Does Stomach Cancer Pain Come and Go?

A classic stomach cancer pain is felt as a dull ache in the middle of the stomach. The pain may have certain aggravating and relieving factors.

Stomach cancer, also known as gastric cancer, develops in the lining of the stomach. Stomach cancer tends to develop slowly over many years. Recovery from stomach cancer is better if diagnosed and treated in the early stages.

The average 5-year survival rate:

• is about 68 percent for a person who receives treatment before cancer spreads.
• reduces by 31 percent if the cancer spreaders or metastasizes into deeper tissues of the stomach.
• drops to 5 percent if cancer has spread to distant organs.

The early stages rarely cause symptoms so are often undetected. Some common symptoms experienced in stomach cancer are abdominal (stomach) pain, heartburn, nausea, loss of appetite, and indigestion. The pain associated with stomach cancer is usually persistent and "gnawing;” it can worsen over time. A classic stomach cancer pain is felt as a dull ache in the middle of the stomach. The pain may have certain aggravating and relieving factors. Cold foods, such as iced drinks or ice cream, may offer temporary respite from the pain. In some patients, the pain may be constant.

The exact cause of stomach cancer is not known. Stomach cancer begins when genetic mutations or changes in deoxyribonucleic acid (DNA) occur in the stomach cells. These changes in DNA cause the normal healthy cells to become cancerous and grow out of control, forming a tumor that invades and destroys healthy tissue.

Risk factors of stomach cancer:

Factors that can increase the risk of stomach cancer include:

• Infection by the bacterium Helicobacter pylori, which causes ulcers (accounts for more than 60 percent of stomach cancer cases)
• Chronic gastritis (stomach inflammation) due to any cause
• Stomach surgery for an ulcer
• Pernicious anemia
• Intestinal metaplasia (stomach lining is replaced with intestine lining)
• Stomach polyps
• Tumors in other parts of the digestive system
• Epstein-Barr virus infection
• Family history of stomach cancer
• Genetic syndromes, such as familial adenomatous polyposis, Lynch syndrome, Li-Fraumeni syndrome
• Type A blood
• Gastroesophageal reflux disease
• Obesity
• Diet high in salted, processed, pickled, or smoked foods
• Diet low in fruits and vegetables
• Eating food, which is not prepared or stored properly
• Lack of exercise
• Adults over 50 years of age
• Male gender
• Smoking
• Working in coal, metal, timber, or rubber industries
• Exposure to asbestos

Early signs and symptoms include:

• Heartburn
• Constant belching
• Gnawing or sharp abdominal pain
• Nausea
• Loss of appetite
• Indigestion
• Stomach discomfort
• Feeling bloated after meals
• Pain in the breastbone
• Trapped wind

Later stage signs and symptoms include:

• Worsening stomach pain
• Difficulty swallowing
• Weight loss
• Loss of appetite
• Anemia
• Fatigue
• Jaundice (yellowing of skin and eyes)
• Vomiting
• Blood in the stool
• Ascites (fluid build-up in abdomen)

Stomach cancer is staged based on the growth of cancer within the stomach and other parts of the body:

• Stage 0: Abnormal cancer cells are found in the mucosa (inner lining) of the stomach wall.
• Stage I: Tumor is found in situ (within the stomach) and cancer cells may have spread to one or two lymph nodes.
• Stage II: Spread of cancer to deeper layers of the stomach and nearby lymph nodes.
• Stage III: Spread of cancer to all layers of the stomach, more lymph nodes, and nearby organs, such as the spleen, pancreas, adrenal gland, abdomen wall, small intestine, colon, abdomen wall, diaphragm, or kidney.
• Stage IV: Spread of cancer to other parts of the body (metastasize), such as the lungs, bones, liver, lining of the abdomen, and distant lymph nodes. A cure is rarely possible at this stage.

Treatment for stomach cancer depends on several factors, including the site of the tumor, the extent to which the cancer has spread, and the patient’s health and preferences.

5 Treatments options include:

• Surgery: The tumor and healthy tissues around it are removed surgically to ensure that no cancer cells remain. Types of surgeries include:
  • Endoscopic mucosal resection: Endoscopy is used to remove tiny tumors in early-stage cancer.
  • Subtotal gastrectomy: Part of the stomach is removed.
  • Total gastrectomy: The whole stomach is removed.
• Chemotherapy: Chemotherapy uses cytotoxic medicines to stop cancer cells from dividing and multiplying. Chemotherapy may be used to shrink the tumor before surgery or kill the remaining cancer cells after surgery.
• Radiation therapy: Radioactive rays are used to target and kill cancerous cells. It may be used along with chemotherapy.
• Targeted medications: Targeted medications are administered through intravenous (IV) infusion to attack specific proteins produced by cancer cells. The medicines are:
  • Herceptin (trastuzumab) targets the HER2 protein that promotes cell growth.
  • Cyramza (ramucirumab) blocks VEGF protein to prevent the production of new blood vessels needed by tumors to grow.
• Immunotherapy: This treatment encourages the body’s immune cells to recognize and destroy cancer cells.