Gastric cancer usually causes no symptoms in the early stage; by the time complaints appear the disease has generally progressed. The main risk factors are Helicobacter pylori infection, a diet heavy in salted and smoked food, smoking and a family history. Diagnosis is made by gastroscopy and biopsy. The primary treatment is surgery: depending on where the tumour sits, part or all of the stomach is removed along with the surrounding lymph nodes.
Gastric cancer is among the most common cancers both worldwide and in Turkey. Its hardest feature is that it causes almost no symptoms in the early stage, and the complaints that do appear resemble ordinary indigestion, so they are often put off. This article covers the risk factors, the warning signs and how surgical treatment is planned.
What Are the Risk Factors?
Several factors play a part in gastric cancer:
- Helicobacter pylori infection. The most important modifiable factor. Long-standing infection can set off a sequence running from chronic gastritis through atrophy to malignant change.
- Diet. Eating heavily salted, pickled, smoked and processed food raises the risk. Fresh fruit and vegetables are regarded as protective.
- Smoking and alcohol.
- A family history of gastric cancer and certain hereditary syndromes
- Chronic atrophic gastritis, pernicious anaemia and gastric polyps
- Previous stomach surgery
Which Symptoms Are Warning Signs?
In the early stage there are either no symptoms or none that can be told apart from indigestion. As it progresses, the following appear:
- Persistent stomach pain and a feeling of fullness
- Feeling full quickly on eating little
- Loss of appetite and unexplained weight loss
- Nausea and vomiting; in advanced cases food coming back up
- Difficulty swallowing, particularly where the tumour is near the entrance to the stomach
- Vomit resembling coffee grounds, or black tarry stools
- Unexplained anaemia and fatigue
Important. Newly starting, persistent stomach symptoms over the age of 40, indigestion that does not settle with medication, weight loss and anaemia all call for gastroscopy. Dismissing these as "gastritis" and treating them with medication for months is the commonest mistake.
How Is It Diagnosed?
The only route to diagnosis is gastroscopy. The lining of the stomach is seen directly during the procedure and biopsies are taken from suspicious areas. The pathology result confirms the diagnosis.
Once diagnosed, the extent of disease is established with:
- Computed tomography
- Endoscopic ultrasound where needed, showing how deeply the tumour has invaded the wall
- PET/CT in selected cases
- Diagnostic laparoscopy in some patients, to look for spread within the abdomen that CT does not show
Blood tumour markers such as CEA, CA 19-9 and CA 72-4 do not establish the diagnosis, but they are used in pre-operative assessment and in follow-up after treatment.
When Is Surgery Needed?
Surgery is the primary treatment in gastric cancer. Its extent is set by the site and spread of the tumour:
Subtotal gastrectomy. Where the tumour is in the lower part of the stomach, part of the stomach is removed and the remainder joined to the small intestine.
Total gastrectomy. Where the tumour is in the upper part or is widespread, the whole stomach is removed and the oesophagus joined directly to the small intestine.
Lymph node dissection. The most decisive part of the operation. Removing an adequate number of the lymph nodes running along the vessels that supply the stomach is critical both for accurate staging and for the success of treatment. It matters as much as removing the tumour itself.
In suitable cases the operation can be performed laparoscopically. In some very early tumours, endoscopic removal may come into consideration.
Treatment Beyond Surgery
Chemotherapy is often part of treatment in gastric cancer. In some patients it is given before surgery, to shrink the tumour and make the operation safer. Chemotherapy after surgery is planned according to the pathology result. These decisions are taken at an oncology board.
Life After Surgery
The pattern of eating changes permanently. Portions become smaller and meals more frequent; five or six small meals a day are advised. Fluids are taken between meals rather than with them.
Patients who have had the whole stomach removed need vitamin B12 for life, because the substance needed to absorb it is produced in the stomach. Absorption of iron and calcium can also fall, so blood levels are monitored regularly.
Dumping syndrome can occur as sugary and fatty foods pass rapidly into the small intestine; portion control and avoiding sugar largely prevent it.
Follow-up continues with examination, blood tests, tumour markers, computed tomography and gastroscopy where needed. Long-term recovery rates in early-stage gastric cancer are markedly higher, which makes not putting off symptoms the single most decisive factor.
A Published Study on Gastric Cancer
Op. Dr. Ersan Semerci completed his general surgery residency at Ankara Oncology Hospital. He has oncological surgery experience in stomach, colon and rectal cancers as well as in thyroid and breast cancer.
He has a scientific study bearing directly on the subject of this article: the prognostic value of preoperative CEA, CA 19-9, CA 72-4 and AFP levels in gastric cancer, Advances in Therapy, 2008. The study examines how much the tumour markers measured before surgery tell us about the course of the disease.
He has also published a case report on gastric outlet obstruction caused by a giant gastric trichobezoar and a review on the approach to non-variceal upper gastrointestinal bleeding. His experience of more than 3,000 bariatric surgery cases also means working with this anatomical region regularly.
Op. Dr. Ersan Semerci has practised in Mersin since 2010 and currently works at VM Medicalpark Mersin Hospital. Gastroscopy, gastric cancer surgery and post-operative follow-up are carried out at this hospital.
Op. Dr. Ersan Semerci has practised in Mersin since 2010 and currently works at VM Medicalpark Mersin Hospital. Consultations and operations in Gastric Cancer are carried out at this hospital. Patients travelling from Mersin and neighbouring provinces can book via WhatsApp.
Book on WhatsAppIs there a screening programme for gastric cancer?
There is no population-level national screening programme for gastric cancer in Turkey. That makes it all the more important to take warning symptoms seriously and not to delay gastroscopy in people at risk.
Does treating Helicobacter pylori reduce the risk?
Treating the infection breaks the chain set off by long-standing inflammation and does reduce the risk. Treatment is therefore recommended where the infection is found.
I have constant stomach problems. Should I have a gastroscopy?
Gastroscopy is needed for stomach symptoms that start over the age of 40, do not settle with medication, or come with weight loss or anaemia. Below that age, warning signs are not waited on either.
Can I eat normally if the whole stomach is removed?
The pattern of eating changes: portions become smaller and meals more frequent. Most patients adapt over time. Vitamin B12 supplementation continues for life.
Can the operation be done by keyhole surgery?
In suitable cases the laparoscopic approach can be used. The site, size and spread of the tumour and the patient's general condition determine that decision; oncological adequacy is never compromised.
Pain moving from the navel to the right lower abdomen, the methods used in diagnosis, conditions that can mimic it, laparoscopic appendicectomy and the cost of delay.
Answers to the most common questions about appointments, the hospital, treatment scope and surgical experience are in the FAQ section on the home page.
All Blog ArticlesConsultation and Appointments in Mersin
For Gastric Cancer and related symptoms you can book an appointment at VM Medicalpark Mersin Hospital. Mezitli / Mersin, Turkey, weekdays 09:00-17:00.
WhatsApp: +90 542 236 05 33Disclaimer. This article is provided for general information only. It does not constitute medical advice, diagnosis or a treatment recommendation, and it is not a substitute for examination, diagnosis and treatment by a physician. The content is not tailored to any individual and is not intended as advertising. Do not start, change or stop any treatment on the basis of the information here. Consult your own doctor about any decision concerning your health and see a healthcare provider about your symptoms. The site owner accepts no liability for any consequences arising from use of this content. Last updated: 2026-08-11.