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Stomach cancer, also known as gastric cancer, develops when abnormal cells in the stomach grow uncontrollably and form a tumor. The stomach is located in the upper middle abdomen, just below the ribs, and plays a key role in digestion.
Cancer can develop in any part of the stomach. Globally, it most often occurs in the main body of the stomach, while in the United States it more commonly begins at the gastroesophageal junction — the area where the esophagus (food pipe) meets the stomach.
The location of the tumor, its stage, and the type of cells involved are important factors in deciding the treatment plan. Stomach cancer is more treatable when detected early, but unfortunately, most cases are diagnosed at an advanced stage when a cure is less likely.
Stomach cancer usually starts in the inner lining (mucosa) of the stomach. Over time, if untreated, it can form a tumor that grows deeper into the stomach wall and spread (metastasize) to nearby organs such as the liver, pancreas, or lymph nodes. About 95% of cases are adenocarcinomas, which begin in the glandular cells of the stomach lining.
Persistent indigestion or heartburn
Stomach pain or discomfort (often above the belly button)
Feeling full quickly after eating small amounts
Bloating or gas after meals
Nausea and vomiting
Loss of appetite
Unexplained weight loss
Fatigue or weakness
Trouble swallowing (if cancer is near the gastroesophageal junction)
Vomiting blood
Black, tarry stools (due to internal bleeding)
Swelling in the abdomen (fluid buildup)
Yellowing of skin and eyes (if it spreads to the liver)
Lumps in lymph nodes
Because symptoms often appear late, many cases are diagnosed at advanced stages.
Helicobacter pylori (H. pylori) infection – a major cause of chronic stomach inflammation and ulcers
Gastritis (long-term stomach lining inflammation)
Gastroesophageal reflux disease (GERD)
Stomach polyps or ulcers
Autoimmune atrophic gastritis
Epstein-Barr virus infection
Smoking or tobacco use (smoking, chewing, vaping)
Heavy alcohol consumption
Diet high in salted, smoked, pickled, or fatty foods
Low intake of fresh fruits and vegetables
Occupational exposure to coal, rubber, or metal dust
Obesity
Family history of stomach cancer
Certain inherited syndromes:
Lynch syndrome
Li-Fraumeni syndrome
Peutz-Jeghers syndrome
Familial adenomatous polyposis
Hereditary diffuse gastric cancer
People with Type A blood are at higher risk (cause unknown).
More common in East Asia, South America, and Eastern Europe than in the U.S.
In the U.S., it is more often diagnosed in Black, Hispanic, Asian/Pacific Islander, and Native American/Alaska Native populations.
Men are nearly twice as likely as women to develop stomach cancer.
Risk increases with age but is rising among younger women, especially Hispanic women.
If symptoms suggest stomach cancer, doctors perform several steps to confirm diagnosis:
Medical history and physical exam – checking family risk and abdominal changes
Blood tests – to check for anemia (possible stomach bleeding)
Stool test – for hidden (occult) blood
Upper Endoscopy (EGD) with Biopsy – a flexible tube with a camera is inserted through the mouth to view the stomach; tissue samples are taken for lab testing.
CT Scan – produces detailed images of the abdomen; contrast dye may be used.
Endoscopic Ultrasound – shows depth of tumor invasion and lymph node involvement.
PET-CT Scan – detects spread by highlighting cancerous activity.
MRI with contrast – provides detailed imaging of tumor and spread.
Laparoscopy – minimally invasive surgery to examine abdominal organs and collect fluid/tissue samples.
Biomarker Testing – analyzes cancer cells for HER2, PD-L1, MSI, MMR deficiency, TMB, and NTRK gene changes to guide targeted therapies.
Staging determines how far the cancer has spread:
Stage 0–1: Cancer limited to the inner lining of the stomach.
Stage 2–3: Cancer has grown deeper or spread to nearby lymph nodes.
Stage 4: Advanced cancer that has spread to distant organs such as liver, lungs, or bones.
Endoscopic Mucosal Resection (EMR): Removes very small, early cancers from the stomach lining.
Subtotal Gastrectomy: Removes part of the stomach and nearby tissue.
Total Gastrectomy: Removes the entire stomach; the esophagus is connected to the small intestine.
Lymph Node Removal: To check for spread.
Palliative Surgery: To relieve symptoms in advanced cancer.
Systemic Chemotherapy: Drugs travel through the bloodstream to kill cancer cells.
Neoadjuvant Chemotherapy: Given before surgery to shrink tumors.
Adjuvant Chemotherapy: Given after surgery to kill remaining cancer cells.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy): Heated chemo placed directly into the abdomen after surgery (experimental, mainly for stage 4).
External Beam Radiation Therapy (EBRT): Directs radiation at tumors.
Chemoradiation: Radiation combined with chemotherapy for better results.
Neoadjuvant Radiation: Used before surgery to shrink tumors.
Adjuvant Radiation: Used after surgery to destroy residual cancer cells.
Palliative Radiation: Relieves pain or bleeding in advanced cases.
Medicines that block specific proteins or pathways cancer cells use to grow. Often combined with chemotherapy. Examples include drugs for HER2-positive or PD-L1-positive stomach cancers.
Boosts the immune system to detect and kill cancer cells. May be used for advanced, recurrent, or biomarker-positive stomach cancers.
A supportive approach to relieve symptoms such as pain, nausea, fatigue, or emotional stress. Can be given alongside curative treatments or as the main focus in advanced disease.
The prognosis depends on how early the cancer is detected.
Early-stage stomach cancer is often curable with surgery and additional therapies.
Advanced-stage stomach cancer is harder to treat and often requires a combination of therapies to manage symptoms and slow progression.