smoked, salted, and pickled foods may increase the risk of stomach cancer. People who are obese, lack physical activity, or have a history of tobacco use are also more likely to develop stomach cancer.
• Sex/race/ethnicity: Men are more likely than women to develop stomach cancer. Asian, Pacific Islander, Hispanic, and Black/African American people are also at higher risk.

Having a risk factor does not mean you will get cancer. Talk with your healthcare team if you think you may be at risk.

Signs & Symptoms

In its early stages, stomach cancer often does not cause symptoms. As the cancer grows, the most common symptoms are:

• Difficulty swallowing
• Discomfort or pain in the stomach area
• Feeling full or bloated after eating small amounts of food or a small meal
• Nausea and vomiting
• Vomiting blood or having blood in the stool
• Weight loss
• Fatigue (due to blood loss from the tumor)

Listen to Our Podcast: Understanding the Full Impact of Stomach Cancer

Diagnostic Procedures

If a patient has symptoms, a doctor may refer the patient to a gastroenterologist. This is a doctor who specializes in digestive problems. The doctor may perform one or more of the following procedures to determine if stomach cancer is present:

• Physical exam: Your healthcare team will feel for swollen lymph nodes and check for signs of jaundice (yellowing of your skin or eyes). They will also check for fluid, swelling, or any other abdominal changes.
• Upper GI series: You will drink a solution made of barium, which will make the lining of the stomach show up clearly on x-rays. Your healthcare team will x-ray your stomach and esophagus.
• Endoscopy: Your healthcare team will use a thin, lit tube called an endoscope to look into the stomach. The endoscope passes through the mouth and esophagus into the stomach to examine any problematic areas.
• Biopsy: During your endoscopy, your healthcare team will remove samples of tissue from your stomach. A pathologist will look at the sample under a microscope to check for cancer cells. This is the only way to tell if stomach cancer is present.

Approximately 26,500 new cases of stomach cancer are expected to be diagnosed in the United States in 2021.

Treatment Options

There are several treatment options for stomach cancer. They depend on the cancer stage, the patient’s age, and their general health. Discuss all your options with your healthcare team to develop a treatment plan that best fits your needs.

Many patients have one or more of the following treatments:

• Surgery: This is the most common treatment for stomach cancer. There are 2 main types of surgery for the disease:
  • A partial gastrectomy removes part of the stomach and may also remove part of the esophagus, small intestines, nearby tissues, and lymph nodes.
  • A total gastrectomy removes the entire stomach, nearby lymph nodes, parts of the small intestine, and other tissues. The surgeon connects the esophagus to the small intestine and makes a new stomach from intestinal tissue.
• Radiation therapy: A large machine directs radiation at the abdomen and uses high-energy rays to kill cancer cells. Radiation can be given alone or with chemotherapy, surgery, or both. It is used to destroy cancer cells that remain after surgery and to relieve pain caused by cancer.
• Chemotherapy: This treatment uses drugs to kill cancer cells. In patients with stomach cancer, chemotherapy may be given alone, with surgery, radiation, or both. Most often, drugs are injected into the veins.
• Immunotherapy: This treatment helps your body’s immune system to identify, attack, and kill cancer cells.

It helps to learn about the side effects of treatment before you begin so you will know what to expect. Talk with your healthcare team about potential side effects and effective medications to address them. 

Surgery is the most common treatment for stomach cancer, but it can be combined with other treatments.

Resources & Support

Our research reveals that a cancer diagnosis impacts more than just people’s physical well-being. For example, 89% of gastric cancer patients and survivors who participated in our cancer experience survey reported moderate to very serious concern about their cancer progressing or coming back, and 65% were at risk for anxiety. Further, prior to making a treatment decision, 69% weren’t knowledgeable about treatment options, and 87% of participants weren’t aware of the financial impact of their cancer treatment.

If you are living with stomach cancer or are a caregiver to someone with stomach cancer, these resources can help ease the burden of your journey:  

• Find more information about gastric cancer, including staging of the disease and treatment side effects.    
• Connect with our Cancer Support Helpline by phone or online. Our experienced Helpline staff are here to offer free navigation for cancer patients or their loved ones. 
• Access personalized cancer support resources at your fingertips. We’ve introduced a way for you to easily access the resources you need, anytime, anywhere. 
• Find a caring and supportive CSC location near you. We have 190 locations worldwide, including 52 licensed affiliates and health care partnerships.

You can also join CSC’s free digital support community for people impacted by cancer, MyLifeLine.org. Members have access to a variety of discussion boards where they can share their ideas and experiences. They can also create a private support website to keep their friends and family updated and organize help for things like meals and rides to medical appointments. 

“Just hang in there. We are not alone. If you start talking about it, people will respond mostly with kindness and love.”

— Tammy, cancer survivor

Editor's Note: This blog was originally published in November 2021 and has been updated.