What Should You Know About Advanced Gastric (Stomach) Cancer?

by Judi Ebbert, PhD, MPH, RN Health Writer

Advanced gastric cancer is a serious disease. That’s because most cases of gastric cancer are diagnosed when the disease has become advanced, or metastatic. That means that by the time it’s discovered, it has already spread to other organs in the body. Read on to understand more about stage 4 gastric cancer.

Man lying on couch with stomach pain.

Its silence can be insidious

Gastric cancer can be silent in the early stage, when it’s localized to the lining of the stomach. Symptoms are sometimes mistaken for other unrelated issues or emerge only after gastric cancer has advanced beyond the lining of the stomach and, often, made its way to other parts of the body.

Doctor holding model of human stomach.

Gastric cancer invades the stomach wall and peritoneal cavity

Gastric cancer can spread by invading the stomach wall, moving into nearby soft tissue and fat and then into organs such as the spleen, pancreas, intestines, liver, and blood vessels. Gastric cancer can spread throughout the entire abdomen, known as the peritoneal cavity. Once cancer cells grow outside of the stomach itself, they can spread to any surface in the abdominal cavity, which contains the stomach, small and large intestines, pancreas, liver, gallbladder, kidneys, and spleen.

Lymphatic system and lymph nodes.

Gastric cancer invades the bloodstream and lymphatic system

Gastric cancer can enter the bloodstream and travel to distant organs to create new tumors. Cancer cells also travel through the lymphatic system, a network of vessels and nodes throughout the body. The stomach wall has lots of blood and lymphatic vessels, making it easy for cancer cells to travel to the liver, pancreas, spleen, and aorta, the main artery that stems from the left ventricle of the heart.

Doctor holding model of esophagus and stomach.

What’s the gastroesophageal junction connection?

The gastroesophageal junction (GEJ) is where the lower part of the esophagus joins the stomach. It’s small in length and subject to inflammation in people who have gastroesophageal reflux (GERD) or infection by the organism known as Helicobacter pylori (a risk factor for gastric cancer). Both conditions, as a result of chronic inflammation, can cause tissue from the stomach to sit above the junction, in the esophagus.

Stomach cancer.

But gastric and esophageal cancers differ

The esophagus is a long muscular tube that connects the throat to the stomach. The esophagus carries food, liquids, and saliva from the mouth to the stomach. The stomach holds food and pumps it into the intestines to start digestion. Esophageal cancer, like stomach/gastric cancer, can be an adenocarcinoma. Esophageal cancers can also be a type known as squamous cell.

Couple drinking shots of alcohol.

Risk factors and symptoms also differ for gastric and esophageal cancers

Risk factors for gastric and esophageal cancers differ. Heavy use of alcohol combined with heavy smoking increase risk for esophageal cancer. Alcohol use and eating a lot of smoked food and nitrates increase risk of gastric cancer. Symptoms of esophageal and stomach cancers also differ. Esophageal cancer causes difficulty in eating, throat discomfort, and fluid accumulation in the chest. Gastric cancer causes stomach pain and loss of appetite.

Woman comforting senior woman friend.

Prognosis matters

Overall survival for people with gastric cancer has improved over the last 30 years, but the five-year survival rate for people with advanced disease is dismal. The five-year survival rate for stomach cancer is 30.6 percent But knowing the prognosis can help you actively engage your health care team to provide supportive care that enhances your quality of life.

Chemotherapy IV.

Treatment should focus on quality of life

Treatment of stage 4 or recurrent gastric cancer may include chemotherapy to lessen symptoms and support quality of life. A targeted therapy known as a monoclonal antibody is also an option. Monoclonal antibody drugs help one’s natural immune system better attack cancer cells. Monoclonal antibodies have various functions, among them flagging, destroying, blocking, and attacking cancer cells. They also can carry other treatments to cancer cells.


Treatment can relieve discomfort

That’s why laser treatment is used to reduce tumor size by focusing a laser beam on the cancer cells. Sometimes treatment involves insertion of a stent to relieve blockage in the stomach. Another approach for relieving blockage is a gastrojejunostomy, which acts as a bypass around the obstruction. Radiation therapy and surgery can be used to shrink a tumor or stop bleeding.

Woman getting information about clinical trials.

Clinical trials are opportunities to explore

Clinical trials are opportunities to try promising new approaches for relieving symptoms and improving quality of life. They may include new ways of combining and delivering therapies to obtain benefits. There are several ways to find clinical trials, and a good start is to discuss them with your oncologist. At the same time, it’s important to proactively search for them using reliable sources such as the National Cancer Institute’s clinical trial search tool.

Support key on computer keyboard.

Supportive care should include a support network

Nothing is more comforting than to have the support of one’s care team, family and friends, and a network of people who are going through the same experience. Websites for organizations dedicated to gastric cancer are a priceless resource for information, services, and the ability to connect to a network of survivors who are sharing their experiences with gastric cancer. See the next slide for links to organizations that are devoted to helping people with gastric cancer.

Child comforting woman with cancer.

Connections are powerful

No Stomach for Cancer offers support to patients and caregivers. All you have to do is pick up the telephone and ask for support. Debbie’s Dream Foundation offers information, support, and resources to search for clinical trials. At Debbie’s Dream, patients can read survival stories and help others by submitting their own story. People can become advocates to ask Congress to invest more federal resources in gastric cancer research. These resources add a dimension of purpose — a way to use one’s disease experience to help others and be helped in the process.

Judi Ebbert, PhD, MPH, RN
Meet Our Writer
Judi Ebbert, PhD, MPH, RN

Judi Ebbert earned her PhD at the University of South Florida’s College of Public Health. She has worked at three NCI-designated comprehensive cancer centers and is a writer/editor at Moffitt Cancer Center. Judi has great interest in chronic disease prevention and treatment, and is an advocate for equitable access to care and optimal quality of life for all people. She loves swimming, her dogs and cats, great food, art, humor, and cinematic thrillers. She’s on Twitter @judithebbert.