Stage 4 stomach cancer is an advanced form of the disease. It occurs when cancer cells have spread from the original tumor in the stomach to distant organs or tissues, such as the liver or lungs.

Symptoms may include abdominal pain, nausea or vomiting, weight loss, bloody stools, and jaundice, which causes yellowing of the skin, eyes, or both.

Doctors find it difficult to treat stage 4 stomach cancer because they can no longer use surgery to cure it. Instead, treatments focus on controlling and preventing the growth of tumors, relieving pain and other symptoms, and improving quality of life.

Treatment typically involves a combination of chemotherapy and radiation therapy and surgery to remove tumors causing blockages or other issues.

This article provides an overview of the symptoms, treatment, and outlook of stage 4 stomach cancer.

A black and white image of a person's abdomen.Share on Pinterest
Oppie Muharti/EyeEm/Getty Images

Cancer staging is the process of determining the extent and severity of cancer in a person’s body. The cancer stage is important in determining the most appropriate treatment and predicting the individual’s outlook.

Staging typically involves a combination of imaging studies, physical examinations, and laboratory tests to determine the size of the tumor and if it has spread to nearby lymph nodes or other organs.

There are several staging systems, but doctors typically use the American Joint Committee on Cancer TNM system for stomach cancer. The TNM system considers three factors:

  • Tumor (T): This describes the extent of the primary tumor, including how far it has grown into the stomach wall tissue and if it has reached nearby structures or organs.
  • Nodes (N): This describes whether or not cancer has spread to nearby lymph nodes.
  • Metastases (M): This describes any spread of the disease to distant organs, such as the liver or lungs.

Each classification has a score according to its severity. A doctor then considers these scores to assign a stage to the cancer that indicates how advanced it is.

Stage 4 stomach cancer is the most advanced and metastatic stage.

This means that the original tumor has spread to other distant organs and parts of the body, and surgical removal is no longer an option. Metastases, which refer to the spread to other organs, define stage 4 cancer.

Even if the original tumor has not grown into the lower layers of the stomach wall or spread to nearby lymph nodes, doctors classify it as stage 4 if it spreads to any distant site.

In stage 4 stomach cancer, individuals may experience the following symptoms:

  • bloody stool
  • vomiting
  • unintentional weight loss
  • severe stomach pain
  • jaundice — yellowing of the eyes, skin, or both
  • a buildup of fluid in the abdomen, or ascites
  • difficulty swallowing and eating

Depending on where the cancer has spread, people with stage 4 stomach cancer may experience other symptoms, such as difficulty breathing or bone pain.

The duration of stage 4 stomach cancer is difficult to predict and varies greatly from person to person. Cancer statistics derive from large groups of individuals and are not specific.

Every person’s situation is unique, and some respond better to treatment than others. Furthermore, cancer treatments and individualized care advances can improve outcomes for many.

Stage 4 stomach cancer is difficult to cure, and treatments aim to control cancer and relieve symptoms.

Doctors may use chemotherapy to control the growth of cancer. They may also recommend immunotherapy or radiation therapy if the person is healthy enough to tolerate them.

If someone has intestinal blockages or bleeding, doctors may suggest palliative surgery, such as a gastric bypass, to minimize pain, difficulty eating, or other symptoms.

Alternatively, they may use endoscopic procedures instead of open surgery. This involves passing a long, flexible tube down the throat and into the stomach.

Because stomach cancer can lead to eating problems, a person may also need a feeding tube. This thin tube runs through the nose, throat, and stomach to directly deliver nutrition and hydration.

Stage 4 stomach cancer has spread to distant sites, meaning the outlook is generally unfavorable. Around 6% of people with stage 4 of this disease survive for 5 years or more after diagnosis.

However, treatment and supportive care can help people manage their symptoms and may improve their likelihood of survival.

It is important to remember that prognosis can vary from person to person, depending on the individual’s health, age, response to treatment, and other factors. People should speak with their doctor about their specific outlook.

Stage 4 stomach cancer is an advanced form of the disease that has spread to other organs or parts of the body. Cancers of this stage are difficult to cure, and treatment focuses on controlling the effects of cancer and managing symptoms.

People should speak with a doctor about their outlook to ask if any emerging treatments can provide relief.