Symptoms and Diagnosis

In this section we’re going to take a look at:

Remember, everyone is different and your symptoms and experience may be different from that described below. If you have any further questions, be sure to ask your medical professional.


People with early stage stomach cancer can often have no symptoms so the disease goes unnoticed until it spreads to other parts of the body. However, some of the symptoms which can be apparent in the early stages are:

  • Feeling full after eating a small meal
  • A Swollen abdomen
  • Indigestion or heartburn
  • Loss of appetite
  • Losing weight
  • Nausea
  • Pain or tenderness in the abdomen
  • Reduced red blood cell count
  • Vomiting (with or without blood).

Many of these symptoms can be signs of a non-cancer related condition. Be sure to visit your doctor if you have any of these symptoms.

A Diagnosis of Stomach Cancer

A diagnosis of stomach cancer usually begins with a visit to your GP to check out your symptoms. Your GP is likely to ask you a range of questions about your current and previous health, including questions about your eating habits and any pain you may be experiencing.

Other possible tests include:

  • An abdomen examination: Your doctor will examine your stomach and abdomen to check for any abnormalities
  • Blood tests:A blood sample may be taken to check your general health and to see whether you’re anaemic or have a low red blood cell count (which can sometimes be a sign of stomach cancer).
  • Endoscopy: This is procedure is sometimes also called a gastroscopy. A doctor will insert an endoscope, or thin flexible tube with a video camera attached, down your throat and into your stomach to examine your oesophagus, stomach and the beginning of the small bowel. The procedure can sometimes be uncomfortable, but is not painful.
  • Biopsy: During the endoscopy your doctor may take some tissue samples to determine whether there are any cancer cells present.
  • Endoscopic ultrasound: This is an ultrasound done using an endoscope and gives your doctor good images of the extent of cancer within the stomach.
  • Imaging tests:These are tests which allow your doctor to get a better picture of any tumour in your stomach or oesophagus. There are a number of scans you could have including:
    • An x-ray
    • A CT scan or computerised x-ray
    • An MRI scan
    • A PET scan
  • Laparoscopy: This is a small operation in which the surgeon inserts a thin tube with a tiny video camera (a laparoscope) near the belly button. The surgeon may also take tissue samples during this procedure.

Stage and Grade of Stomach Cancer

The results of your biopsy will be used to determine what stage and grade of stomach cancer you have.

The “grade” of cancer is simply a measure of how different the cancer cells are compared with normal cells.

There are three grades of stomach cancer:



Grade 1

The cells are still quite similar to normal stomach cells and are slow growing.

Grade 2

The cells are slightly different to normal stomach cells and are faster growing.

Grade 3

The cells are very different to normal stomach cells and are fast growing and more likely to spread.

You will also be told what “stage” of cancer you have. The staging of cancer is simply a way of determining how far the cancer has spread.

There are four stages of stomach cancer and these are:



Stage I

The cancer is limited to the lining of the stomach.

Stage II

The cancer is in the lining of the stomach and has spread to nearby lymph nodes.

Stage III

The cancer cells have spread to the muscle layer of the stomach and nearby lymph nodes.

Stage IV

(Metastatic or Secondary)

The cancer has spread to other parts of the body such as the lungs or bones.

Your biopsy will also be tested for the presence of a protein known as HER2/neu. This is a growth promoting gene that can be “switched on” in some cancers, including stomach cancer. HER2/neu or HER2-Positive cancers are often fast growing and aggressive.

  1. Ministry of Health. 2014. Cancer: New registrations and deaths 2011. Wellington: Ministry of Health. Available from: . Accessed April 2015.
  2. 2. Biggar M, et al. Gastric cancer location and histological subtype in Pacific people and Maori defies international trends. NZ Med J 2011;124:39–44.