Do not ignore the persistent belching, pain or discomfort in the upper abdomen, or bloated feeling after a light meal. These general symptoms could mean poor digestion or point to something more serious like stomach cancer.

The good news is early stage stomach cancer is curable. Survival rate is as high as 80 per cent, but drops to 10 per cent at the advanced stage.

Also known as gastric cancer, stomach cancer is the 7th cancer affecting men and 9th cancer affecting women in Singapore. 

Stomach cancer (or gastric cancer) hits men above 40 more frequently, and is more common among the Chinese compared to Malays and Indians.

5 Ways to lower risk of stomach cancer (gastric cancer)

  1. Eat a healthy diet that includes plenty of fruit and vegetables.

  2. Consume less salted and pickled foods such as salted fish and meats.

  3. Consume less smoked, preserved and cured meats like bacon, ham and bak kua.

  4. Lose weight if you are obese (Asians should target a BMI between 18.5 and 22.9)

  5. Quit smoking (if you are a smoker)


People at higher risk of getting stomach cancer include those who have:

  • Chronic gastritis 

  • Past surgery for stomach ulcers or

  • Family history of stomach cancer. 

"Patients with pernicious anaemia or chronic Helicobacter pylori infection of the stomach ​are also at risk,” added the Division of Medical Oncology from National Cancer Centre Singapore (NCCS), a member of the SingHealth group.​ 

Family history of stomach cancer or hereditary stomach polyps can also be a factor.

Smoking raises the risk by 2.5 times. Other risks include diets with large amounts of smoked foods, salted fish and meat, and pickled foods. 


It takes many years for the cancer to develop and before symptoms are felt. Stomach cancer is hard to detect because symptoms are often non-specific, and in the early stages absent or very mild. They could also be similar to those of peptic ulcer diseases or gastritis.

Stomach cancer symptoms include:

  • Persistent indigestion and a burning sensation after meals (heartburn)
  • Bloated feeling after meals 
  • Upper abdominal discomfort or pain 
  • Early feeling of fullness despite a small meal 
  • Loss of appetite
  • Weight loss
  • Nausea, vomiting 
  • Blood in stools or black tarry stools


The doctor will take a full medical history and per form a physical examination. A test may be done to detect blood in the stool because stomach cancer sometimes causes bleeding that may not be visible.

A gastroscopy may be called for, in which a fibre-optic scope with a light at the end of it is passed through the mouth and into the stomach. This is to examine the organ and take tissue samples from suspicious areas for examination.

Another test may be ordered where the patient swallows a thick, chalky liquid called barium which shows up on x-rays, so that abnormalities in the oesophagus and stomach can be detected.

When stomach cancer is diagnosed, further tests, such as a computerised tomography (CT) scan or a positron emission tomography (PET) scan, may be needed to determine if the cancer has spread.

Treatment for stomach cancer (gastric cancer)

Success of the treatment is dependent on the stage of the stomach cancer (whether it is localised or has spread to other parts of the body), the patient’s age and general health.

1. Surgery

Surgery typically offers the best chance to cure stomach cancer. Known as a gastrectomy, there are two types:

  • Partial gastrectomy: Only part of the stomach may need to be removed if the cancer is confined to the lower end of the stomach. 

  • Total gastrectomy: The surgeon may remove the entire stomach if the cancer is located in the middle of the stomach. The lymph nodes near the stomach and surrounding tissue will be removed, and sometimes the spleen may need to be removed as well.

Patients with precancerous lesions and very early-stage gastric cancer may be suitable for less invasive procedures such as endoscopic mucosal resection (EMR) or submucosal dissection (ESD). This involves passing an endoscope fitted with a video camera and special blades to remove the cancerous growths.

2. Chemotherapy

Doctors may recommend chemotherapy prior to surgery to shrink large tumours as well as after surgery to kill off any remaining cancer cells and improve the chance of cure.

Recent research carried out at Duke-NUS identified three subtypes of gastric adenocarcinomas - the most common type of stomach cancer. Each subtype had different genetic abnormalities and was found to respond differently to treatments in the laboratory.

Published in Gastroenterology, this study showed that the metabolic subtype was the most sensitive to 5-fluorouracil (5-FU) which is commonly used to treat gastric cancers.

The proliferative subtype of adenocarcinoma was less sensitive to 5-FU treatment.

The mesenchymal subtype seemed to be more sensitive to drugs targeting the PI3K-AKT-mTOR process which is commonly abnormal in cancers.

3. Radiotherapy

Doctors may include radiotherapy to shrink an advanced tumour or prevent gastric cancer from returning after surgery.

4. Targeted therapy

Targeted drug treatments work by blocking specific weaknesses present within cancer cells, causing the cancer cells to die. Targeted drug therapy is usually combined with chemotherapy for treating advanced or recurrent stomach cancer.

5. Immunotherapy

Immunotherapy is a drug treatment that helps a patient’s immune system fight cancer. Immunotherapy may be recommended if the stomach cancer is advanced, recurs or spreads to other parts of the body.


  1. Good nutrition
    Many patients with stomach cancer (gastric cancer) lose a lot of weight. It is important for them to eat well as building up to a nearly normal weight can aid recovery.

    Cancer and its treatments can cause a loss of appetite. Advice from a dietician to learn more about possible dietary changes will be helpful after stomach surgery.

  2. Strong support
    Supportive care to help people and their families to cope with cancer and its treatment should begin once cancer is suspected. Patients do not need to struggle with the illness alone.

    Useful support services include the Medical Social Service Department of the hospital where treatment is done, and cancer support groups.

Ref: I23 (ed)

Other cancer articles you may be interested in:

10 Most Common Cancers in Singapore (for Men and Women)

Colorectal Cancer: 8 Ways to Lower Your Risk

Breast Cancer: What Puts You at Risk

Prostate Cancer: All You Need to Know

Liver Cancer: Causes, Symptoms, Treatment

Kidney Cancer: Causes, Symptoms, Treatment