When Your Stomach Problems Can Be a Sign of Something Serious

With symptoms that can include indigestion, heartburn, stomach discomfort, a bloated feeling after eating, mild nausea or loss of appetite, it would be easy to dismiss it as “just some stomach problems.” That would be unwise, experts say. Those “problems” could be a sign of something more serious—early-stage stomach cancer.

Most patients with early-stage stomach cancer, also known as gastric cancer, are asymptomatic, says Ramon Jimenez, M.D., a surgical oncologist and chief of the Division of Melanoma and Soft Tissue Sarcomas at Baptist Health Miami Cancer Institute. Dr. Jimenez has special expertise in in the surgical management of melanoma, soft tissue sarcoma, upper gastrointestinal malignancy and hepatobiliary and pancreatic tumors.

Ramon Jimenez, M.D., surgical oncologist and chief of the Division of Melanoma and Soft Tissue Sarcomas at Baptist Health Miami Cancer Institute

“When symptoms are present, they can be subtle and nonspecific,” Dr. Jimenez says. “They may include but are not limited to anemia, early satiety, postprandial fullness, weight loss or heartburn.”

For many patients, their stomach cancer is discovered incidentally at the time of an upper endoscopy, Dr. Jimenez notes, where it is usually seen as a small ulcer. “The main diagnostic tests for stomach cancer include a blood count to check for anemia, an upper endoscopy with biopsy, and cross-sectional imaging of the abdomen.”

What are the symptoms of advanced stomach cancer?

Once cancer has taken hold in the cells lining the stomach wall, it can advance and spread to other parts of the body. Symptoms of advanced stomach cancer may include the symptoms of early-stage stomach cancer as well as:

• blood in the stool  
• vomiting  
• weight loss for no known reason  
• stomach pain  
• jaundice (yellowing of eyes and skin)  
• ascites (buildup of fluid in the abdomen)  
• trouble swallowing  

Who is at risk for getting stomach cancer?

While stomach cancer has become less common in the United States, it remains one of the leading causes of cancer-related deaths in the world. It is more common in countries in East Asia, Eastern Europe, and South and Central America.

According to the American Cancer Society (ACS), stomach cancer accounts for about 1.5 percent of all new cancers diagnosed in the U.S. each year. The ACS says an estimated 26,890 new cases of stomach cancer (16,160 in men and 10,730 in women) will be diagnosed this year, and roughly 10,880 people will die from the disease.

The National Cancer Institute (NCI) says that in the United States, the disease occurs more often among Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native individuals than among White individuals.

Stomach cancer can be diagnosed at any age, but the risk increases as a person gets older, according to the NCI. “Males are nearly twice as likely as females to be diagnosed with stomach cancer, and Black males are nearly twice as likely as White males to die of it,” the NCI states. It also points out that in recent years, stomach cancer rates have been increasing in younger females, particularly among Hispanic females.

Even so, there is no screening program for gastric cancer in the U.S. – “primarily because there are not enough cases to justify an early detection program,” says Dr. Jimenez. “In other countries such as China, Japan, and Korea, where there is a high incidence of gastric cancer, early screening programs are in place and are proving effective in catching early-stage stomach cancer.”

How is stomach cancer treated?

There are a variety of treatment options for stomach cancer, according to Dr. Jimenez. These include endoscopic mucosal resection (EMR); surgery; chemotherapy; radiation, and immunotherapy. “Patients with early gastric cancer may only require EMR or surgery but most patients are treated with a combination of surgery and chemotherapy,” he says.

Researchers today are studying the efficacy of immunotherapy – currently approved only for stage 4 stomach cancer – in treating early-stage stomach cancer. “Some of the early trial results are so impressive that they may lead to application for earlier gastric cancer stages,” Dr. Jimenez says. “The research is ongoing.”