Stomach cancer is cancer that starts in the stomach. It’s staged according to how far it has spread (metastasized) at the time of diagnosis.

In stage 4, stomach cancer has spread through tissue, the bloodstream, or lymph system to distant parts of the body. Cancer may be found in organs such as the liver, lungs, or distant lymph nodes.

Stage 4 is also called advanced stomach cancer.

Knowing the stage of stomach cancer helps determine treatment options. It also provides a general overview of what to expect.

Keep reading to learn more about stage 4 stomach cancer, how it’s treated, and the five-year survival rate.

Stage 4 stomach cancer is harder to treat than earlier stage stomach cancer. That’s because it’s no longer confined to the stomach and may involve several distant organs. It’s usually not curable, but it’s certainly treatable.

The goal of treatment is to ease symptoms and control the cancer’s growth. Your doctor will recommend therapies based on your age and overall health, including any other health conditions you may have. Your options also depend on specific characteristics of the cancer.

Treatment for cancer usually involves a combination of therapies. Your treatment plan can be adjusted based on how well it’s working. Tell your doctor if you have new symptoms along the way so they can be factored in.

Some treatments for stage 4 stomach cancer are:

Laser therapy or stent

Laser therapy can be used to destroy tumors, stop bleeding, or alleviate a blockage in the stomach.

This can sometimes be accomplished without surgery.

The doctor inserts a long, flexible tube called an endoscope down the throat and into the stomach to deliver the laser beam. This is also called endoscopic tumor ablation.

Hollow tubes called stents can sometimes help. By placing a stent between the stomach and esophagus or between the stomach and small intestine, food will be able to pass through unobstructed.


A subtotal gastrectomy is a procedure in which the surgeon removes the part of the stomach that has tumors. This can help ease bleeding and pain.

If tumors in the lower part of the stomach are preventing food from passing, gastric bypass surgery may be an option.

In this procedure, part of the small intestine is attached to the upper part of the stomach, bypassing the tumors, and allowing food to flow out of the stomach.

Sometimes, stomach cancer makes it difficult to eat. If that happens, a feeding tube can be surgically inserted through the skin into the stomach so you can get the nutrients you need.


Chemotherapy is a systemic treatment, meaning it can treat tumors throughout your body. Chemotherapy drugs can help shrink tumors, relieve symptoms, and prolong life.

Radiation therapy

Radiation therapy is a targeted treatment, meaning it can be directed at specific tumors. It can help shrink the tumors, stop bleeding, and relieve pain.

Targeted drug therapy or immunotherapy

Targeted drug therapy can be used to treat advanced stomach cancer. These drugs attack specific characteristics of the cancer. Some of these are:

  • imatinib (Gleevec), for stromal tumors
  • ramucirumab (Cyramza), for advanced stomach cancer when other treatments aren’t effective
  • regorafenib (Stivarga), for stromal tumors
  • sunitinib (Sutent), for stromal tumors
  • trastuzumab (Herceptin), for HER2-positive tumors

Immunotherapy drugs boost your immune system to help attack cancer.

Pembrolizumab (Keytruda) is an immunotherapy drug used to treat stomach cancer that has returned or spread in people who have tried but didn’t respond to or stopped responding to two or more types of chemotherapy.

Clinical trials

Clinical trials are studies to test the safety and effectiveness of experimental therapies that aren’t yet approved by the FDA for general use. These trials can offer groundbreaking new treatments.

Eligibility rules are usually quite specific, so ask your doctor about trials that might be a good fit for you. You can also search for clinical trials at

Supplemental care

Because stomach cancer can interfere with eating and how food flows through your digestive system, it can lead to malnutrition. Consider working with a nutritionist who can help you get the most out of your diet.

Your doctor may also prescribe dietary supplements, pain relievers, or other medications to help you deal with a variety of symptoms.

Be sure to tell your doctor about new or changing symptoms. There are effective ways to manage them.

Ask your doctor to refer you to a palliative care team. These specialists work with your other doctors but focus on easing symptoms and improving quality of life.

You can have palliative care even while receiving treatment for the cancer.

When you think about life expectancy, there are some important things to keep in mind:

  • Many factors affect your prognosis, including age, overall health, and the treatments you choose. Also, everyone responds differently to treatments, and there’s no way to know how your body will respond.
  • Survival rates are based on the stage at diagnosis.
  • Relative survival rates compare people who have stomach cancer with people in the general population who don’t have cancer.
  • These statistics were compiled based on people diagnosed years ago. Cancer treatments change quickly. The latest treatments and increasing lifespans aren’t reflected in those earlier numbers.

According to the Surveillance, Epidemiology and End Results (SEER) Program, the overall relative survival rate for all stages of stomach cancer is 31.5 percent. The five-year relative survival rate for distant stomach cancer (stage 4) is 5.3 percent. These figures include people diagnosed between 2009 and 2015.

Your doctor will consider your complete medical profile to help you understand your own outlook.

Treatment for stage 4 stomach cancer is designed to slow cancer growth and manage symptoms. It’s important that you maintain good communication with your doctor and other members of your care team to get the best out of your therapies.

Innovative new treatments are helping people with stage 4 stomach cancer have a better quality of life and, potentially, a longer life than people diagnosed years ago.