Stomach cancer, also known as gastric cancer, develops when abnormal cells grow uncontrollably in any part of the stomach lining. Over time, these cancer cells can penetrate deeper layers of the stomach and eventually spread beyond the original site. Understanding where and how stomach cancer spreads is essential for early detection, effective treatment, and improving patient outcomes.
Stomach cancer often grows slowly, which means many people do not experience noticeable symptoms in the early stages. By the time symptoms become clear, the disease may have already advanced or spread to nearby or distant organs. This process of spreading is known as metastasis, a key factor that determines the seriousness of the condition, the treatment plan, and the overall prognosis.
Symptoms and Causes
Symptoms
Stomach cancer may remain silent initially, but as it progresses or spreads, symptoms become more noticeable. Common symptoms include:
- Persistent stomach pain or discomfort
- A feeling of fullness even after eating a small amount
- Unexplained weight loss
- Nausea or frequent vomiting
- Indigestion, heartburn, or bloating
- Blood in stool or black, tarry stools
- Loss of appetite and fatigue
When stomach cancer spreads, symptoms may depend on the affected area. For example, liver involvement may cause jaundice, while lung spread may lead to breathing difficulties.
Causes
The exact cause of stomach cancer is not always clear, but several risk factors increase the chances of its development:
- Helicobacter pylori infection (a major risk factor)
- Long-term stomach inflammation
- Smoking and excessive alcohol use
- Frequent intake of salted, smoked, or processed foods
- Family history of gastric cancer
- Obesity
- Certain genetic conditions
While not all risk factors guarantee cancer, they significantly increase the likelihood of abnormal cell growth.
Diagnosis and Tests
Diagnosing stomach cancer and determining whether it has spread requires a series of tests. Each test helps doctors understand the stage of the disease and create a suitable treatment plan.
1. Endoscopy
An upper endoscopy allows the doctor to view the inside of the stomach using a thin, flexible tube with a camera. This is usually the first and most important test. Suspicious areas can be biopsied during the procedure.
2. Biopsy
A biopsy confirms the presence of cancer cells. The removed tissue is examined under a microscope to determine the type and stage of cancer.
3. Imaging Tests
Imaging studies reveal whether and where the cancer has spread. These may include:
- CT scans of the chest, abdomen, and pelvis
- MRI scans for detailed soft-tissue evaluation
- PET scans to detect active cancer cells in distant areas
- Ultrasound, especially endoscopic ultrasound, to assess depth of tumor invasion
4. Blood Tests
Doctors may order blood tests to check for anemia, liver function changes, or tumor markers that indicate cancer spread.
These diagnostic tools help determine how far the cancer has progressed and which organs may be affected.
Management and Treatment
Treating stomach cancer depends on its stage, location, and whether it has spread to other organs. Early-stage cancer has more treatment options, while advanced cancer requires a combination approach.
1. Surgery
If detected early, surgery can remove the tumor completely. Options include:
- Subtotal gastrectomy: removing part of the stomach
- Total gastrectomy: removing the entire stomach
If cancer has spread locally to nearby lymph nodes, these nodes are removed as well.
2. Chemotherapy
Chemotherapy uses drugs to kill cancer cells or shrink tumors. It may be given:
- Before surgery (to shrink tumors)
- After surgery (to destroy remaining cells)
- As the main treatment when cancer has spread widely
3. Radiation Therapy
Radiation targets and destroys cancerous tissue. It is often combined with chemotherapy, especially for advanced cancer.
4. Targeted Therapy
Targeted drugs focus on specific proteins or genetic changes in cancer cells. This type of therapy is beneficial for patients whose cancer expresses certain markers like HER2.
5. Immunotherapy
Immunotherapy helps the body’s immune system recognize and attack cancer cells. It is effective for some advanced or recurrent stomach cancers.
The goal of treatment varies depending on the spread—curing the disease in early stages or controlling symptoms and improving quality of life in advanced cases.
Is there a way to stop stomach cancer from spreading?
Treatments like surgery, chemotherapy and radiation are the only way to stop the spread of stomach cancer. How you utilize those treatments and the order in which you receive them depend on how extensive the cancer has become and how your body responds to treatment.
“For stomach cancers that are very early and localized in an area of the stomach, sometimes, we can use endoscopic treatments,” explains Dr. Lo Menzo. “In later stages when endoscopic treatments are not possible, we tend to use some combination of chemotherapy and/or radiation therapy followed by gastrectomy to remove part or all of the stomach.”
Once the cancer has spread to other locations, like your liver or lungs, your healthcare providers will need to make other interventions to try to treat the cancer in those specific areas.
“Although surgery is an option in some cases, that is not the only curative intervention because we have to target the cancer cells that are now no longer by the original tumor,” he adds.
Relying on chemotherapy and radiation therapy even before surgery can sometimes kill off any of the stomach cancer cells that have already migrated away from the original tumor.
“Most likely, someone will need additional chemotherapy after surgery,” Dr. Lo Menzo stresses.
All of this is to say, treatment options vary and so do their outcomes. Along the way, it’s important that you continue to take care of yourself in other areas of your life. Often, people will make certain lifestyle modifications to help reduce the severity of their symptoms as they go through treatment, and to help improve their quality of life. However you choose to treat the spread of cancer is up to you and your extensive multidisciplinary team of healthcare providers.
Outlook / Prognosis
The prognosis of stomach cancer largely depends on how far the cancer has spread at the time of diagnosis. Early-stage stomach cancer has a significantly higher survival rate because the tumor is confined to the stomach lining. However, once the cancer spreads to nearby tissues, lymph nodes, or distant organs, treatment becomes more complex.
Stomach cancer commonly spreads to:
- Lymph nodes
- Liver
- Lungs
- Pancreas
- Esophagus
- Bones
The earlier the cancer is detected, the better the outcome. Patients diagnosed in the advanced stage can still benefit from modern therapies that slow disease progression, manage symptoms, and improve overall wellbeing.
Continuous research is leading to better diagnostic tools and innovative treatments, giving hope for improved survival rates in the future.
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