While some instances of stomach cancer are incurable, individual outlooks depend on the size, stage, and general health of the person. Early detection and a favorable response to treatment will help to increase a person’s chances of curing stomach cancer.

Stomach cancer, or gastric cancer, is a disease where malignant (cancerous) cells develop in the lining of the stomach. According to the World Health Organization (WHO), in 2020, there were approximately 1.1 million new instances of stomach cancers worldwide.

Most diagnoses of stomach cancer, around 90–95%, are adenocarcinomas. This type of stomach cancer develops in the glands of the stomach lining. These are responsible for the production of mucus.

In this article, we discuss the outlook for people with stomach cancer, including management and treatment options.

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Stomach cancer is curable if a person can receive a diagnosis in the early stages. The success of treatments depends highly on the stage of cancer at the point of diagnosis.

The stages of stomach cancer, according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, include:

  • Localized: No indication that cancer is developing outside of the stomach.
  • Regional: Cancer develops in nearby structures, such as lymph nodes.
  • Distant: Cancer reaches organs distantly outside the stomach, such as the liver.

However, it is unlikely that a person will experience symptoms of stomach cancer in the early stages. This makes receiving an early diagnosis difficult.

Curing stomach cancer can involve several types of treatment.

Learn more about the stages of stomach cancer here.

An oncologist is a specialist doctor who will guide a person through a cancer diagnosis.

The type of treatment an oncologist will recommend to a person with stomach cancer depends on the location of the cancer within the stomach, as well as the extent of any spread, or metastasis.

Surgery

Surgery can be a method for both eliminating cancer and managing symptoms if it is not removable completely.

If an oncologist confirms that surgery may be successful in removing cancer, it can be one of the following procedures: Upper endoscopy or gastrectomy.

Upper endoscopy is suitable while cancer is in the early stages and is mainly in the upper layers of the stomach. Cancer removal in this procedure involves cutting the tumor from the stomach wall and removing it through a person’s mouth.

Gastrectomy is suitable when cancer spreads beyond the stomach lining. It involves removing sections of a person’s stomach.

Subtotal gastrectomy removes a section of the stomach, while total gastrectomy removes the entire organ. In this instance, the surgeon will attach the esophagus to the small intestine so that the digestive system remains functional. A person with a total gastrectomy will have to eat less food at a time but more frequently.

During a gastrectomy, the surgeon may remove a person’s nearby lymph nodes.

Chemotherapy

Chemotherapy uses anticancer medications, which a doctor either injects through an intravenous (IV) line or delivers by oral tablets. For stomach cancer, chemotherapy is useful at different stages:

  • Before surgery: This is neoadjuvant treatment and is where chemotherapy shrinks tumors to increase the likelihood that surgery will be successful. It can help to increase survival rates and prevent cancer from returning.
  • After surgery: This is an adjuvant treatment. It kills any cancer that a surgeon may leave behind after surgery, which was perhaps too small to see during the procedure.
  • As a primary treatment: This is suitable if cancer spreads to distant body regions. This is typically palliative or end-of-life care with the primary purpose of relieving symptoms and elongating survival.

Learn about the possible side effects of chemotherapy here.

Radiation therapy

Radiation therapy uses powerful rays to destroy cancer cells in certain regions of the body.

Cycles of this treatment target regions of the body from different angles, which helps to focus the radiation on the cancer cells and limit damage to healthy tissues.

Learn the differences between radiation and chemotherapy here.

Newer treatments

Newer treatments — immunotherapy and targeted drug therapy — work differently from other anticancer medications and procedures.

Immunotherapy involves medicines that encourage the body’s immune cells to attack only cancer cells. Doctors typically reserve immunotherapy for late stages of stomach cancer. It takes place in cycles every few weeks. Examples include nivolumab (Opdivo) and pembrolizumab (Keytruda).

Targeted drug therapy targets specific proteins that the cells of cancerous tumors produce. Some target the blood vessels where cancer cells grow as they increase in size. IV infusion delivers these medications. They include trastuzumab (Herceptin) and ramucirumab (Cyramza).

Learn more alternatives to chemotherapy here.

If a person’s condition is too far advanced for treatments to be successful, or their doctor does not think they would withstand the side effects, then palliative care is the next step in managing their condition.

This is specialist care that aims to make a person the most comfortable they can be, prioritizing symptom relief.

Due to the typically late-stage diagnosis for people with stomach cancer, the outlook is generally poor. The 5-year relative survival rate for early stage stomach cancer is 72%, according to the American Cancer Society. However, this reduces as the stages get more aggressive.

As cancer spreads further from the stomach, the survival rate reduces to 6%. It is because of this that early diagnosis is so important. Recognizing the early symptoms and undergoing regular screening are two ways to help catch stomach cancer early.

Learn more about the outlook for stomach cancer here.

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.

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If a person receives a prompt diagnosis of stomach cancer before it spreads out of their stomach, they have a higher chance of eliminating it. However, if it is in an advanced stage, successful treatment is more difficult.

New treatments such as immunotherapy and targeted drug therapy provide more effective treatment than ever before, particularly for advanced conditions.

A person’s doctor will assess the location and size of the cancer and assess the person’s overall health to determine the best treatment.