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Stomach cancer Q&As

Published by Bupa's health information team, September 2008.

Answers to questions about stomach cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Will I be able to eat after I've had surgery?

Yes, but you might have to make some changes to the foods you eat and the amount you eat. Stomach surgery can cause some troublesome effects on your digestion, but many of these can either be prevented or eased. A dietitian can help you to choose the right foods for you.

Explanation

Treatment for stomach cancer often means having an operation to remove part, or all, of your stomach. After surgery you will still be able to eat and drink but you will probably find that you can't eat or drink as much in one go. Some foods might also start to disagree with you. Surgery on your stomach can have some effects on the rest of your digestive system.

Because your stomach is now smaller, or because your food is going straight into your small bowel, you may find that eating even small amounts of food can make you feel uncomfortably full at first. Start by eating very small amounts often, for example every hour, and then gradually increase the amount you eat and then the time between your meals. Foods that are very high in fibre, for example whole grains, green vegetables, beans and pulses can make the feeling of fullness worse, so eat only small amounts of these foods or don't eat them at all to begin with. Fizzy drinks have the same effect. To make sure you get enough food, don't drink too much at mealtimes as fluid will make you feel fuller.

If you have had part of your stomach removed, you might find that you wake up in the morning feeling uncomfortably full and with stomach pain. This may cause you to be sick, which can get rid of this feeling. The fluid you bring up is a mix of bile and digestive juices which have built up overnight. There are medicines you can take that may help to improve your symptoms but these may not work or be suitable for everyone. You should see your doctor for advice.

You may develop strong urges to go to the toilet and sudden diarrhoea. This can be embarrassing and upsetting. It's difficult to predict how you might be affected by diarrhoea. Some people find the problem improves as time goes on, or learn to control it by altering diet or medicines, although some symptoms may persist. Antidiarrhoea medicines can sometimes help. Talk to your nurse or doctor for advice.

Indigestion and wind are common problems after stomach surgery. Indigestion can be uncomfortable and trapped wind in your digestive system can also be quite painful. Peppermint water can help with trapped wind - put a few drops of peppermint oil into hot water and drink it. Antacid medicines can help with indigestion. Alcohol, fizzy drinks and very spicy foods can make this worse so it's best to try to eat only small amounts of these, or not have them at all.

If you have any of these problems, you might have problems getting enough of the right sort of foods, which could cause you to lose weight. If weight loss does become a problem and you continue to lose weight, ask your nurse or doctor to refer you to a specialist dietitian. He or she will be able to suggest ways for you to get more calories without upsetting your digestion.

Iron, calcium and vitamin D are absorbed into your body through your stomach. Therefore, if you have all or part of your stomach removed you may need to find other ways to get these nutrients. If you have had all of your stomach removed, you will probably need to take calcium, iron and vitamin D as supplements and have regular vitamin B12 injections - these help your body to produce red blood cells. If you have had part of your stomach removed, your doctor will take blood samples regularly to make sure you are getting enough iron and vitamin B12.

Further information

Sources

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What is dumping syndrome?

Dumping syndrome is a side-effect of stomach surgery that is caused by the fast movement of food into your small bowel. This can cause unpleasant symptoms straight after eating or a few hours after a meal. However, there are things you can do to prevent or ease your symptoms.

Explanation

Dumping syndrome can affect you if you have stomach surgery. It usually starts soon after surgery but often settles down in the six months following the operation. Around two in every 100 people who have their stomach removed will continue to have this problem for longer than six months. There are two types of dumping syndrome - early and late.

Early dumping syndrome happens because food moves out of your stomach into your small bowel too quickly. This sudden amount of food in your bowel draws fluid from other parts of your body, which causes your blood pressure to drop. This can cause symptoms straight after a meal, including:

  • sweating and feeling hot
  • a fast heart rate and palpitations
  • feeling sick or vomiting
  • feeling faint
  • a bloated stomach and rumbling abdomen (tummy)
  • watery diarrhoea

Very large volumes of fluid can leave your bloodstream to go into your bowel meaning the symptoms can be quite dramatic and uncomfortable. Early dumping syndrome often gets better on its own after a few months but you can ease the symptoms by:

  • eating small meals often
  • resting, if you can, for 15 to 30 minutes after meals by either sitting or lying down
  • cutting down on carbohydrates and sugary foods as they can make your symptoms worse - if you can, try to cut out sugar
  • drinking between meals rather than during or just after them
  • only eating a small amount of foods that have a high acid content such as oranges and tomatoes
  • trying not to eat late at night
  • not eating foods that are either very hot or very cold

Late dumping syndrome is a problem that happens one or two hours after you have eaten a meal or if you have missed a meal. The main symptom is a sudden feeling of light-headedness. It's even possible that you could faint for a few moments. As well as feeling light-headed you might also feel shaky and sick. These symptoms are caused by a low blood sugar level caused by high levels of the hormone insulin being released into your bloodstream. You can help to ease the symptoms by following the same advice as for early dumping. You might also find it useful to carry glucose tablets with you to take when your symptoms first start.

Further information

Sources

  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007: 441
  • Dumping syndrome. CORE. www.corecharity.org.uk, accessed 28 June 2008
  • Dietary problems after surgery for stomach cancer. Cancerbackup. www.cancerbackup.org.uk, accessed 28 June 2008
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How will the treatment of my cancer be decided?

Your treatment will be based on your individual circumstances and will take into account your wishes, your general health, the type of cancer you have and how far it has spread. A team of specialists can help you to decide which treatment is best for you. Making a decision about what treatment to have can be very difficult. Therefore, it's important that you understand fully what the options are and what the outcomes of your decisions might be.

Explanation

Your treatment is planned to take into account your individual circumstances. Whether your cancer has spread or not, your general health and your wishes are the main factors which will help your doctor to choose your treatment options. A team of specialists including a surgeon, cancer specialist and cancer nurses can help you to decide which treatment is best for you. If it's possible, try to have your treatment at a specialist centre where lots of people with stomach cancer are treated.

When you see the doctor it's useful to have a family member or friend with you. They can help to remember what has been said. It may be an idea to write down some questions before you see the doctor so you don't forget them.

The main treatments for stomach cancer are surgery and chemotherapy - this may be used before, during or after surgery. Chemotherapy is also sometimes used if surgery isn't possible. Radiotherapy is rarely used as a treatment for stomach cancer.

If your cancer is diagnosed early before it has spread, it's easier to control and possibly cure it. This will almost certainly mean that surgery will be your main option. Surgery for stomach cancer is a big operation and it's important that you are fit and well enough to get through the operation and make a good recovery. Surgery is always offered if you have stomach cancer that is potentially curable and if you are well enough to have the operation. The aim of surgery is to remove all of the cancer and reduce the risk of it spreading any further. Whenever possible your surgeon will only remove part of your stomach rather than all of it, as this means you are likely to have fewer complications after your operation. Many patients also get some benefit from having chemotherapy before and after their surgery.

If your cancer has spread outside your stomach, any treatment you have may be able to ease your symptoms and control the cancer but is unlikely to cure it. Surgery may help to ease your symptoms and give you a better quality of life, for example by unblocking the entrance to your stomach. Chemotherapy can also help to relieve your symptoms and slow down the cancer growth. Radiotherapy is rarely used to treat stomach cancer.

Making a decision about what treatment to have can be very difficult. It's important that you understand fully what the options are and what the outcomes of your decisions might be. Talk to the doctors and nurses, ask questions and for more information if you need it. Discuss it with your family, or your GP may be able to advise you. Some people feel more comfortable if they get a second opinion from another doctor. Ask your doctor to refer you to someone else if you think it would be helpful.

If your cancer is advanced, sometimes treatments have to be balanced with the risk of side-effects and the effect this has on your quality of life. A few people choose not to have any treatment at all, but if you are thinking of this, it's vital that you understand what the results might be. You might find it helpful to talk to a counsellor or to a nurse at one of the cancer charities as well as to your doctor.

Further information

Sources

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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