A gastric tumour is a growth in the stomach. The most common malignant type is adenocarcinoma, usually called stomach cancer. Other types include gastrointestinal stromal tumours (GIST), lymphoma, neuroendocrine tumours and benign polyps, each treated differently.
Stomach cancer often causes vague symptoms until it is advanced, which is why persistent indigestion with warning features deserves an endoscopy. Surgery is the basis of curative treatment, usually combined with chemotherapy, and very early cancers can sometimes be removed through the endoscope.
Symptoms
- Persistent indigestion, heartburn or upper abdominal discomfort
- Feeling full after small meals
- Loss of appetite and unintended weight loss
- Nausea or vomiting, sometimes with blood
- Black, tarry stools
- Tiredness from anaemia
- Difficulty swallowing when the tumour is near the top of the stomach
Causes and risk factors
Long-term infection with Helicobacter pylori is the leading cause worldwide, producing chronic inflammation that may progress over decades. Risk is increased by smoking, a diet rich in salted, smoked and pickled food, low intake of fruit and vegetables, excess alcohol, obesity and reflux for tumours at the junction with the gullet, pernicious anaemia, previous partial stomach removal and a family history. Rare inherited causes include CDH1 gene changes leading to hereditary diffuse gastric cancer. Rates are highest in East Asia, Eastern Europe and parts of South America.
How it is diagnosed
- Upper endoscopy with biopsies: The essential test. Several samples are taken, and H. pylori is checked at the same time.
- CT of chest, abdomen and pelvis: Assesses the extent in the stomach wall, lymph nodes and distant organs.
- Endoscopic ultrasound: Shows the depth of invasion, which is important when endoscopic removal is being considered, and helps characterise lumps under the lining such as GIST.
- Staging laparoscopy: A keyhole look inside the abdomen under anaesthetic to find small deposits on the peritoneum that scans miss, before committing to major surgery.
- Tumour markers in the tissue: HER2, PD-L1 and mismatch repair status guide drug treatment.
Treatment options
- Endoscopic resection: Endoscopic submucosal dissection removes very early cancers confined to the lining, keeping the stomach.
- Gastrectomy: Removal of part or all of the stomach with surrounding lymph nodes (D2 dissection), by open or keyhole surgery.
- Chemotherapy around surgery: For most operable cancers beyond the earliest stage, about 2 months of chemotherapy before and 2 months after surgery.
- GIST treatment: Surgical removal without extensive node dissection, and imatinib tablets before or after surgery for higher-risk tumours.
- H. pylori eradication: A course of antibiotics and acid suppression. It can cure early MALT lymphoma of the stomach and lowers future cancer risk.
- Treatment of advanced disease: Chemotherapy, targeted drugs, immunotherapy, stents and nutritional support to control symptoms.
When it is urgent
Go to an emergency department near you if you vomit blood or material that looks like coffee grounds, pass black tarry stools, feel faint, have sudden severe abdominal pain, or cannot keep any fluids down. After a gastrectomy, fever, increasing pain, a racing heart or breathlessness in the first weeks need urgent assessment.
Travelling to Türkiye for treatment
Travel may be appropriate for endoscopy with expert pathology, a second opinion on staging, endoscopic submucosal dissection, or a planned gastrectomy, for which 2 to 3 weeks' stay is prudent. The chemotherapy before and after surgery spans about 4 to 5 months and is best given near home, so the sequence must be coordinated between teams. After gastrectomy you will need long-term dietary support, vitamin B12 injections and follow-up locally.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Is every stomach tumour cancer?
No. Many polyps are benign, and GISTs and neuroendocrine tumours range from indolent to aggressive. The biopsy and scans define what you have.
Can I live without a stomach?
Yes. The gullet is joined to the small bowel. You will eat smaller, more frequent meals, may lose weight at first and will need vitamin B12 for life.
Should I be tested for H. pylori?
If you have persistent indigestion, a family history of stomach cancer or come from a high-risk region, testing and treatment are worthwhile.
Is keyhole gastrectomy as good as open surgery?
In experienced hands and for suitable tumours, results appear comparable, with quicker recovery. Large or locally advanced tumours may still be better served by open surgery.