Stomach cancer

A disease with an insidious course and symptoms resembling ordinary indigestion — and with one cause, H. pylori, that can be found and treated.

What it is

Stomach cancer arises from the lining of the gastric wall. Its course is often insidious, with symptoms resembling ordinary digestive complaints.

A meaningful proportion of cases is linked to chronic Helicobacter pylori infection — a cause that can be detected and treated.

Symptoms and diagnosis

Persistent dyspepsia that does not settle, early satiety, difficulty swallowing, unexplained weight loss or iron-deficiency anaemia all justify gastroscopy.

Diagnosis is made by endoscopy and biopsy; staging is completed with CT and, in selected cases, endoscopic ultrasound or laparoscopy.

Biomarkers

HER2 status, PD-L1 expression and microsatellite instability (MSI) largely determine the systemic strategy in advanced disease and open the way to targeted treatment and immunotherapy.

Treatment options

In operable disease, systemic treatment is usually given both before and after surgery. In advanced disease chemotherapy is the backbone, with targeted agents or immunotherapy added according to biomarkers.

Nutritional support is not secondary here — it is part of the treatment.

How this is approached at the practice

Every case is discussed in a multidisciplinary team meeting (MDT) — surgeon, radiation oncologist, pathologist, radiologist and, where needed, psycho-oncologist and dietitian. The treatment decision is not made by one doctor alone.

Before any treatment is proposed, the tumour undergoes full molecular and immunohistochemical characterisation, so the choice targets your specific biology rather than a generic protocol. Every alternative is presented with its trade-offs, and a second opinion is treated as an ally.

Biomarkers tested

Molecular and immunohistochemical characterisation is done before treatment is chosen, so the decision rests on this particular tumour’s biology.

Frequently asked questions

Does H. pylori infection mean I will develop cancer?

No. The infection is very common and the great majority of those carrying it will never develop cancer. Eradicating it does reduce risk, however, and is recommended when it is found.