After a stomach cancer diagnosis, other tests might be needed to find out how far the cancer has spread. This is called staging. Tests may include blood tests, endoscopic ultrasound, CT or PET imaging, or laparoscopy. Staging tells the healthcare team about the size of the cancer and whether it has spread to nearby lymph nodes or to other parts of the body. The care team uses the stage to decide on treatment and get an idea of your outcome.
Staging terms
For the most common type of stomach cancer, called adenocarcinoma, the stages range from 0 to 4. Higher numbers mean the cancer has grown farther through the stomach, spread to nearby lymph nodes or spread to other parts of the body. Different stages may be used after the first treatment.
The stages also are different for other types of stomach cancer, including gastric lymphomas, neuroendocrine tumors and gastrointestinal stromal tumors.
Stage 0
This is the earliest stage of stomach cancer. Cancer cells or cells that are likely to become cancer are found only in the innermost lining of the stomach. The cells have not grown deeper into the layers of the stomach or spread to other parts of the body.
At this stage, the treatment is often aimed at removing the cells completely with a procedure or surgery.
Stage 1
In this stage, the cancer has grown into the layers of the stomach wall. The cancer may have spread to one or two nearby lymph nodes. The cancer has not spread to distant parts of the body.
Stage 1 is an early stage of stomach cancer. The cancer cells often can be cut away from the inner lining of the stomach. But if the cancer grows into the muscle layer of the stomach wall, this may not be an option. Some stage 1 cancers need surgery to remove all or some of the stomach. Chemotherapy and radiation may not be needed if surgery can remove all the cancer and there's a low risk of cancer coming back.
Stage 2
In this stage, the cancer has grown into the inner layers of the stomach wall, spread to nearby lymph nodes or both. Or the cancer has grown deeper into or through the stomach wall but hasn't spread to lymph nodes. At this stage, the cancer has not spread to distant parts of the body.
For stage 2 stomach cancers, surgery may not be the first treatment. Instead, treatment to shrink the cancer may be done first. This makes it easier to remove the cancer completely. Treatment options may include chemotherapy, immunotherapy, or a combination of chemotherapy and radiation therapy. Surgery often involves removing all or some of the stomach and some lymph nodes.
Stage 3
In stage 3, the cancer has grown deeper into or through the stomach wall and has spread to nearby lymph nodes. It hasn't spread to other parts of the body.
Surgery often involves removing all or some of the stomach and some lymph nodes. Immunotherapy may be used before surgery. This treatment can help shrink the cancer to make it easier to remove. Sometimes immunotherapy kills all the cancer cells, and surgery may not be needed.
Systemic chemotherapy is often used before surgery. Chemotherapy may help shrink the cancer so that it's easier to remove. Radiation also may be used before surgery to shrink the cancer. Sometimes it is used after surgery if the cancer wasn't removed completely.
Stage 4
Stage 4 means the stomach cancer has spread to distant parts of the body. It also is called metastatic stomach cancer. At this stage, the cancer may have spread to the lining of the abdomen, liver, lungs or lymph nodes outside the local area of the stomach. Because the cancer has spread to another part of the body, surgery often cannot remove it completely. But surgery is sometimes used to help control symptoms. Targeted therapy may be used with systemic chemotherapy for cancer that has spread to distant parts of the body or has come back after treatment.
TNM staging
To describe each stage in more detail, healthcare professionals commonly use the TNM system. This system looks at three key factors:
- T. The size of the primary tumor.
- N. Whether the cancer has spread to nearby lymph nodes.
- M. Whether the cancer has spread to other parts of the body, called metastasis.
Staging can be complex. If you're not sure what something means, ask your healthcare team to explain it in a way that makes sense to you.
How fast does stomach cancer spread?
How quickly a cancer grows or spreads varies from person to person. Some types of stomach cancer may be more aggressive than others. Staging for stomach cancer is a way to describe the extent of the cancer at diagnosis. But it does not tell you how quickly the cancer is growing or spreading. Different types of stomach cancer can spread in different ways. For example, cancer cells that form a mass versus ones that are more diffuse spread at different rates. Your healthcare team can tell you more about what the features of your cancer may mean for you.
Looking ahead
After a diagnosis of stomach cancer, the outlook is different for everyone. Treatment for stomach cancer continues to improve. Your healthcare team can help you identify options for your care. The options and goals of treatment depend on the stage and type of cancer, your health and how well the treatment kills the cancer cells.
Your experience with cancer is unique, and your care team supports you through each step. After treatment, regular follow-up with your care team can help manage your health and check for any signs that the cancer has come back.
Aug. 22, 2026