Controlling symptoms of advanced stomach cancer

Advanced stomach cancer means that a cancer that began in the stomach has spread to another part of the body or has come back after previous treatment. Advanced cancer can cause symptoms. You might have one or more symptoms.

Tell your doctor or nurse about any symptoms that you have so they can help you.

Unfortunately advanced cancer can’t be cured. But treatments such as chemotherapy, radiotherapy or targeted drugs can sometimes help to shrink the cancer, reduce symptoms and help you feel better. Other treatments such as stents or laser therapy can treat specific symptoms such as a blockage in the stomach.

Tiredness and feeling unwell

Tiredness is a common symptom of advanced cancer. You may feel that you don’t have any energy and this can be overwhelming.

Let your doctor or nurse know if you’re very tired as they might be able to prescribe medicine to help or other treatments. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).

Resting
It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise
Exercising can be hard when you feel very tired. But research shows that daily light to moderate exercise can give you more energy. Going for a gentle walk is very good. Gentle exercises in bed or standing up can help if you can’t move around easily. 
Your hospital physiotherapist might be able to help you plan an exercise programme that suits your needs.  

Sleeping
You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

A blockage in the stomach

The cancer might block the entrance to the stomach or the entrance to the small bowel. Then food can’t pass through. This causes pain, sickness and makes you feel very unwell. You need to go to the hospital if this happens. 

Your doctor might put a tube called a stent into your stomach to allow food to pass through. Or they might recommend laser therapy to burn away the cancer cells causing the blockage. Surgery to bypass or remove part of your stomach can help if you’re well enough to cope with it.

Loss of appetite

You might not feel like eating and may lose weight. It is important to eat as much as you can.

Tips:

  • Eating several small meals and snacks throughout the day can be easier to manage.
  • Ask your doctor or dietitian to recommend high calorie drinks to boost your calorie intake.
  • Eat whatever you feel like eating rather than what you think you should eat.
  • Drink plenty of fluids even if you can't eat.
  • Don't fill your stomach with a large amount of liquid before eating.
  • Try to eat high calorie foods to keep your weight up.

Sickness

Treatment for sickness depends on what is causing it. Some painkillers or cancer treatments can cause sickness. You might also feel sick if you are constipated.

Talking this over with a doctor or nurse is a good idea. Then, you can get the treatment you need.

Some people find that ginger is a good natural remedy for sickness. Try eating stem ginger or crystallised ginger if you like it. Or drinking boiled water with a small piece of fresh ginger in it. Some people find sipping fizzy ginger drinks can help. 

Pain

You might have pain in the area of the cancer but not everyone does. Painkillers can usually control pain well. 

There are many different painkillers and ways of taking them. Your doctor and nurse can help you to be pain free most of the time. 

You and your friends or relatives can do things to help reduce the pain. Complementary therapies such as relaxation and massage may help.

Swollen tummy - ascites

You might have a swollen tummy (abdomen) if your cancer has spread to the lining of your abdomen (peritoneum) or liver. The swelling is due to a build up of fluid called ascites. It can make your clothes feel tighter. Your tummy might feel bloated. You might also find it difficult to sit comfortably or to move around. Ascites can make you feel breathless, especially when lying flat.

Your doctor can drain off the fluid by putting a small, flexible tube into the abdomen. This helps you to feel more comfortable.

Bowel problems

Bowel problems such as diarrhoea or constipation can be caused by the cancer. They can also be caused by cancer treatments or medicines. For example, painkillers commonly cause constipation. 

Talk to your doctor or nurse if you have bowel problems. They can help by giving you medicine. Your dietitian can give you advice on what to eat or drink. 

Darker poo

Your poo might look darker if the cancer causes bleeding in the stomach.

Radiotherapy to the stomach can help to shrink the cancer and stop the bleeding.

Symptoms if the cancer has spread

You might have other symptoms, depending on where the cancer has spread.

Help with controlling symptoms

Symptoms can usually be well controlled. Your doctor or nurse can tell you about medicines that will help you. They can also tell you about things that you or your friends and family can do.

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

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