The prognosis for stomach cancer can depend on many factors, including how far the cancer has spread and the person’s overall health. Early diagnosis and treatment can help improve outcomes.

Prognosis refers to a doctor’s prediction of how a condition can affect a person and response to treatment.

More than half of stomach cancer cases are curable if the cancer has not spread and a doctor diagnoses it early.

Most of the time, however, a doctor does not diagnose stomach cancer until it has spread. This means the prognosis is often poor.

Overall, 33.3% of people with stomach cancer survive 5 years or longer, according to the National Cancer Institute.

Seeking early care for stomach cancer symptoms, such as bloody vomiting, stomach pain, or frequent gastrointestinal problems, may help a person get the treatment they need to improve their prognosis.

Read on to learn more about stomach cancer prognosis.

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Cancer is unpredictable, and so are treatment results. Some people survive very advanced cancers, while others with early cancers see their cancers metastasize and spread. No formula can conclusively determine a person’s prognosis.

That said, a few important factors can help doctors predict prognosis, including:

Type and stage of stomach cancer

Tumors that test positive for Epstein-Barr virus tend to have a better prognosis because they respond well to treatment.

Well-differentiated intestinal cancer also has a better prognosis than diffuse cancer, which is more aggressive and likely to spread. The long-term survival rates for diffuse cancer are very low, and the cancer almost always returns.

Also, early-stage cancers that have not spread to other body areas have a better prognosis. The portion of the stomach where the cancer is located can also influence prognosis.

Treatment decisions and response

Several treatments are available for stomach cancer, including:

  • chemotherapy
  • targeted therapies
  • surgery
  • radiation

A person’s prognosis is better if they can have surgery. Complete removal of the cancer offers the best prognosis and has a 50% cure rate.

Some people — particularly those with advanced or terminal cancer — may not want to continue treatment, especially if it is painful, time-consuming, or causes side effects that are hard to manage. They may instead choose palliative care or hospice. This often means a shorter life. For some people, however, it improves quality of life.

Even with surgery, long-term cancer remission is unlikely for people with disseminated stomach cancer.

Typically, a person’s response to treatment influences prognosis. For example, people who develop severe side effects and whose cancers do not shrink tend to have a worse prognosis than those who tolerate treatment well while experiencing improvements in their tumors.

Overall health

A person’s health status can determine the following:

  • whether it is safe to have surgery
  • how well they can tolerate treatment
  • how sick the cancer might make them

People in better health at diagnosis often have a better prognosis.

Individual characteristics

Other factors, including age, can impact outlook. For example, older people with gastric cancer are likely to have an increased risk of surgical complications and a poorer prognosis.

The relationship between gender and race in the stomach cancer prognosis is more complex. Further research into how they impact prognosis would be beneficial.

Access to care and treatment

Having access to quality, early treatment may determine prognosis, especially in people for whom financial or other barriers delay a diagnosis.

Doctors determine the cancer stage by taking a sample of the tissue from the site of the suspected cancer and performing a biopsy. They may also take imaging scans of the body to assess for cancer cells.

Stomach cancer staging is a measure of how far the cancer has spread. The TNM system uses three key pieces of information to stage stomach cancer, including:

  • T: the extent of the tumor
  • N: spread to nearby lymph nodes
  • M: metastasis — or spread to distant parts of the body

Below are survival rates based on the TNM stages:

Stage 0

Known also as carcinoma in situ, stage 0 cancer has the highest cure rate. This cancer has invaded only the epithelial tissue, not the deeper tissue of the stomach, and has not spread.

More than 90% of patients will likely survive 5 years or longer with surgical intervention.

Stage I

Type I is localized cancer. Type IA means the cancer is only in the stomach tissue, while type IB means it has spread to one or two local lymph nodes.

With curative surgery, this rate rises to 93.6% for type IA. With neoadjuvant therapies instead of surgery, 5-year survival is 76.5%.

Neoadjuvant approaches refer to treatments that shrink the tumor, for example, chemotherapy or radiation.

Stage II

Stage II means that the cancer has spread to several lymph nodes. Doctors further divide the cancer into subtypes based on specific characteristics.

Type IIA, which has the lowest spread, has the best prognosis with curative surgery, with a 5-year survival rate of 81.8%.

With neoadjuvant therapies alone, 5-year survival for type II is 46.3%.

Stage III

Stage III cancer has spread to nearby regions, or many local lymph nodes.

With curative surgery, the survival rate is 54.2%. However, with neoadjuvant therapies alone, 5-year survival is 18.3%.

Stage IV

Stage IV has the worst prognosis, likely because the cancer has spread to other organs, such as the brain or lungs.

Surgery cannot cure it. However, other treatments may prolong a person’s life. Even with treatment, however, the 5-year survival rate is low.

In the early stages, stomach cancer responds well to treatment, and is often even curable. However, most cancers go undiagnosed until the later stages, when treatment and cure become less likely.

As a result, the overall prognosis for stomach cancer is not favorable, with 5-year survival for all combined types of just 32%.

Every cancer is different, and survival rates are constantly shifting thanks to new treatments. Moreover, each cancer is different, and every person living with cancer has different risk factors.

The most reliable source of information about a person’s prognosis is an oncologist familiar with their situation.