Signs and Symptoms of Stomach Cancer

Updated on 2024-03-26 10:30:14 0 0

By Jaime R. Herndon, MS, MPH

Medically reviewed by Oliver Eng, MD

The signs and symptoms of stomach cancer, also known as gastric cancer, can range from blood in the stool to abdominal pain. For many people, though, there are no symptoms of stomach cancer, especially in its early stages. Symptoms may also be so vague or non-specific and easily mistaken for other conditions or everyday stomach issues.

Depending on the type of stomach cancer you have, as well as the stage of disease, symptoms can vary. There are also many other reasons for different signs and symptoms, so it's important to remember not to panic.

Keep reading to learn more about stomach cancer's signs and symptoms. Call your healthcare provider if you have persistent or recurrent symptoms or feel something isn't right. They can do an exam and get to the bottom of what may be causing your symptoms.

Symptoms alone cannot diagnose stomach cancer. Only an investigation by a healthcare provider, which may involve imaging studies and a biopsy, can definitively diagnose the disease.

This article explains the seven symptoms commonly experienced in people with stomach cancer.

Blood in the Stool

Bloody stool can be a symptom of stomach cancer. However, it can occur with other noncancerous conditions as well. The color of blood in the stool often provides vital clues about the origin of bleeding.

Bright red blood in the stool, also known as hematochezia, is generally not a sign of stomach cancer. When the blood is bright red, the bleeding occurs nearer to the rectum rather than farther up in the gastrointestinal tract.1

Bright red blood may indicate different conditions, including:2

Cancer in the colon or rectum (colorectal cancer)
Anal fissures (a tear in the anus)
Ulcerative colitis (a form of inflammatory bowel disease)

Blood in the stool is not always visible. Your stool can contain trace amounts of blood that only a test, such as the fecal occult blood test (FOBT), can reveal.

Recap

Blood in the stool can indicate many things, including stomach cancer. Bright red blood is more likely to show bleeding lower than the stomach and is, therefore, less likely to be caused by stomach cancer.

Abdominal Pain

Abdominal pain is one of the most common signs of stomach cancer. Moreover, it is often the symptom that prompts people to seek medical attention.3

Symptoms can range from persistent mild discomfort to severe pain. The pain and discomfort generally occur in the upper abdomen area.

With that said, because the body delivers nerve signals to the brain, where you feel pain doesn't necessarily reflect the source of the pain. For example, stomach pain can sometimes occur due to problems with the liver, esophagus, pancreas, and other organs.

Abdominal pain has many possible causes that are far more common than stomach cancer. These include:4

Stomach flu
Gastritis (stomach lining inflammation)
Pancreatitis (pancreas inflammation)
Gastroesophageal reflux disease (GERD) (also called acid reflux and heartburn

Other cancers involving abdominal pain include pancreatic, liver, bile duct, and gallbladder cancer.

Regardless of where it occurs, it would be best if you had persistent abdominal pain evaluated by a healthcare provider. Chronic symptoms should never be ignored and may require an endoscopic exam to uncover the cause.

Recap

Abdominal pain is a common symptom of stomach cancer, usually felt in the upper abdomen. However, other conditions are often to blame, including stomach flu, gastritis, pancreatitis, and GERD.

Persistent Nausea or Vomiting

Nausea and vomiting are also common symptoms of stomach cancer. While many other conditions cause nausea or vomiting, the persistence of symptoms is generally a sign of a more serious medical condition.3

If symptoms are ongoing or you vomit blood—even if just a tiny amount—make an appointment to see your healthcare provider immediately. Bloody vomit, also known as hematemesis, may be a sign of cancer or a noncancerous condition, including:

Peptic ulcer5
Severe GERD6
Esophageal varices (varicose veins in the esophagus)7

Bleeding from the stomach can also give vomit a coffee ground-like appearance. This kind of bleeding is more typical when stomach cancer is advanced. However, it can also result from conditions affecting the esophagus or other parts of the upper gastrointestinal tract.

A gastric hemorrhage is a medical emergency. If you are vomiting a large amount of blood—more than a few teaspoons—go to the emergency room.

Recap

Persistent vomiting and nausea, especially with blood, can signify stomach cancer. It can also indicate other non-cancerous conditions, such as peptic ulcer, severe GERD, and conditions affecting the esophagus. Always seek medical attention if you vomit blood.

Loss of Appetite

It's not uncommon to lose your appetite for a day or two, but if you don't feel like eating for more than a few days, see your healthcare provider. Although stomach cancer is one of many conditions that can cause a loss of appetite, the persistent loss of appetite should raise concerns.

In addition, people with stomach cancer may also experience early satiation, in which you feel full after eating only a few bites.3

Cancer can change the body's metabolism and increase the production of inflammatory cytokines (proteins that act as messengers between cells). These changes can affect the chemical messengers, called neurotransmitters, that influence appetite. If the tumor grows, it can also reduce the functional size of the stomach, making you feel prematurely full.8

Unexpected Weight Loss

The persistence of these symptoms can lead to unintentional extreme weight loss, a condition referred to as cachexia. This kind of weight loss is common in people with advanced cancer.8

Call your healthcare provider if you have lost more than 5% of your normal body weight during six months or less and haven't been dieting or exercising.9 Unintentional weight loss is a key symptom of advanced cancer.

Recap

Loss of appetite is a common occurrence for most people occasionally. However, persistent lack of appetite or feeling full too fast can signify stomach cancer. So, if it persists or you are unintentionally losing weight, see a healthcare provider for an evaluation.

Bloating

Abdominal bloating can be a symptom of stomach cancer, primarily when it occurs after meals.3 Even so, bloating is frequently missed in people with stomach cancer because it is a symptom of other, more common causes, including:

Indigestion
Constipation
Menstruation

Heartburn or Acid Reflux

Similarly, heartburn is more often related to conditions like acid reflux and GERD but can also signify stomach cancer. The bacteria H. pylori is not only linked to GERD and peptic ulcers but significantly increases the risk of stomach cancer.10

On the flip side, chronic acid reflux can lead to a condition called Barrett's esophagitis which, in turn, increases the risk of esophageal cancer.11

Recap

Many everyday things can cause bloating and heartburn, but they can also be a symptom of stomach cancer. In addition, chronic reflux can increase the risk of some cancers, including stomach cancer.

Persistent Fatigue

Fatigue that lasts more than a few days or weeks may suggest a medical concern. For example, with stomach cancer, fatigue is often related to anemia (low red blood cells) due to blood loss in the stool.

At the same time, being under the burden of chronic inflammation can trigger fatigue—a phenomenon common in people with cancer, autoimmune diseases, and neurodegenerative disorders like Huntington's and Parkinson's disease.12

Cancer-related fatigue is different than fatigue associated with exhaustion, depression, or acute illness. It is the kind of fatigue that doesn't improve with a good night's rest or other common interventions.

Cancer-related fatigue often develops gradually, and it may help to think back six to 12 months to compare your energy levels. However, persistent fatigue is not "normal" even if cancer is not the cause.

Recap

Chronic fatigue may be a sign of stomach cancer and other health conditions. Therefore, you should always have persistent fatigue evaluated by a healthcare provider.

Summary

Stomach cancer can have multiple symptoms. However, many of these symptoms are also signs of other, more common conditions. Symptoms that could mean stomach cancer include bloody stools (predominantly black and tarry stools), abdominal pain, bloating and heartburn, loss of appetite, fatigue, and nausea and vomiting. See your healthcare provider if you're having symptoms that are out of the ordinary, especially if they persist.

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Walsh CJ, Delaney S, Rowlands A. Rectal bleeding in general practice: new guidance on commissioning. Br J Gen Pract. 2018;68(676):514-515. doi:10.3399/bjgp18X699485

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Bharucha AE, Chakraborty S, Sletten CD. Common functional gastroenterologic disorders associated with abdominal pain. Mayo Clin Proc. 2016;91(8):1118-1132. doi:10.1016/j.mayocp.2016.06.003

Laine L. Upper gastrointestinal bleeding due to a peptic ulcer. Solomon CG, ed. N Engl J Med. 2016;374(24):2367-2376. doi:10.1056/NEJMcp1514257

Riley CA, Wu EL, Hsieh MC, Marino MJ, Wu XC, McCoul ED. Association of gastroesophageal reflux with malignancy of the upper aerodigestive tract in elderly patients. JAMA Otolaryngol Head Neck Surg. 2018;144(2):140.doi:10.1001/jamaoto.2017.2561

National Institutes of Health. Bleeding esophageal varices.

Ezeoke CC, Morley JE. Pathophysiology of anorexia in the cancer cachexia syndrome. J Cachexia Sarcopenia Muscle. 2015;6(4):287-302. doi:10.1002/jcsm.12059

Yoon SL, Kim JA, Kelly DL, Lyon D, George TJ. Predicting unintentional weight loss in patients with gastrointestinal cancer. Journal of Cachexia, Sarcopenia and Muscle. 2019;10(3):526-535. doi:10.1002/jcsm.12398

Kim JJ. Upper gastrointestinal cancer and reflux disease. J Gastric Cancer. 2013;13(2):79–85. doi:10.5230/jgc.2013.13.2.79

Harris C, Croce B, Munkholm-Larsen S. Esophageal cancer. Ann Cardiothorac Surg. 2017;6(2):190. doi:10.21037/acs.2017.03.01

Omdal R. SP0059 CNS effects of inflammation: the brain and fatigue. Ann Rheum Dis. 2015;74:16. doi:10.1136/annrheumdis-2015-eular.6791