Gastric Cancer Nursing Care Plan & Management


  • It is also called malignant tumor of the stomach.
  • It is usually an adenocarcinoma.
  • It spreads rapidly to the lungs, lymph nodes, and liver.
  • Risk factors include chronic atrophic gastritis with intestinal metaplasia; pernicious anemia or having had gastric resections (greater than 15 years prior); and adenomatous polyps.
  • This cancer is most common in men older than age 40 and in blacks.
  • Complications are hemorrhage and dumping syndrome from surgery or widespread metastasis and death.
Causes/ Risk Factors

No one knows why some people develop stomach cancer and others don’t. The number of people affected varies widely between different countries. For example, stomach cancer is far more common in Japan than in the UK. There is also evidence that people from poorer backgrounds are at increased risk.

There are a many other factors that increase the risk of developing stomach cancer.

  • Age. Stomach cancer is most common around the age of 60. It’s rare under the age of 40.
  • Gender. Men are around twice as likely to develop stomach cancer as women.
  • Helicobacter pylori infection. These bacteria live in the stomach lining of many people, and don’t usually cause any symptoms. However, the infection sometimes causes inflammation of the stomach lining (gastritis), indigestion and stomach ulcers. It is known to increase the risk of stomach cancer.
  • Diet. A diet high in salt and foods that are smoked or cured may increase the risk of stomach cancer. In particular, certain food preservative chemicals known as nitrosamines, which are found cured meats such as bacon and ham, may increase your chance of developing stomach cancer.
  • Family history. Some people inherit an increased risk of developing stomach cancer.
  • Type A blood group. Some research indicates that people who have type A blood are at higher risk of developing stomach cancer.
  • Smoking. When you smoke, you swallow small amounts of tobacco smoke, which increases your risk of getting stomach cancer.
  • Atrophic gastritis. This condition causes the lining of the stomach to waste away. It has also been linked with an increased risk of stomach cancer.
  • Pernicious anaemia. This is type of anaemia raises your risk of stomach cancer.
  1. Most often, the patient presents with the same symptoms as gastric ulcer. Later, evaluation shows the lesion to be malignant.
  2. Gastric fullness (early satiety), dyspepsia lasting more than 4 weeks, progressive loss of appetite are initial symptoms.
  3. Stool samples are positive for occult blood.
  4. Vomiting may occur and may have coffee-ground appearance.
  5. Later manifestations include pain in black or epigastric area (often induced by eating, relieved by antacids or vomiting); weight loss; hemorrhage; gastric obstruction.
Diagnostic Evaluation
  1. Upper GI X-ray with contrast media may initially show suspicious ulceration that requires further evaluation.
  2. Endoscopy with biopsy and cytology confirms malignant disease.
  3. Imaging studies (bone scan, liver scan, CT scan) helps determining metastasis.
  4. Complete blood count (CBC) may indicate anemia from blood loss.
Primary Nursing Diagnosis
  • Pain (acute) related to gastric erosion
Therapeutic Intervention / Medical Management
  • The only successful treatment of gastric cancer is gastric resection, surgical removal of part of the stomach with involved lymph nodes; postoperative staging is done and further treatment may be necessary.
  • Surgical options include proximal or distal subtotal gastric resection; total gastrectomy (includes adjacent organs such as tail of pancreas, portion of liver, duodenum); or palliative surgery such as subtotal gastrectomy with gastroenterostomy to maintain continuity of the GI tract.
  • Surgery may be combined with chemotherapy to provide palliation and prolong life.
Pharmacologic Intervention
  • Chemotherapeutic agents used as adjuvant (in addition to) or neoadjuvant (before surgery) often in combination: fluorouracil, doxorubicin, methyl-CCNU, cisplatin, methotrexate, etoposide to treat cancer that has metastasized to organs beyond stomach; shrink tumors before surgery.
  • B vitamin complex tablet Combat vitamin B12deficiency and megaloblastic anemia from lack of intrinsic factor
  • Narcotic analgesics manage pain, side effects of treatment drugs such as morphine, meperidine which increase patient comfort during end-stage disease
  • Other Medications: Antiemetics may be used to control nausea, which increases as the tumor enlarges. In the advanced stages, the physician may prescribe sedatives, narcotics, and tranquilizers to increase the patient’s comfort. Antispasmodics and antacids may also help relieve GI discomfort.