Stomach Cancer

Stomach (gastric) cancer is cancer of the stomach lining. Its pattern varies strongly by region — in India, incidence is particularly high in parts of the north-east. Most gastric cancer in India is linked to chronic infection with Helicobacter pylori, along with dietary and lifestyle factors.

Symptoms

• Persistent indigestion, upper-abdominal pain.
• Early satiety (feeling full quickly).
• Loss of appetite, unexplained weight loss.
• Nausea, vomiting — sometimes vomiting food eaten days earlier (outlet obstruction).
• Vomiting blood, coffee-ground material, black tarry stools.
• Iron-deficiency anaemia, fatigue.
• Swallowing difficulty — with cancers at the junction with the oesophagus.

Risk factors

• H. pylori infection (chronic) — the biggest single risk.
• Smoked, pickled, salted foods (nitrosamines).
• Smoking, heavy alcohol.
• Obesity.
• Previous stomach surgery, pernicious anaemia.
• Family history; inherited syndromes (CDH1, Lynch).
• Low vegetable/fruit intake.

Evaluation

Upper endoscopy with biopsy is the key test — available widely in Indian towns and cities. Staging with CT, endoscopic ultrasound, and sometimes diagnostic laparoscopy.

Treatment

• Endoscopic resection — for very early cancers.
• Surgery (partial or total gastrectomy) — main curative treatment.
• Chemotherapy before and after surgery — improves cure rates.
• Targeted therapy (HER2+, Claudin 18.2), immunotherapy — selected cases.
• Palliation — symptom control, nutrition, stenting for obstruction, pain management.
• Care at a high-volume gastro-oncology centre matters more than in many cancers.

Prevention

• Treat H. pylori infection when detected — reduces future stomach cancer risk.
• Cut smoked, salted, pickled foods; eat plenty of vegetables and fruit.
• Don't smoke; cut alcohol.
• Endoscopic surveillance for high-risk groups (prior gastric surgery, CDH1 family, pernicious anaemia).
• Population-based endoscopic screening — discussed in high-incidence regions like the north-east, not yet a national programme.