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(A-Z listing includes diseases, conditions, tests and procedures)

Stomach (Gastric) Cancer

Gastric cancer, or stomach cancer, is cancer that originates in the stomach. The most common type of gastric cancer is adenocarcinoma, which starts in the lining of the stomach.

A: Early gastric cancer; B: Endoscopic view.
A: Early gastric cancer; B: Endoscopic view. (Click to enlarge)

Gastric Cancer Symptoms

Many patients receive a diagnosis of gastric cancer at a late stage, because the cancer may not cause any symptoms in its early stage. Some of the symptoms are similar to other, less serious conditions. See a gastroenterologist if you experience any of the following symptoms for more than two weeks:

  • Unexplained weight loss

  • Abdominal pain, nausea and vomiting

  • Loss of appetite

  • Difficulty or painful swallowing

Gastric Cancer Diagnosis at Johns Hopkins

During your appointment, your doctor will ask you about your medical history and perform a thorough physical examination. This will provide your doctors with many important details, such as anemia, blood in the stool and weight loss. You will have blood tests as well.

Other diagnostic procedures include:

  • Endoscopy with Biopsy

  • Endoscopic Ultrasound

    TNM staging of gastric cancer, showing depth of invasion.
    TNM staging of gastric cancer, showing depth of invasion. (Click to Enlarge)

Endoscopy with Biopsy

Endoscopy provides the most specific and effective means of diagnosing gastric cancers. During an endoscopy, your doctor can see the esophagus, stomach and most of the small intestine.

During an endoscopy:

  1. You receive anesthesia and will be asleep during the procedure.

  2. You lie on your left side.

  3. The doctor uses an endoscope, which is a thin, lighted tube with a tiny camera at its tip. It is passed through your mouth and pharynx and into the esophagus.

  4. The endoscope transmits an image of the esophagus, stomach and first part of the small intestine (duodenum) to a monitor for your doctor to view.

  5. Your doctor performs a biopsy, which is removing part of the abnormal tissue and sending it to the lab for analysis. Biopsy provides a definitive diagnosis.

You may undergo an endoscopy after your diagnosis, in order to stage the cancer and establish treatment goals.

Double-snare technique for endoscopic mucosal resection of early gastric cancer.
Double-snare technique for endoscopic mucosal resection of early gastric cancer. (Click to Enlarge)


Endoscopic Ultrasound

An endoscopic ultrasound (EUS) combines the endoscope with an ultrasound to provide images and information about your digestive tract. An ultrasound uses sound wave technology to provide detailed images. EUS can establish how deep the tumor is and whether the cancer has metastasized (spread).

Gastric Cancer Treatment at Johns Hopkins

Ongoing research has led to the identification of new risk factors and treatment. Advanced endoscopic techniques lead to earlier detection of gastric cancer, which means the cancer is easier to treat. The most effective treatment method for patients with gastric cancer is curative resection, which is surgery to remove the cancer. The exact type of surgery you have will depend on where the cancer is located. Your surgeon may remove the entire stomach or only the cancerous section. Learn more about treatment for gastric cancer at Johns Hopkins.

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