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How Do I Know If I Have It?

Your doctors may identify signs of stomach cancer, such as enlarged lymph nodes, an enlarged liver, and increased fluid in the abdomen (ascites), during a physical exam. But these generally indicate advanced cancer.

When a patient complains of vague symptoms such as indigestion, weight loss, nausea, and loss of appetite, a doctor may order screening tests. These include:

Upper GI series. These are X-rays of the esophagus (food tube) and stomach — the upper gastrointestinal, or GI, tract. The patient drinks a barium solution, which outlines the stomach on the X-ray, helping the physician find tumors or other abnormalities.

Endoscopy and biopsy. This test examines the esophagus and stomach using a thin, lighted tube called an endoscope, which is passed through the mouth to the stomach. Through the endoscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor will remove some tissue to be biopsied. A biopsy is the only sure way to diagnose cancer. Endoscopy and biopsy are the best methods of identifying stomach cancer.

What Are the Treatments?

Stomach cancer can be treated with the following, in combination or alone:

• Surgery, called gastrectomy, to remove all or part of the stomach, as well as some of the tissue surrounding the stomach. Lymph nodes near the stomach are also removed and biopsied to check for cancer cells. Stomach lymphomas, more often than adenocarcinomas, are treated by gastrectomy. Only about one-third of stomach cancer cases can be treated and cured surgically.
• Chemotherapy
• Radiation therapy
• Biological therapy (natural substances are used to boost the body's immune system to fight certain illnesses).

If treated at an early stage before it spreads, stomach cancer is curable. A patient whose tumor is removed completely has a good chance of surviving at least five years. Unfortunately, by the time most cases of stomach cancer are diagnosed, the cancer has spread to local lymph nodes or other organs, making it difficult to treat. Fewer than one in five patients diagnosed with stomach cancer that has spread to other organs or lymph nodes survives five years.