Stomach Pain: Could It Be Stomach Cancer? - Family Medicine

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Gastric cancer issues?


Hello: My mother has been experiencing stomach pain frequently at night, but not during the day.
I would like to ask: 1.
Is it possible for stomach pain caused by gastric cancer to occur intermittently? 2.
What additional symptoms, when combined with stomach pain, could indicate the possibility of gastric cancer? 3.
Besides gastroscopy, what other high-accuracy diagnostic methods are available to check for gastric cancer? Thank you.

Jia Si Ting, 30~39 year old female. Ask Date: 2012/01/28

Dr. Chen Bozhang reply Family Medicine


The symptoms of early gastric cancer are very similar to those of chronic gastritis or peptic ulcers, including dyspepsia, bloating, nausea, stomach pain, and loss of appetite.
Based on symptoms alone, it is difficult to distinguish between esophagitis, gastritis, gastric ulcers, or gastric cancer.
More severe and invasive gastric cancer may present with additional symptoms such as weight loss, vomiting, swallowing difficulties, anemia, and melena.

In your letter, you mentioned that your mother often experiences stomach pain at night.
This symptom does not allow for a clear distinction of the underlying cause.
Typically, eating late-night snacks, consuming difficult-to-digest or irritating foods at dinner, or experiencing emotional stress can lead to nighttime stomach pain.

It is advisable for you to visit a gastroenterology clinic, where a physician can conduct a thorough history-taking, physical examination, and relevant imaging studies to reach a diagnosis.
In addition to endoscopy, gastric cancer can also be diagnosed through upper gastrointestinal imaging, which is a non-invasive test that requires fasting and the ingestion of a barium contrast agent to visualize the gastrointestinal mucosa.
However, if abnormalities are found in the upper gastrointestinal imaging, the physician will still recommend an endoscopy, as early gastric cancer may not be detectable through upper gastrointestinal imaging.
Therefore, please discuss in detail with a gastroenterologist to choose the appropriate examinations to avoid delays in important diagnosis and treatment.

Reply Date: 2012/01/28

More Info


Stomach pain can be a concerning symptom, and it's understandable to worry about the possibility of stomach cancer, especially if there is a family history of cancer or if the symptoms are persistent or severe. Let's address your questions one by one.

1. Can stomach cancer cause intermittent pain?
Yes, stomach cancer can cause intermittent pain. However, it's important to note that stomach cancer often does not present with pain in the early stages. When pain does occur, it can vary in intensity and frequency. Some patients may experience pain that comes and goes, which can be influenced by factors such as food intake, stress, or other gastrointestinal issues. It's crucial to differentiate between pain caused by cancer and pain caused by other conditions, such as gastritis, ulcers, or functional gastrointestinal disorders.

2. What accompanying symptoms might indicate stomach cancer?
While stomach cancer can present with various symptoms, certain signs may raise suspicion. These include:
- Persistent abdominal pain, especially if it worsens over time.

- Unexplained weight loss.

- Loss of appetite or feeling full after eating small amounts.

- Nausea or vomiting, particularly if there is blood in the vomit.

- Changes in bowel habits, such as black or tarry stools, which may indicate bleeding.

- Fatigue or weakness without a clear cause.

If you or someone you know is experiencing these symptoms, it is essential to seek medical evaluation promptly.

3. What are the recommended tests for diagnosing stomach cancer?
The most definitive test for diagnosing stomach cancer is an upper gastrointestinal endoscopy (gastroscopy), where a thin, flexible tube with a camera is inserted through the mouth to visualize the stomach lining and take biopsies if necessary. However, there are other tests that can aid in the evaluation:
- Imaging studies: CT scans or MRI can help assess the stomach and surrounding structures for any abnormalities.

- Barium swallow: This X-ray test involves swallowing a barium solution to highlight the stomach and can show structural changes.

- Blood tests: While not diagnostic for cancer, certain blood tests can help assess overall health and detect anemia, which may be associated with bleeding.

In conclusion, while stomach pain can be a symptom of stomach cancer, it is essential to consider the overall clinical picture, including accompanying symptoms and risk factors. If your mother is experiencing persistent stomach pain, especially at night, it would be prudent for her to consult a healthcare provider for a thorough evaluation. Early detection and diagnosis are key to effective treatment, so addressing these concerns with a medical professional is crucial. Regular check-ups, especially in individuals with a family history of cancer, can help monitor any changes and catch potential issues early.

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