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Should I see a stomach cancer specialist?

Men and woman discussing stomach cancer

This page tells you about the guidelines that GPs have to help them decide who needs to see a specialist for suspected stomach cancer and how soon. There is information about

 

A quick guide to what's on this page

Should I see a stomach cancer specialist?

It can be very difficult for GPs to decide who may have suspected cancer and who has something less serious. The National Institute for Health and Care Excellence (NICE) has developed guidelines for GPs to help them decide who needs to see a specialist urgently (within 2 weeks).

Urgent referral to a specialist 

Your GP will consider referring you urgently to a specialist if 

  • You have a swelling or lump in your stomach area. 

Your GP will offer you an urgent endoscopy to look for stomach cancer if 

  • You have problems with swallowing at any age or
  • Are aged 55 and over with weight loss and have any of the other following symptoms - pain in the upper tummy (abdomen), acid indigestion (reflux), indigestion.

Non-urgent referral

Your GP should consider referring you for a non-urgent endoscopy if 

  • You have been vomiting blood at any age, or if you are aged 55 or over and have
  • Indigestion that has not improved with medication
  • Pain in the upper tummy (abdomen) with low red blood cell levels or 
  • If you have a raised platelet count with any of the following symptoms, feeling sick (nausea), vomiting, weight loss, acid indigestion (reflux), indigestion (dyspepsia), pain in the upper tummy (abdomen). 

Or if you are aged 55 or over and have nausea and vomiting with any of the following symptoms, weight loss, acid indigestion (reflux), indigestion (dyspepsia), pain in the upper tummy (abdomen)

 

CR PDF Icon You can view and print the quick guides for all the pages in the about stomach cancer section.

 

 

UK referral guidelines

It can be difficult for GPs to decide who may have a suspected cancer and who may have something much more minor that will go away on its own. With many symptoms, it is OK for your GP to ask you to wait. And to see if your symptoms get better or respond to treatment (such as antacids or antibiotics). If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed. Then people needing urgent appointments wouldn't be able to get them.

The National Institute for Health and Care Excellence (NICE) have produced guidelines for GPs to help them decide which patients need to see a specialist urgently.

Seeing a specialist

While reading these guidelines, it is important to remember that

  • 90 out of every 100 people diagnosed with stomach cancer (90%) are over the age of 55
  • The chance of a person with indigestion who is under 55 having stomach cancer is one in a million
 

Guidelines for urgent referral

According to the NICE referral guidelines, you should get an appointment within 2 weeks for an urgent referral. If you are referred for an urgent endoscopy your doctor will temporarily stop any drugs you are on for indigestion. Ideally you should be off these for at least two weeks before the test. Your GP might also arrange for you to have a blood test to check for low red blood cells (anaemia)

Your GP should consider referring you to a specialist if you have

  • A swelling or lump in your tummy (abdomen) that they think could be stomach cancer

Your GP should offer you an urgent test called an endoscopy if you are aged 55 or over and have

  • Pain in the upper tummy (abdomen)
  • Acid indigestion (reflux)
  • Indigestion (dyspepsia) or

If you have 

  • Problems swallowing at any age

 

 

Non-urgent referral for an endoscopy

If you have the following symptoms your GP should consider referring you for an endoscopy

  • Vomiting blood at any age (haematemesis) or

If you are aged 55 or over with

  • Indigestion that has not improved with medication
  • Pain in the upper tummy (abdomen) with low red blood cell levels (anaemia) or
  • A raised platelet count with any of the following symptoms - feeling sick (nausea), vomiting, weight loss, acid indigestion (reflux), indigestion (dyspepsia), pain in the upper tummy (abdomen)
  • Nausea and vomiting with any of the following symptoms - weight loss, acid indigestion (reflux), indigestion (dyspepsia), pain in the upper tummy (abdomen).

 

 

When the GP uses their judgement to decide on referral

Your GP will make a decision after examining you and taking all your medical history into account. If they feel that your symptoms are getting worse or are not getting better with treatment, then they may consider referring you for further investigations. 

 

 

What to do if you are still worried

If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you. And then you may be able to decide together whether you need to see a specialist and if so, how soon.

Do bear in mind that this type of cancer is much more common in older people than in younger people. It is also important to know that indigestion is a very common symptom amongst the general population. Having this symptom alone should not worry you. But if it is combined with weight loss, anaemia or being sick then your GP should refer you to a specialist.

Difficulty swallowing is not a common symptom amongst the general population. Anyone with swallowing problems should be referred for further investigations.

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Updated: 23 June 2015