For months, 51-year-old Carla Louro of Sayreville felt something was wrong. She was full after just a few bites of food, lost weight without trying, and felt constantly exhausted.
“I kept being told it was stress or gastritis,” she recalled. “I went through so many tests — blood work, ultrasounds, even a colonoscopy — before anyone thought to do an upper endoscopy.”
By the time the test was done, months after her initial complaints, it was too late: Louro had diffuse-type gastric cancer, an aggressive form that often hides beneath the stomach lining.
Dr. Marion Liu, a surgical oncologist at Memorial Sloan Kettering Cancer Center in Monmouth County, said stomach cancer, a disease long thought to affect mostly older adults, is hard to detect and is increasingly diagnosed in younger patients.
According to the Mayo Clinic, dietary changes, chronic gastritis, and infections like H. pylori — a bacterium that silently inflames the stomach lining — may all play a role. The trend is especially notable among Asian communities that have long faced higher rates of the cancer, according to the National Institute for Health.
Nationally, stomach cancer accounts for 1.5% of new cancer diagnoses, with an estimated 30,300 new cases expected in 2025 according to the American Cancer Society. Researchers in New Jersey reported an average of 442 new late-stage cases per year from a 2017–2021 study.
Symptoms of stomach cancer
“Most patients with early gastric cancer have no symptoms at all,” Liu said. “Vague complaints like indigestion or mild discomfort often get dismissed. By the time symptoms such as early satiety, dark stools, or unexplained weight loss appear, the disease is often advanced.”
Louro remembers how subtle her early symptoms were. “I just felt tired all the time and didn’t have much appetite,” she said. “I thought I was just stressed or not eating well. It never occurred to me it could be cancer.”
Louro was diagnosed twice within a year with H. pylori, and although treatment cleared the infection, her symptoms continued. She said her bloodwork was also abnormal, and she was sent to an oncologist who gave her iron infusions. But her iron levels weren’t improving the way they should.
H. pylori is a major but overlooked contributor. Many carriers show no symptoms. Detection requires a stool test or endoscopic biopsy. Treatment typically includes antibiotics and acid-reducing medication.
Liu stresses a critical step:
“You have to get tested for H. pylori after treatment to make sure the infection is actually cleared,” she said. “Household members may also need testing, since the bacteria can spread through shared dishes or food.”
Cultural disposition and age
Dietary habits and cultural traditions may further influence risk. Liu said stomach cancer is more common in Asian populations, where preserved, fermented, and smoked foods are dietary staples.
In several Asian countries, where H. pylori is more common and stomach cancer rates are significantly higher, routine screening is standard practice, similar to colon cancer screening in the U.S., according to The Lancet.
While dietary and cultural factors play a role, Dr. Liu has also observed a troubling trend: stomach cancer in younger patients. Liu said she has treated patients in their 20s; her colleagues have seen cases in teenagers.
“My youngest patient is 27,” she said. “My partners have had 16-year-olds.”
She recommended genetic testing for patients who are under 50, have a family history of gastric cancer or have lobular breast cancer, which is associated with increased gastric cancer risk.
The role of lymph nodes and treatment
Lymph nodes help your body fight infections. In some cases, cancer cells can spread to lymph nodes, so doctors examine them to determine how advanced the cancer is.
“In cancer, lymph nodes are important because cancer cells can spread to them, and examining the lymph nodes helps determine how advanced the cancer is,” Liu said.
Once doctors know the stage of the cancer, intensive treatment is required: chemotherapy before surgery, surgery to remove part or all of the stomach plus removal of the surrounding lymph nodes and additional chemotherapy afterward.
Louro described her own experience with treatment after her surgery in April.
“I had chemo first, then surgery to remove most of my stomach,” she said. “The first few months were rough — I had to learn how to eat all over again. I focus on small, frequent meals and make sure I get enough protein. Slowly, it’s getting easier.”
Early detection is crucial. Louro said her symptoms were dismissed for months before her diagnosis. Her oncologist told her that patients with her condition typically have a prognosis of 12 to 15 months.
Liu said to combat a late diagnosis, people should see their primary care physicians if they experience:
- Persistent stomach symptoms, such as early fullness
- Unexplained weight loss
- Black stools
“When you can’t eat, when you’re losing weight, when there’s blood — those are alarm signs,” Liu said. “Don’t brush them off.”
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