Early gastric cancer typically causes no signs or symptoms. As gastric cancer advances, it can cause complications, such as:

• Obstruction of stomach outlet. Cancer may make it difficult or impossible for food and liquid to pass into the small intestine.
• Gastric cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.

Symptoms of the gastric cancer include:

• Indigestion and stomach discomfort or pain
• A bloated feeling after eating.
• Loss of appetite.
• Blood in the stool (which will appear black)
• Vomiting.
• Weight loss for no known reason.
• Trouble swallowing.

Do consult your doctor if you have persistent gastric discomfort/ pain,  vomiting, anemia or unexplained weight loss. 

Helicobacter pylori infection is an important risk factor for gastric cancer. If you are diagnosed to have Helicobacter pylori infection either by blood test, urea breath test or gastroscopy, you should discuss with the doctor for the eradication of the infection. 

Eradicating the bacteria would lower the risk of gastric cancer. It is believed that eradicating the infection earlier in life would confer a better protection.

Gastric cancer occurs when cells in your stomach develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the stomach that can grow to invade nearby structures and spread to other parts of the body. Presence of certain risk factors can increase a person’s chance of getting stomach cancer.

Having any of the following medical conditions or lifestyle factors can increase one’s risk:

• Helicobacter pylori (H. pylori) infection of the stomach.
• Chronic gastritis (inflammation of the stomach).
• Pernicious anemia.
• Intestinal metaplasia (a condition in which the normal stomach lining is replaced with the cells that line the intestines).
• Eating a diet high in salted, smoked foods and low in fruits and vegetables.
• Eating foods that have not been prepared or stored properly.
• Being older or male.
• Smoking cigarettes.
• A family history of stomach cancer

Diagnosis of gastric cancer is based on seeing what is happening within the stomach.

The following tests and procedures may be used:

1) Gastroscopy. This is a procedure to look inside the esophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope (a thin, lighted tube) is passed through the mouth and down the throat into the esophagus. Often, a biopsy is performed, where cells are removed so they can be viewed under a microscope to check for signs of cancer. The sample of tissue may also be checked for Helicobacter pylori (H. pylori) infection.

2) A Barium swallow, where a series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. However, unlike an endoscopy, no cells can be taken for sampling, and so any suspicious findings on a Barium study have to be followed-on by an endoscopy.

The doctor would first need to find out if cancer has spread past the inner lining of the stomach in order to decide on the way to treat it. The process of doing so is called staging. It may involve gastroscopy, endoscopic ultrasound, CT scan, MRI scan or PET scan.

Stage 0 cancer or cancer confined to the inner lining of the stomach can be treated endoscopically. The tumor is removed completely using the gastroscope and some special instruments. There is no external scar and the patient recovers immediately after the procedure.

More advanced stage of cancer may require surgery to remove part or all of the stomach. Some reconnection of the digestive system may be needed so that you can continue to eat.

Chemotherapy is sometimes needed before or after the surgery.

Radiation can be used to kill cancer cells as well.

Immunotherapy is the medication that works with our body’s immune system to kill cancer cells.