Advanced Stomach Cancer

Advanced Stomach Cancer

Advanced stomach cancer—also called advanced gastric cancer—refers to cancer that has grown deep into the stomach wall, spread to nearby lymph nodes, or travelled to distant organs such as the liver, lungs, or lining of the abdomen. At this stage, treatment becomes more complex, and the focus often shifts from cure to control, symptom relief, and the extension of quality of life.

Understanding the Disease

Stomach cancer usually develops slowly over many years. It often begins with subtle changes in the stomach lining, sometimes linked to chronic inflammation, Helicobacter pylori infection, smoking, heavy alcohol use, obesity, or long-term dietary patterns high in salty and smoked foods. In the early stages, it may cause mild or no symptoms, which is why many cases are diagnosed late.

Advanced disease means the cancer has moved beyond the earliest layers. Doctors classify this using staging systems (Stage III or IV in many cases). Stage IV typically indicates spread to distant organs (metastasis).

Common Symptoms

Symptoms of advanced stomach cancer can be more noticeable and may include

Persistent abdominal pain or discomfort

Difficulty swallowing (if the upper stomach is involved)

Feeling full quickly after eating small amounts

Unintentional weight loss

Nausea or vomiting, sometimes with blood

Black or tarry stools (due to bleeding)

Fatigue from anaemia

Because these symptoms overlap with common digestive problems, many people delay seeking care until the disease has progressed.

Diagnosis usually involves

Endoscopy: A flexible camera is passed into the stomach to visualise and biopsy suspicious areas.

Imaging tests such as CT scans, PET scans, or MRI scans help determine how far the cancer has spread.

Biopsy and molecular testing: The tumour tissue is analysed for specific markers such as HER2 status, PD-L1 expression, or genetic mutations. These markers guide treatment decisions.

Modern oncology increasingly relies on molecular profiling. Knowing whether a tumour expresses HER2, for example, can open the door to targeted therapy.

Treatment Options

While early stomach cancer may be treated with surgery alone, advanced cases typically require a combination approach.

Chemotherapy

Chemotherapy remains the backbone of treatment. It can shrink tumours, slow progression, and relieve symptoms. In advanced stages, chemotherapy is often given systemically to target cancer cells throughout the body.

Targeted Therapy

If the tumour tests positive for certain markers (like HER2), targeted drugs may be added. These medications are designed to attack specific molecules involved in cancer growth, potentially improving outcomes compared to chemotherapy alone.

Immunotherapy

Immunotherapy helps the body’s immune system recognise and attack cancer cells. Drugs known as immune checkpoint inhibitors have shown benefit in selected patients, especially when PD-L1 levels are elevated or specific genetic features are present.

Palliative Care

Palliative care is not just end-of-life care. It focuses on symptom management—pain control, nutritional support, managing nausea, and improving overall comfort. In advanced stomach cancer, early integration of palliative care improves both quality of life and sometimes survival.

Surgery (Selective Cases)

Surgery is less common in widely metastatic disease but may be considered in specific situations, such as relieving obstruction or controlling bleeding.

Nutrition and Quality of Life

Nutrition becomes a major concern. Many patients struggle with appetite loss, early satiety, or difficulty digesting food. Smaller, more frequent meals, high-protein supplements, and soft foods are often recommended. In some cases, feeding tubes or intravenous nutrition may be necessary.

Maintaining muscle mass and strength is important. Light physical activity, when possible, helps reduce fatigue and maintain independence. Emotional support is equally crucial—advanced cancer brings psychological stress for both patients and families.

Prognosis

Prognosis depends on many factors: stage, overall health, response to treatment, tumour biology, and access to modern therapies. While advanced stomach cancer has historically carried a poor survival rate, newer targeted treatments and immunotherapies are gradually improving outcomes.

Each patient’s journey is unique. Some respond well to treatment and achieve months or even years of stable disease. Others may have a more aggressive progression.

Prevention and Early Detection

Although this article focuses on advanced disease, prevention matters. Treating H. pylori infection, avoiding smoking, moderating alcohol, maintaining a healthy weight, and consuming a diet rich in fruits and vegetables may lower risk. In high-risk regions, screening programs have significantly improved early detection rates.

Final Thoughts

Advanced stomach cancer is a serious diagnosis, but it is not without options. Treatment today is more personalised than ever, guided by tumour biology and patient-specific factors. The goal is not only to extend life but to preserve dignity, comfort, and meaningful time.

Facing advanced cancer requires a multidisciplinary team—oncologists, surgeons, nutritionists, palliative care specialists, and mental health professionals. With coordinated care, patients can navigate this challenging stage with better support and informed decision-making.