An NCI-designated Comprehensive Cancer Center
By H. Chung So | January 7, 2016

Early-stage stomach cancer is curable – and getting more curable all the time. Better detection gets the credit for that. So does increased knowledge of risk.

Yanghee Woo, M.D., the director of City of Hope’s Gastroenterology Minimally Invasive Therapy Program, and director of international surgery, is committed to improving the current picture even further. 

Here, Woo shares the three most important things she would like people to know about the symptoms and treatment of stomach cancer, including seven high-risk factors:

1. Early detection is key.

Successful treatment starts with early detection. Unfortunately, in the beginning, gastric cancer does not have specific “alarm” symptoms. Moreover, the United States lacks routine screening. As a result, most cases of stomach cancer are diagnosed in the advanced stages.

That’s why it’s important for people to know their risk for stomach cancer. High-risk factors include:

  • Sex: Men are twice as likely to develop stomach cancer.
  • Race and ethnicity: In the U.S., Korean-Americans have the highest stomach cancer risk among all ethnic groups. African-Americans, Latinos and other Asian-Americans also have an elevated risk of developing stomach cancer.
  • Helicobacter pylori infection: H. pylori infection, a type of bacterium, is found in the majority of stomach cancer patients.
  • Atrophic gastritis: This chronic inflammation of the stomach lining can lead to the development of non-normal cells. Over time, those cells can develop in to cancer. 
  • Genetics: Parents, siblings or children of a stomach cancer patient have a higher risk of developing the disease.   
  • Diet: A diet high in salted, pickled, smoked or preserved foods is linked to a higher stomach cancer risk. Conversely, a diet high in fruits and vegetables is linked to a lower risk.
  • Smoking: Cigarettes, which contain more than 43 known cancer-causing agents and 400 other toxic substances, are associated with increased risk of developing gastric cancer.

Anyone at high risk should talk to his or her physician about risk assessment. This can include an upper endoscopy screening, which can help ensure timely detection and treatment. People at high risk should also consider signing up for City of Hope’s gastric cancer registry, meant to improve stomach cancer detection and treatment.

People at high risk also need to be vigilant about seeking medical attention when they have symptoms associated with stomach cancer, such as dark or bloody stool, persistent feeling of fullness or bloating, unexplained weight loss, abdominal pain, or persistent heartburn, nausea, indigestion, diarrhea or constipation.

2. An accurate diagnosis is crucial.

To ensure the correct treatment and surgery, patients must get an accurate diagnosis. This includes identifying the stage at which the cancer has been diagnosed. 

This process starts with an upper endoscopy and biopsy, which must be performed by an experienced gastroenterologist. If the biopsy reveals cancer, a staging work-up with endoscopic ultrasound will determine the extent of the disease, including the depth of tumor invasion into the stomach wall, and whether the disease has spread to the lymph nodes. In addition, imaging studies, including a CT scan of the abdomen and pelvis and chest, or a PET CT, will evaluate for disease in the lymph nodes and other organs. 

3. Comprehensive, expert cancer care makes the difference. 

Proper treatment of gastric cancer significantly improves quality of life, as well as long-term survival. 

Such care can be found at comprehensive cancer centers like City of Hope. Here, multidisciplinary teams of specialists work together based on individual patients’ needs. Those specialists combine the latest research with the most advanced therapies to produce the best results.  

City of Hope is known worldwide for precisely this type of care.


Learn more about City of Hope's stomach (gastric) cancer program and research. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

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