Indigestion, heartburn, abdominal pain and fatigue can be the result of overeating, acid reflux or insomnia. But did you know that they can also be signs of stomach cancer? How do you know if you should see a doctor?
Chul S. Hyun, MD, PhD, a gastroenterologist at Yale New Haven Health and associate professor of Internal Medicine at Yale School of Medicine, answers your questions about stomach cancer. Dr. Hyun is also the director of the Gastric Cancer Prevention and Screening Program at Yale.
What are the signs and symptoms of stomach cancer?
Stomach cancer (also known as gastric cancer) develops when abnormal cells grow uncontrollably in the lining of the stomach. It’s the fifth most common cancer worldwide and the fourth-leading cause of cancer-related death. However, it afflicts population groups disproportionately.
In its early stages, stomach cancer may not cause noticeable symptoms. When symptoms do appear, they can be subtle and may be mistaken for common digestive issues. Early warning signs include:
- Persistent indigestion or stomach discomfort
- Feeling full after eating only small amounts of food
- Mild nausea or loss of appetite
- Unexplained fatigue or weakness
As the disease progresses, symptoms may become more noticeable:
- Unintentional weight loss
- Persistent stomach pain or discomfort, particularly in the upper abdomen
- Difficulty swallowing
- Vomiting, sometimes with blood
- Blood in the stool or black, tarry stools
- Persistent bloating or swelling of the abdomen
Because these symptoms overlap with many less serious conditions, you might delay seeking medical attention. However, persistent or worsening symptoms should always be evaluated by a healthcare provider.
What are the risk factors for stomach cancer?
Several factors can increase your risk of developing stomach cancer. Unfortunately, there is no structured system in the United States to routinely screen for gastric cancer. Understanding your personal risks can help guide prevention and screening efforts.
Risk factors include:
- Infection with Helicobacter pylori (H. pylori): H. pylori is a common bacterial infection that can sometimes cause chronic inflammation of the stomach lining, stomach pain or discomfort and other symptoms. However, most people who are infected don't have any symptoms. Having H. pylori is one of the strongest risk factors for gastric cancer. Testing for it may be appropriate if you have: any persistent upper digestive symptoms, a history of stomach ulcers, a family history of gastric cancer, or other risk factors for gastric cancer as listed below. Treatment typically involves a combination of antibiotics and acid-suppressing medication to eliminate the infection.
- Ethnicity: The incidence of gastric cancer is significantly higher among people who are Asian, Hispanic, African American and Eastern European. If you were born in or lived for a long period of time in Korea, Japan, China, Vietnam or Latin America, your risk may be up to five times higher than that of non-Hispanic white Americans.
- Diet and lifestyle: Diets high in smoked, salted, or pickled foods increase your risk, while diets rich in fruits and vegetables may be protective. Smoking significantly raises the chance of developing stomach cancer, and heavy alcohol use may also contribute.
- Age and gender: Stomach cancer is more common in older adults, particularly those over 60. Men are also more likely than women to develop it.
- Family history and genetics: A family history of stomach cancer or certain inherited conditions, such as hereditary diffuse gastric cancer syndrome, can increase risk.
- Certain medical conditions: Chronic gastric inflammation (gastritis), stomach ulcers, pernicious anemia, and previous stomach surgery can all raise risk over time.
- Obesity: Excess body weight has been linked to a higher risk, particularly for cancers in the upper part of the stomach.
When should I see a doctor?
It’s important to seek medical advice if you experience persistent digestive symptoms, unexplained weight loss, or signs of bleeding (such as vomiting blood or dark stools). Early detection can significantly improve treatment options and survival rates.
Key takeaways
In the U.S., gastric cancer is typically identified when symptoms are experienced rather than through routine screening. As a result, many gastric cancers are diagnosed at advanced stages – which sharply reduces the chance for a cure. Stomach cancer often develops silently, making awareness essential. Understanding your personal risk factors is the most important thing you can do for your health.
While many symptoms can be caused by benign conditions, paying attention to ongoing changes in your digestive health can support earlier diagnosis and better outcomes. When stomach cancer is found early, most people survive. If you have concerns, don’t hesitate to talk with a healthcare professional.
Learn more about Digestive Health Services at Yale New Haven Health.
