Stomach cancer

For a lay person:

Stomach cancer is a cancer that starts in the lining of the stomach. It is more common in East Asia and in older adults, and is linked to long-term Helicobacter pylori infection, smoking and a diet high in salted and smoked foods. Early symptoms such as indigestion are often mild, so it may be found late.

For a trained medical person:

Most cases are adenocarcinomas, intestinal or diffuse type, with H. pylori-associated atrophic gastritis and intestinal metaplasia as key precursors. Diagnosis is by upper endoscopy with biopsy, with CT, endoscopic ultrasound and laparoscopy for staging, and HER2 and other biomarkers guiding therapy. Treatment is endoscopic resection for very early cancer, otherwise gastrectomy with perioperative chemotherapy, and systemic chemotherapy, targeted therapy or immunotherapy for advanced disease.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Disharmony of Liver and Stomach; Spleen and Stomach Deficient Cold; Stomach Heat Damaging Yin; Internal Obstruction of Blood Stasis; Phlegm-Damp Obstructing Stomach; Qi and Blood Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: This needs specialist oncology care; Chinese medicine is adjunctive at most. See a doctor for indigestion with weight loss, difficulty swallowing or persistent vomiting, get urgent care for vomiting blood or black stools, and check herbs with your team during chemotherapy.