Clinical reference

Stomach Cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Gastric Cancer - StatPearls - NCBI Bookshelf (NBK459142) - https://www.ncbi.nlm.nih.gov/books/NBK459142/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD25 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against3 documents

No dose - referral pathway, no medicine given in primary care
Stomach Cancer - disease-level clinical article (gastric-cancer-clinical.txt)
Stomach Cancer - disease-level clinical article (gastric-cancer-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

Early on, persistent indigestion, stomach discomfort, and fullness or bloating after small meals can occur [abdominal distension · abdominal pain · indigestion]

Signs — what you find (4)

A palpable abdominal mass or a distended stomach suggesting outlet obstruction can be found in advanced disease [abdominal mass]
Metastatic spread can show as a left supraclavicular Virchow node, a periumbilical Sister Mary Joseph nodule, or a left axillary Irish node [metastasis]
Peritoneal spread can present as a Krukenberg ovarian mass, a rectal Blumer shelf, ascites, or an enlarged liver [ascites · hepatomegaly]
Rare paraneoplastic clues include acanthosis nigricans, microangiopathic hemolytic anemia, Trousseau syndrome, or membranous nephropathy [anaemia]

Tests (6)

A suspicious gastric ulcer needs multiple biopsies - sensitivity rises from about 70% with one sample to 98% with seven
Endoscopic ultrasound separates T1 from T2 tumor depth with about 85% sensitivity and 90% specificity
Staging CT is limited for T and N staging and small peritoneal deposits, with accuracy ranging only 42% to 82%
PET-CT can help assess whether the tumor is resectable when initial staging shows no metastatic disease
Tumor markers such as CEA, CA-125, CA19-9, and CA72-4 add little diagnostically and can rise from unrelated conditions
Staging laparoscopy with peritoneal washings finds hidden peritoneal disease in up to 40% of patients missed by other imaging

If not this — what else fits (8)

Acute gastritis
Atrophic gastritis
Chronic gastritis
Esophageal cancer
Esophageal stricture
Esophagitis
Non-Hodgkin lymphoma of the stomach
Peptic ulcer disease

SourceStatPearls "Gastric Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

Stomach cancer needs urgent endoscopy, biopsy, and oncology/surgical referral. GP gives symptomatic relief (acid suppression, analgesia) while arranging urgent referral. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Stomach cancer needs urgent endoscopy, biopsy, and oncology/surgical referral. GP gives symptomatic relief (acid suppression, analgesia) while arranging urgent referral.

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - The specific alarm symptoms mandating urgent upper endoscopy are gastrointestinal bleeding, unexplained weight loss, and dysphagia.
RED FLAG - The physical examination signs of metastatic or advanced gastric cancer are Virchow node, Sister Mary Joseph periumbilical nodule, and Irish node.
RED FLAG - Persistent vomiting, black stool, a palpable abdominal mass, or new dyspepsia in a patient over 55: refer for urgent upper endoscopy.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.