Early stage stomach cancer typically doesn’t have specific symptoms. But in later stages, the cancer often presents with symptoms ranging from unintended weight loss to jaundice, and usually with a noticeable stomach lump.

Stomach cancer is extremely difficult to cure once it’s advanced. People with end stage stomach cancer live at least 5 years about 7% as often as people without stomach cancer.

End stage stomach cancer is also called stage 4 cancer or metastatic cancer. Treatment for end stage stomach cancer is usually palliative, meaning it focuses on reducing your symptoms and increasing your survival time. Medications and other supportive treatments may be able to ease symptoms like:

Your healthcare team can help make your experience as comfortable as possible during this difficult time in your life.

Here, we look at the potential symptoms of end stage stomach cancer and what you can expect during this time.

Stomach cancer usually doesn’t cause symptoms in the early stages. In rare cases, general and nonspecific symptoms may appear.

In a 2020 case study, researchers reported a 76-year-old woman who had left upper back pain for a year that came and went. She had occasional heartburn. While out shopping, she had a brief episode where she became pale and felt weak, nauseated, and light-headed.

Symptoms of stomach cancer often don’t appear until the late stages, often when the cancer has already spread to other parts of your body (the definition of “end stage” for this condition).

Symptoms of end stage stomach cancer can include:

All of these symptoms can have causes other than stomach cancer.

The most common finding during a physical exam is a noticeable mass around your stomach.

Stomach cancer metastases

Metastases are areas in distant parts of your body where the cancer has spread. Here are some of the most common places stomach cancer spreads and some of the potential symptoms they may cause:

LocationPotential symptoms
Peritoneum (lining of abdominal cavity)• bloating
• abdominal pain
• constipation
Liver• jaundice
• fatigue
• fever
Bone• fracture
• bone pain
• bone swelling
Brain• seizures
• confusion
• cognitive changes
Distant lymph nodes• swollen lymph nodes, usually in your neck, underarm, or groin
Lung• trouble breathing
• unexplained weight loss
• coughing up blood

Treatment for stomach cancer that can’t be removed surgically or that has returned after previous treatment is usually palliative. Your treatment may include the following:

Chemotherapy

Many different chemotherapy drugs are used to treat late stage stomach cancer. These drugs include:

  • capecitabine (such as Xeloda, Xitabin, and Capcibin)
  • docetaxel (Taxotere, Docefrez)
  • cisplatin (Platinol and others)
  • doxorubicin (such as Adriamycin, Doxil, and Caelyx)
  • epirubicin (Pharmorubicin)
  • etoposide (such as Etopophos, Toposar, and Vepesid)
  • fluorouracil (such as Carac, Efudex, and Fluoroplex)
  • irinotecan (such as Camptosar, Campto, and Onivyde)
  • leucovorin (Wellcovorin)
  • oxaliplatin (Eloxatin)
  • paclitaxel (such as Nov-Onxol, Onxol, and Paclitaxel Novaplus)
  • trifluridine and tipiracil (Lonsurf)

Some clinics may offer hyperthermic intraperitoneal chemotherapy, where warmed chemotherapy drugs are used to wash the inside of your abdomen during surgery.

Ramucirumab, possibly with chemotherapy

Ramucirumab (Cyramza) falls into a class of drugs called targeted therapy. These medications specifically target cancer cells while leaving healthy cells relatively intact. They generally cause fewer side effects than chemotherapy.

Trastuzumab deruxtecan

Trastuzumab deruxtecan (Enhertu) is a targeted therapy drug. Doctors use it to treat stomach cancer that’s overexpressing the protein HER2. These cancers are called HER2-positive stomach cancers.

Pembrolizumab

Pembrolizumab (Keytruda) is a type of immunotherapy drug. Doctors administer pembrolizumab for stomach cancers with certain genetic changes called:

  • DNA-mismatched repair deficiency cancer
  • microsatellite instability-high cancer
  • tumor mutational burden-high cancer

Other treatments

You may receive treatment for blockages in your gastrointestinal tract, such as:

  • endoluminal laser therapy
  • endoluminal stent placement
  • gastrojejunostomy, a surgical bypass between your stomach and your middle small intestines

Radiation therapy and surgery may also be performed to reduce symptoms. Doctors also prescribe medications to help manage your discomfort.

Supportive treatments can help minimize pain caused by complications of your cancer. Strong pain medications can help lessen physical discomfort. Many of these medications cause side effects like sleepiness or confusion.

The side effects of these medications, combined with the progression of your disease, will likely cause you to spend progressively more time asleep.

As you get closer to the end of life, your heart rate will likely slow down. Decreased blood and oxygen supply to your brain may cause you to lose consciousness. At this point, you’re unlikely to experience any significant pain.

Even though dying of stomach cancer often isn’t physically painful for the person going through it, it can be emotionally painful for you and the people close to you.

Here are some ways you may be able to provide comfort to a loved one with stomach cancer.

Supporting their physical needs

You may be able to make your loved one more physically comfortable by:

  • helping them change their position in their bed frequently
  • elevating their head, if it’s comfortable for them
  • providing them with blankets or a fan to help them stay comfortable
  • helping them bathe
  • bringing them fluids and easy-to-eat sources of nutrition like smoothies
  • using moisturizer to soothe their dry skin

Supporting their emotional needs

Every person dying of cancer has their own way of dealing with their situation. Some people may feel afraid or sad while others are at peace about what’s ahead of them.

You can ask your loved one about what they want emotionally. They may want to deal with their finances, resolve unfinished conflicts, or say their final goodbyes.

End stage stomach cancer isn’t considered curable. Treatment revolves around prolonging your life and minimizing your discomfort.

With proper treatment, dying of stomach cancer doesn’t need to be physically painful. But it can still be difficult emotionally for you and your loved ones.

You can help a person dying of stomach cancer by offering them physical and emotional support. You can also talk with a palliative care professional for recommendations.