Skin cancer (non-melanoma)
of cancer, cancer types in adults

Skin cancer is one of the most common cancers in the world. Non-melanoma skin cancer refers to a group of cancers that slowly develop in the upper layers of the skin.

The term ‘non-melanoma’ distinguishes these more common kinds of skin cancer from the less common skin cancer known as melanoma, which spreads faster in the body.

The first sign of non-melanoma skin cancer is usually the appearance of a lump or patch on the skin that doesn’t heal after a few weeks.

In most cases, cancerous lumps are red and firm, while cancerous patches are often flat and scaly.

Speak to your GP if you have any skin abnormality that hasn’t healed after 4 weeks. Although it is unlikely to be skin cancer, it is best to be sure.

Read more about the symptoms of non-melanoma skin cancer

Symptoms

The main symptom of non-melanoma skin cancer is the appearance of a lump or discoloured patch on the skin that doesn’t heal.

The lump or discoloured patch is the cancer, sometimes referred to as a tumour.

Non-melanoma skin cancer most often appears on areas of skin which are regularly exposed to the sun, such as the face, ears, hands and shoulders.

Causes

Non-melanoma skin cancer is mainly caused by overexposure to ultraviolet (UV) light. UV light comes from the sun, as well as artificial sunbeds and sunlamps.

In addition to UV light overexposure, there are certain things that can increase your chances of developing non-melanoma skin cancer, such as:

a family history of the condition pale skin that burns easily a large number of moles or freckles

Read more about the causes of non-melanoma skin cancer


Most skin cancer is caused by ultraviolet (UV) light damaging the DNA in skin cells. The main source of UV light is sunlight.

Sunlight contains 3 types of UV light:

ultraviolet A (UVA) ultraviolet B (UVB) ultraviolet C (UVC)

UVC is filtered out by the Earth’s atmosphere but UVA and UVB damage skin over time, making it more likely for skin cancers to develop. UVB is thought to be the main cause of non-melanoma skin cancer.

Artificial sources of light, such as sunlamps and tanning beds, also increase your risk of developing skin cancer.

Repeated sunburn, either by the sun or artificial sources of light, will make your skin more vulnerable to non-melanoma skin cancer.

Diagnoses

Your GP can examine your skin for signs of skin cancer. They may refer you to a skin specialist (dermatologist) or a specialist plastic surgeon if they are unsure or suspect skin cancer.

Your GP may refer you urgently, within 2 weeks, for squamous cell skin cancer. Basal cell skin cancers usually don’t need an urgent referral but you should still see a specialist within 18 weeks.

The specialist will examine your skin again and will perform a biopsy to confirm a diagnosis of skin cancer.

A biopsy is an operation that removes some affected skin so it can be studied under a microscope.

Read more about diagnosing non-melanoma skin cancer


A diagnosis of non-melanoma skin cancer will usually begin with a visit to your GP who will examine your skin and decide whether you need further assessment by a specialist.

Some GPs take digital photographs of suspected tumours so they can email them to a specialist for assessment.

In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of skin cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected skin cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral.


If you have basal cell carcinoma (BCC), then you usually won’t require further tests, as the cancer is unlikely to spread.

However, in rare cases of squamous cell carcinoma, further tests may be needed to make sure the cancer has not spread to another part of your body.

These tests may include a physical examination of your lymph nodes (glands found throughout your body). If cancer has spread, it may cause your glands to swell.

If the dermatologist or plastic surgeon thinks there is a high risk of the cancer spreading, it may be necessary to perform a biopsy on a lymph node. This is called a fine needle aspiration (FNA).

During FNA, cells are removed using a needle and syringe so they can be examined. Finding cancerous cells in a nearby lymph node would suggest the squamous cell carcinoma has started to spread to other parts of your body.

Treatments

Surgery is the main treatment for non-melanoma skin cancer. This involves removing the cancerous tumour and some of the surrounding skin.

Other treatments for non-melanoma skin cancer include cryotherapy, creams, radiotherapy, chemotherapy and a treatment known as photodynamic therapy (PDT).

Treatment for non-melanoma skin cancer is generally successful as, unlike most other types of cancer, there is a considerably lower risk that the cancer will spread to other parts of the body.

It is estimated that basal cell carcinoma will spread to other parts of the body in less than 0.5% of cases. The risk is slightly higher in cases of squamous cell carcinoma, which spreads to other parts of the body in around 2 to 5% of cases.

Treatment for non-melanoma skin cancer is completely successful in approximately 90% of cases.

Read more about treating non-melanoma skin cancer


If you develop a lump, lesion or skin discolouration that hasn’t healed after 4 weeks, speak to your GP. While it is unlikely to be cancer, it is best to be sure.

Read further information:

Cancer Research UK: Skin cancer symptoms Macmillan: Symptoms of skin cancer


Surgery is the main treatment for non-melanoma skin cancer, although it may depend on your individual circumstances.

Overall, treatment is successful for more than 90% of people with non-melanoma skin cancer.

People with cancer should be cared for by a team of specialists that often includes a dermatologist, a plastic surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a pathologist and a specialist nurse.

If you have non-melanoma skin cancer, you may see several (or all) of these professionals as part of your treatment.

When deciding what treatment is best for you, your doctors will consider:

the type of cancer you have the stage of your cancer (how big it is and how far it has spread) your general health

Your cancer team will recommend what they think is the best treatment option, but the final decision will be yours.

Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions you would like to ask the specialist. For example, you may want to find out what the advantages and disadvantages of particular treatments are.

The National Institute for Health and Care Excellence (NICE) has produced healthcare guidelines about NHS skin cancer services. These outline NICE’s main recommendations on how, over the coming years, people with skin cancer or melanoma should be treated.

Read further information:

NICE: improving outcomes for people with skin tumours including melanoma

Preventions

Non-melanoma skin cancer is not always preventable, but you can reduce your chances of developing the condition by avoiding overexposure to UV light.

You can help protect yourself from sunburn by using sunscreen, dressing sensibly in the sun and limiting the time you spend in the sun during the hottest part of the day.

Sunbeds and sunlamps should also be avoided.

Regularly checking your skin for signs of skin cancer can help lead to an early diagnosis and increase your chances of successful treatment.

Read more about sunscreen and sun safety

Complications

If you have had non-melanoma skin cancer in the past, there is a chance the condition may return. The chance of non-melanoma skin cancer returning is increased if your previous cancer was widespread and severe.

If your cancer team feels there is a significant risk of your non-melanoma skin cancer returning, you will probably require regular check-ups to monitor your health. You will also be shown how to examine your skin to check for tumours.

Slapped cheek syndrome
of infections and poisoning

Slapped cheek syndrome is normally a mild infection that clears up by itself in 1 to 3 weeks. Once you’ve had the infection, you’re usually immune to it for life.

However, slapped cheek syndrome can be more serious for some people. If you’re pregnant, have a blood disorder or a weakened immune system and have been exposed to the virus, you should get medical advice.


However, slapped cheek syndrome can be more serious for some people. If you’re pregnant, have a blood disorder or a weakened immune system and have been exposed to the virus, you should get medical advice.

Symptoms

Symptoms of slapped cheek syndrome usually develop 4 to 14 days after becoming infected. Sometimes, symptoms may not appear for up to 21 days.

First symptoms

Some people with slapped cheek syndrome won’t notice any early symptoms, but most people will have the following symptoms for a few days:

a slightly high temperature (fever) of around 38°C (100.4°F) a runny nose a sore throat a headache an upset stomach feeling generally unwell

The infection is most contagious during this initial period.

Adults may also feel joint pain and stiffness. This may continue for several weeks or even months after the other symptoms have passed.

Slapped cheek rash

Image source: dermnetnz.org

After a few days, a distinctive bright red rash on both cheeks (‘slapped cheeks’) normally appears. Adults may not get this.

By the time this rash develops, the condition is no longer contagious.

After another few days, a light pink rash may also appear on the chest, stomach, arms and thighs. This often has a raised, lace-like appearance and may be itchy.

The rashes will normally fade within a week or two. Occasionally, the body rash may come and go for a few weeks after the infection has passed. This can be triggered by exercise, heat, anxiety or stress.

Treatments

You don’t usually need to see your GP if you think you or your child has slapped cheek syndrome as it normally gets better on its own.

Speak to your GP practice if: You’ve been exposed to anyone with slapped cheek syndrome or you have symptoms of the infection and: you’re pregnant – there’s a very small risk of miscarriage or other complications you have a blood disorder, such as sickle cell anaemia or thalassaemia you have a weakened immune system ask for an urgent appointment if you have symptoms of severe anaemia, such as very pale skin, shortness of breath, extreme tiredness or fainting If your GP is closed, phone 111.

In these cases, a blood test may be carried out to see if you’re immune to the infection. If you’re not immune, you’ll be monitored carefully to check for any problems.

If you develop severe anaemia, it’s likely that you’ll be sent to hospital for a blood transfusion.

Preventions

It’s very difficult to prevent slapped cheek syndrome. This is because people who have the infection are most contagious before they develop any obvious symptoms.

Make sure that everyone you live with washes their hands often to help stop the infection from spreading.

There’s currently no vaccine available to protect you against the condition.

Soft tissue sarcomas
of cancer, cancer types in adults

Tissues that can be affected by soft tissue sarcomas include fat, muscle, blood vessels, deep skin tissues, tendons and ligaments.

Soft tissue sarcomas can develop in almost any part of the body, including the legs, arms and the trunk (torso).

There are many different types of soft tissue sarcoma, depending on where in the body they are located. For example:

leiomyosarcomas – which develop in muscle tissue liposarcomas – which develop in fat tissue angiosarcomas – which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) – which can develop in the connective tissues that support the organs of the digestive system

Soft tissue sarcomas account for around 1 in every 100 cancers diagnosed in the UK.


Soft tissue sarcomas can develop in almost any part of the body, including the legs, arms and the trunk (torso).

There are many different types of soft tissue sarcoma, depending on where in the body they are located. For example:

leiomyosarcomas – which develop in muscle tissue liposarcomas – which develop in fat tissue angiosarcomas – which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) – which can develop in the connective tissues that support the organs of the digestive system

Soft tissue sarcomas account for around 1 in every 100 cancers diagnosed in the UK.


There are many different types of soft tissue sarcoma, depending on where in the body they are located. For example:

leiomyosarcomas – which develop in muscle tissue liposarcomas – which develop in fat tissue angiosarcomas – which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) – which can develop in the connective tissues that support the organs of the digestive system

Soft tissue sarcomas account for around 1 in every 100 cancers diagnosed in the UK.

Symptoms

As soft tissue sarcomas can develop in most parts of the body, they can cause a wide range of symptoms.

For example, a tumour near the stomach may cause abdominal (tummy) pain, a feeling of fullness and constipation, whereas a tumour near the lungs may cause a cough or breathlessness.

There are often no obvious symptoms in the early stages of soft tissue sarcomas, although you may notice a soft, painless lump under your skin or deeper, that can’t easily be moved around and gets bigger over time.

You should speak to your GP if you have a worrying lump or any other troublesome symptoms. A lump the size of a golf ball or larger should be regarded as suspicious and needs to be investigated urgently.

Although it is much more likely you have a benign (non-cancerous) condition, it is important to get your symptoms checked out.

Causes

Cancer develops when cells multiply uncontrollably, forming tumours. 

In the vast majority of soft tissue sarcomas it’s unclear what causes this to happen but there are a number of factors known to increase the risk, including:

age – soft tissue sarcomas can occur at any age, including in children, but they are more common in middle-aged or elderly people and your risk increases as you get older certain genetic conditions – some genetic conditions, such as neurofibromatosis type 1 and retinoblastoma, are associated with an increased risk of soft tissue sarcomas previous radiotherapy – some people who have previously had radiotherapy for another type of cancer develop a soft tissue sarcoma, often many years after their previous treatment exposure to certain chemicals – exposure to some chemicals, including vinyl chloride, dioxins and phenoxyacetic herbicides, has been associated with increased rates of soft tissue sarcomas

One particular type of soft tissue sarcoma called Kaposi’s sarcoma – which develops in skin cells – is caused by a virus known as the human herpesvirus type 8 (HHV-8) infecting someone with a weakened immune system (such as people with HIV).

Diagnoses

If your GP feels there is a possibility you do have cancer, they will refer you for a number of hospital tests to confirm whether you have a soft tissue sarcoma.

In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of soft tissue sarcoma and refer people for the right tests faster. To find out if you should be referred for further tests for suspected soft tissue sarcoma, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral.

A diagnosis of a soft tissue sarcoma will usually be made by a hospital specialist and will be based on your symptoms, a physical examination, and the results of:

a biopsy – where a sample of suspected cancerous tissue is removed using a needle or during an operation so it can be tested and analysed in a laboratory imaging tests – a magnetic resonance imaging (MRI) scan is the main type of scan carried out to assess soft tissue sarcomas, although other scans may also be carried out

If a diagnosis of a soft tissue sarcoma is confirmed, these tests will also help determine how far the cancer has spread (known as the ‘stage’) and how aggressive the cancer is (known as the ‘grade’).

Treatments

If you’re diagnosed with a soft tissue sarcoma your care team of specialist doctors and nurses will help you decide on the most appropriate treatment.

Treatment depends on factors such as the stage and grade of the cancer, the location of any tumours, and your age and general health.

The main treatments used are:

surgery – to remove any tumours radiotherapy – where high-energy radiation is used to kill cancer cells chemotherapy – where medication is used to kill cancer cells

Surgery

Surgery is the main treatment for soft tissue sarcomas that are detected at an early stage.

It involves removing the cancerous tumour along with a section of surrounding healthy tissue. This will help ensure no cancer cells are left behind.

Every effort will be made to reduce the impact of surgery on the appearance and functionality of the affected body part.

But there is a possibility you’ll have some difficulty using the part of the body that is operated on after surgery and sometimes reconstructive plastic surgery may be needed to repair significant damage.

In a small number of cases, there may be no option but to amputate the part of the body where the cancer is located, such as part of the leg.

Radiotherapy

Radiotherapy is often used after surgery to destroy any remaining cancer cells. This is carried out using an external machine that directs beams of radiation at a defined treatment area.

Radiotherapy may also sometimes be used before surgery to make a tumour easier to remove, or as part of your treatment to reduce your symptoms if surgery is not possible.

Common side effects of radiotherapy include sore skin, tiredness and hair loss in the treatment area. These tend to get better within a few days or weeks of treatment finishing.

Read more about the side effects of radiotherapy

Chemotherapy

Like radiotherapy, chemotherapy is sometimes used before surgery to shrink a tumour and make it easier to remove. This involves being given anti-cancer medication directly into a vein (intravenously).

Chemotherapy may also be used alone or alongside radiotherapy for soft tissue sarcomas that cannot be surgically removed.

Chemotherapy medications have a poisonous effect on the body’s cells, and can cause a number of temporary but unpleasant side effects, such as feeling tired and weak all the time, feeling and being sick, and hair loss from several parts of the body.

Read more about the side effects of chemotherapy

Soft tissue sarcomas: Teenagers and young adults
of cancer, cancer types in teenagers and young adults

This section is for teenagers and young adults. It’s about a type of cancer called soft tissue sarcoma.

There are several different types of soft tissue sarcoma. The information in this section covers rhabdomyosarcomas, synovial sarcomas, soft tissue Ewing’s sarcoma and fibrosarcomas. These are the most common types in teenagers. If you have a different type and want to know more, contact Macmillan.

If you’re looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma section.

Soft tissue sarcomas are cancers that develop from cells in the soft, supporting tissues of the body. There are many different types, but the ones that tend to affect teenagers are:

rhabdomyosarcomas synovial sarcomas soft tissue Ewing’s sarcoma fibrosarcomas

Sarcomas can also develop in the bones. This is called osteosarcoma. 

Symptoms

The symptoms of a sarcoma will depend on where it is:

if it’s in an arm or leg, symptoms include a lump or swelling in the limb – this is usually painless, but not always if it’s in the tummy (abdomen), symptoms include a painful, swollen tummy, and problems going to the toilet to poo (called constipation) if it’s in your bladder, symptoms include pain in the lower tummy, finding it difficult to pee (pass urine), and having blood in your pee if it’s in the chest, symptoms can include breathlessness, a cough and pain in your chest if it’s in the head or neck, symptoms include a lump, a blockage and discharge from the nose or throat; occasionally an eye may become swollen and stick out a bit

You may also have other symptoms, such as tiredness, loss of appetite or weight loss.

Remember – most people with these symptoms won’t have a sarcoma.  But if you have any of these symptoms, or are worried that you may have a sarcoma, the first thing to do is to speak to your GP. They’ll examine you and refer you to a hospital if they think you need to see a specialist doctor.

Causes

It’s unknown what causes sarcomas in teenagers and young adults.

People often think a knock or injury might have caused a sarcoma, but there’s no evidence for this.

Remember that nothing you’ve done has caused the cancer.


It’s unknown what causes sarcomas in teenagers and young adults.

Remember that nothing you’ve done has caused the cancer. 

Some rare conditions that run in families (known as genetic conditions) can increase the chance (risk) of getting a soft tissue sarcoma. You would usually know if anyone in your family had one of these conditions.

People who had radiotherapy for another type of cancer when they were a child may have an increased risk of developing a sarcoma in later life – this would be from their teens onwards. 

People often think a knock or injury might have caused a sarcoma, but there’s no evidence for this.

If you’re looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information.

Diagnoses

There are some tests you might have at your GP surgery or at the hospital. These tests will help the doctors see whether you have a soft tissue sarcoma.

Treatments

This section is for teenagers and young adults. It’s about treatment for a type of cancer called a soft tissue sarcoma. There are different types of soft tissue sarcoma, and the information in this section covers rhabdomyosarcomas, synovial sarcomas and fibrosarcomas, which are the most common types in teenagers.

If you have a different type and want to know more, please contact Macmillan.

The 3 main types of treatment for soft tissue sarcomas are surgery, chemotherapy and radiotherapy.

Most people have a combination of treatments. Your doctors will plan your treatment based on:

the type of sarcoma you have the stage of the cancer (how big it is and whether it has spread from where it started) the grade of the cancer (how fast-growing the cancer cells are).

If you have any questions about your treatment, ask your doctor or nurse. They’ll be happy to help you understand what’s involved.

If you have a type of soft tissue sarcoma called a soft tissue Ewing’s sarcoma, it’s treated in the same way as a Ewing’s sarcoma in a bone.

Sore throat
of ears nose and throat

Most are caused by minor illnesses such as cold or flu and can be treated at home.







Do take ibuprofen or paracetamol – paracetamol is better for children and for people who can’t take ibuprofen (children under 16 should never take aspirin) drink plenty of cool or warm fluids, and avoid very hot drinks eat cool, soft foods avoid smoking and smoky places suck lozenges, hard sweets, ice cubes or ice lollies – but don’t give young children anything small and hard to suck because of the risk of choking gargle with a homemade mouthwash of warm, salty water (children should not try this)

How to gargle with salt water Dissolve half a teaspoon of salt in a glass of warm water (warm water helps salt dissolve). Gargle with the solution, then spit it out (do not swallow it). Repeat as often as you like.

There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There isn’t much scientific evidence to suggest they help, although some people find them worth using.

Antibiotics aren’t usually prescribed for a sore throat, even if it’s caused by a bacterial infection. They’re unlikely to make you feel better any quicker and they have unpleasant side effects. 

Symptoms

Common causes

A sore throat is often a symptom of: 

colds or flu – you may also have a blocked or runny nose, a cough, a high temperature (fever), a headache and general aches  laryngitis (inflammation of the voice box) – you may also have a hoarse voice, a dry cough and a constant need to clear your throat tonsillitis (inflammation of the tonsils) – you may also have red or spotty tonsils, discomfort when swallowing and a fever   strep throat (a bacterial throat infection) – you may also have swollen glands in your neck, discomfort when swallowing and tonsillitis glandular fever – you may also feel very tired, have a fever and swollen glands in your neck 

It may also be caused by something irritating your throat. For example, smoke, gastro-oesophageal reflux disease (where acid leaks up from the stomach) and allergies. 

Less common causes 

Less often, a sore throat can be a sign of:

a painful collection of pus at the back of the throat (quinsy) – the pain may be severe and you may also have difficulty opening your mouth or difficulty swallowing inflammation of the flap of tissue at the back of the throat (epiglottitis) – the pain may be severe and you may have difficulty breathing and difficulty swallowing

These conditions are more serious and should be seen by a doctor as soon as possible.

Causes

The cause of a sore throat isn’t always obvious. But in most cases it’s a symptom of a viral or bacterial infection.

Common causes

A sore throat is often a symptom of: 

colds or flu – you may also have a blocked or runny nose, a cough, a high temperature (fever), a headache and general aches  laryngitis (inflammation of the voice box) – you may also have a hoarse voice, a dry cough and a constant need to clear your throat tonsillitis (inflammation of the tonsils) – you may also have red or spotty tonsils, discomfort when swallowing and a fever   strep throat (a bacterial throat infection) – you may also have swollen glands in your neck, discomfort when swallowing and tonsillitis glandular fever – you may also feel very tired, have a fever and swollen glands in your neck 

It may also be caused by something irritating your throat. For example, smoke, gastro-oesophageal reflux disease (where acid leaks up from the stomach) and allergies. 

Less common causes 

Less often, a sore throat can be a sign of:

a painful collection of pus at the back of the throat (quinsy) – the pain may be severe and you may also have difficulty opening your mouth or difficulty swallowing inflammation of the flap of tissue at the back of the throat (epiglottitis) – the pain may be severe and you may have difficulty breathing and difficulty swallowing

These conditions are more serious and should be seen by a doctor as soon as possible.

Treatments

There are things you can do to help soothe a sore throat.

Do take ibuprofen or paracetamol – paracetamol is better for children and for people who can’t take ibuprofen (children under 16 should never take aspirin) drink plenty of cool or warm fluids, and avoid very hot drinks eat cool, soft foods avoid smoking and smoky places suck lozenges, hard sweets, ice cubes or ice lollies – but don’t give young children anything small and hard to suck because of the risk of choking gargle with a homemade mouthwash of warm, salty water (children should not try this)

How to gargle with salt water Dissolve half a teaspoon of salt in a glass of warm water (warm water helps salt dissolve). Gargle with the solution, then spit it out (do not swallow it). Repeat as often as you like.

There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There isn’t much scientific evidence to suggest they help, although some people find them worth using.

Antibiotics aren’t usually prescribed for a sore throat, even if it’s caused by a bacterial infection. They’re unlikely to make you feel better any quicker and they have unpleasant side effects. 


Go to A&E or phone 999 if: You or your child have:  symptoms that are severe or getting worse quickly difficulty breathing or swallowing severe pain started drooling  a muffled voice  a high-pitched sound as you breathe (stridor)

If you have a sore throat, you can get advice and treatment directly from a pharmacy.

Find your nearest pharmacy

You don’t usually need to get medical advice if you have a sore throat. Your pharmacist may advise you to see your GP if:

your symptoms are severe – for example with a high temperature or you feel shivery you have persistent symptoms that haven’t started to improve after a week  you experience severe sore throats frequently  you have a weak immune system – for example, you have HIV, are having chemotherapy, or are taking medication that suppresses your immune system 

If your GP practice is closed, phone 111. 

If you have a persistent sore throat (one that lasts 3 to 4 weeks), you should see your GP who may refer you for further tests. This is because your sore throat may be a symptom of a more serious condition. 

Spleen problems and spleen removal
of stomach liver and gastrointestinal tract

The spleen is a fist-sized organ found in the upper left side of your abdomen, next to your stomach and behind your left ribs. 

It’s an important part of your immune system but you can survive without it. This is because the liver can take over many of the spleen’s functions.


It’s an important part of your immune system but you can survive without it. This is because the liver can take over many of the spleen’s functions.

Symptoms

feeling full very quickly after eating (an enlarged spleen can press on the stomach) feeling discomfort or pain behind your left ribs  anaemia and/or fatigue frequent infections easy bleeding

Doctors can often tell if you have an enlarged spleen by feeling your abdomen. A blood test, CT scan or MRI scan would confirm the diagnosis.

The spleen is not usually removed if it’s just enlarged. Instead, you’ll receive treatment for any underlying condition and your spleen will be monitored. Antibiotics may be prescribed if there’s an infection.

You’ll need to avoid contact sports for a while, as you’ll be at greater risk of rupturing the spleen while it is enlarged.

Surgery is only necessary if the enlarged spleen is causing serious complications or if the cause can’t be found.

Stillbirth
of pregnancy and childbirth

It’s a devastating experience for parents and can affect you and your family in ways you don’t expect.



If you already have children, think about how they might be feeling too and what support they’ll need.

This is a very difficult time for you and everyone close to you so it’s important to support each other and ask for help if you need it.

Causes

The stillbirth or death of a newborn baby can happen for lots of reasons and doctors don’t yet know all the causes.

Some are linked to problems with the placenta or mum’s health and others to the baby’s health or development but in some cases the reason can’t be explained.

Although there are many reasons that a stillbirth can happen, you can decrease the risk by maintaining a health lifestyle before and during pregnancy.

Read more about living a healthy lifestyle during pregnancy

Stomach ache and abdominal pain
of stomach liver and gastrointestinal tract

Your pharmacist can recommend treatments to help, such as:

buscopan mebeverine

Find your local pharmacy

Symptoms

Stomach cancer
of cancer, cancer types in adults

Stomach cancer, or gastric cancer, is a fairly uncommon type of cancer. 

The initial symptoms of stomach cancer are vague and easy to mistake for other less serious conditions. They include:

persistent indigestion and heartburn trapped wind and frequent burping feeling very full or bloated after meals persistent stomach pain

Symptoms of advanced stomach cancer can include:

blood in your stools, or black stools loss of appetite weight loss

As the early symptoms of stomach cancer are similar to those of many other conditions, the cancer is often advanced by the time it’s diagnosed. It’s therefore important to get any possible symptoms of stomach cancer checked by your GP as soon as possible.

Read more about diagnosing stomach cancer

Symptoms

Many symptoms of stomach cancer are similar to less serious conditions, so it can be difficult to recognise in the early stages.

Early stage symptoms include:

persistent indigestion trapped wind and frequent burping heartburn feeling full very quickly when eating feeling bloated after eating feeling sick pain in your stomach or breastbone difficulty swallowing (dysphagia) vomiting (the vomit may be streaked with blood), although this is uncommon in the early stages

Causes

Stomach cancer is caused by changes in the cells of the stomach, although it’s unclear exactly why these changes occur.

Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour.

Left untreated, cancer can spread to other parts of the body, usually through the lymphatic system (a network of vessels and glands called lymph nodes located throughout the body).

Once the cancer reaches your lymphatic system, it’s capable of spreading to other parts of your body, including your blood, bones and organs.

It’s not known what triggers the changes in DNA that lead to stomach cancer and why only a small number of people develop the condition.

Diagnoses

Speak to your GP as soon as possible if you have stomach cancer symptoms such as indigestion, unexpected weight loss, anaemia and persistent vomiting.

Your GP will ask about your symptoms and examine your stomach for any lumpiness or tenderness. If they think that stomach cancer may be a possibility they’ll refer you to a specialist for further investigation.

In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of stomach cancer and refer people for the right tests faster. Find out who should be referred for further tests for suspected stomach cancer.


If your GP thinks you may have stomach cancer, they’ll refer you to a specialist for tests.

These may include a blood test and chest X-ray, which will assess your overall health. A sample of your stools may also be tested for blood.

Because of the potentially serious nature of stomach cancer, you should be referred to the specialist within 2 weeks. Read more about waiting times.

Endoscopy and endoscopic ultrasound

An endoscopy is a procedure where the inside of your body is examined using a piece of equipment called an endoscope (a long, thin flexible tube with a light and a video camera at the end).

If you need to have an endoscopy, you won’t be able to eat or drink for four to eight hours before the procedure. This is to ensure your stomach and duodenum (top of the small intestine) are empty.

You’ll be awake during the endoscopy, but may be given a sedative by injection to make you feel drowsy and relaxed. A local anaesthetic may also be sprayed onto the back of your throat, so the area is numbed.

The endoscope will be passed down your gullet (food pipe) and into your stomach so the specialist can look for any stomach ulcers or signs of cancer. If tissue is found that may be cancerous, a sample will be taken for testing. This procedure is known as a biopsy. The sample will be examined under a microscope in a laboratory. The results will show whether the cells are cancerous (malignant) or non-cancerous (benign) and will usually take 7 to 10 days to come back.

The endoscopy itself usually takes about 15 minutes, although you should allow about 2 hours in total for your visit.

If your specialist thinks you may have cancer in the top part of your stomach, you may have an ultrasound scan at the same time as an endoscopy. This is known as an endoscopic ultrasound and uses high-frequency sound waves to produce an image of your stomach (this method is commonly used to view an unborn baby in the womb).

If you have an endoscopic ultrasound, an ultrasound probe will be attached to the end of the endoscope before it’s passed down your throat. The scan will help determine the stage of any cancer in the top part of your stomach.

After an endoscopy, or an endoscopic ultrasound, you won’t be able to drive for several hours because of the sedative. You may also have a sore throat, although this should pass within a few days.

Barium meal X-ray

A barium meal X-ray or barium swallow involves drinking a chalky liquid containing a substance called barium, which makes your stomach show up on an X-ray. Nowadays, however, it’s less commonly used to diagnose stomach cancers.

Organs such as your stomach don’t usually show up on an X-ray because they’re made of soft tissue that isn’t dense enough to stop the X-rays passing through. However, when these organs are filled with barium, it blocks the X-rays and shows up white on an X-ray screen.

You won’t able to eat or drink for at least 6 hours before the procedure because your stomach and duodenum need to be empty. You may be given an injection to relax the muscles in your digestive system.

A barium swallow usually takes about 15 minutes. Afterwards, you’ll be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system. You may feel slightly sick, and the barium may cause constipation. Your stools may be white for a few days afterwards as the barium passes through your system.


If you’re diagnosed with stomach cancer, further tests may be needed to help determine how far it’s spread and how quickly it’s likely to spread (known as the stage and grade). Your cancer specialist (oncologist) will discuss this with you.

However, it may not always be possible to identify the exact stage of your condition until your treatment starts.

Laparoscopy

Your specialist may need to examine your stomach in more detail to see if the cancer has spread, particularly to the lining of the abdominal cavity (peritoneum). If it has, you may need to have a small operation called a laparoscopy. This procedure is carried out under a general anaesthetic, so you’ll be unconscious during it.

During the procedure, a thin viewing tube with a camera at the end (a laparoscope) will be inserted into your stomach through a small incision in the lower part of your tummy. In some cases, your specialist may need to examine more than one area of your stomach and make more than one incision.

Computerised tomography or positron emission tomography scans

During CT scans or PET scans, a series of X-ray images of your body are taken. A computer is then used to put the images together and create a detailed picture of the inside of your body.

These scans will help your doctor assess how advanced your cancer is. It allows them to see whether the cancerous cells have formed tumours anywhere else in the body. The scans can also help your doctors work out which type of treatment will be most effective and appropriate for you.

Liver ultrasound scan

If your specialist thinks your stomach cancer may have spread to your liver, you may need to have a liver ultrasound. This type of scan uses high-frequency sound waves to produce an image of your liver.

Treatments

Many cases of stomach cancer can’t be completely cured, but it’s still possible to relieve symptoms and improve quality of life using chemotherapy and in some cases radiotherapy and surgery.

If operable, surgery can cure stomach cancer as long as all of the cancerous tissue can be removed.

Surgery to remove some or all of the stomach is known as a gastrectomy. It will still be possible to eat normally after a gastrectomy, but you’ll probably have to adjust the size of your portions. 

Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer returning.

Read more about treating stomach cancer


Stomach cancer is usually easier to treat if it’s diagnosed early. It’s therefore important for your GP to refer you to a specialist as soon as possible if stomach cancer is suspected.

Stomach cancer is much more common in older people, with 90 out of 100 cases occurring in people who are over 55 years of age.

Indigestion is a very common symptom in the general population. However, it’s unlikely that someone with indigestion who’s under the age of 55 will have stomach cancer.

However, see your GP if you have indigestion and weight loss, anaemia or persistent vomiting. They should refer you to a specialist for further testing.

Also see your GP if you have difficulty swallowing. This isn’t a common symptom among the general population and the cause should always be investigated.

Read more about diagnosing stomach cancer


The treatments recommended for stomach cancer will depend on your general health and how far the cancer has spread.

Most hospitals use multidisciplinary teams made up of a number of different specialists (see below) who work together to plan and carry out the best treatment, tailored to your circumstances.

Feel free to discuss treatment with your care team at any time and ask questions.


The main treatments for stomach cancer are surgery, chemotherapy and radiotherapy. You may have 1 of these treatments or a combination.

If surgery is recommended, you may have chemotherapy beforehand. If the tumour is in the upper part of your stomach, including the junction between the oesophagus and stomach, you may also have radiotherapy prior to surgery.

Surgery is mainly used if stomach cancer is diagnosed at an early stage, whereas chemotherapy and radiotherapy tend to be used when the condition is diagnosed at a later stage.

Where possible, the primary aim of treatment is to completely remove the tumour and any other cancerous cells in your body. It’s estimated that a cure is possible in 20 to 30% of stomach cancer cases.

If it’s not possible to remove the tumour, your doctors will focus on trying to prevent it from getting any bigger and causing further harm to your body. This may be done using surgery or chemotherapy. 

In some cases, it’s not possible to eliminate the cancer or slow it down. In this case, your treatment will aim to relieve your symptoms and make you as comfortable as possible, usually with surgery or radiotherapy.

A relatively new medication called trastuzumab (see below) can also be used to treat some types of advanced stomach cancer.

Your healthcare team will talk to you about which treatments are most suitable.

Stomach ulcer
of stomach liver and gastrointestinal tract

Stomach ulcers (gastric ulcers) are open sores that develop on the lining of the stomach. Ulcers can also occur in part of the intestine just beyond the stomach. These are called duodenal ulcers.

Stomach and duodenal ulcers are sometimes called peptic ulcers. This information applies to both.

Symptoms

Although the most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen (tummy). Not all stomach ulcers are painful.

Some people experience:

indigestion heartburn nausea (feeling sick)

You should speak to your GP if you think you have a stomach ulcer.

More about the symptoms of a stomach ulcer

Get urgent medical advice

Speak to your GP immediately (or phone 111) if:

your symptoms persist you’re vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds you’re passing dark, sticky, tar-like stools you feel a sudden, sharp pain in your tummy that gets steadily worse

These could be a sign of a serious complication.


The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy).

However, some stomach ulcers aren’t painful and are only noticed when a complication develops, such as bleeding from the ulcer.


Less common symptoms of a stomach ulcer include:

indigestion heartburn loss of appetite feeling and being sick weight loss

Some people also find they burp or become bloated after eating fatty foods.

Causes

Stomach ulcers occur when the layer protecting the stomach lining from stomach acid breaks down. This allows the stomach lining to become damaged.

This is usually caused by:

an infection with Helicobacter pylori (H. pylori) bacteria taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin – particularly if they’re taken for a long time or at high doses

There’s little evidence that stress or certain foods causes stomach ulcers.

More about the causes of stomach ulcers


Stomach ulcers are usually caused by Helicobacter pylori (H. pylori) bacteria or non-steroidal anti-inflammatory drugs (NSAIDs).

These can break down the stomach’s defence against the acid it produces to digest food. The stomach lining then becomes damaged causing an ulcer to form.


If your stomach ulcer’s caused by taking NSAIDs:

you’ll be given a course of PPI medication your use of NSAIDs will be reviewed, and you may be advised to use an alternative painkiller

Alternative painkillers

You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol.

COX-2 inhibitors are sometimes recommended. These are an alternative type of NSAID that’s less likely to cause stomach ulcers.

Low-dose aspirin

If you’re taking low-dose aspirin to reduce your risk of blood clots, your GP will tell you whether you need to keep taking it.

If you do, you may also be prescribed long-term treatment with a PPI or H2-receptor antagonist to prevent further ulcers.

Complications

It’s important to understand the potential risks associated with continued NSAID use.

You’re more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.

Read more about the complications of stomach ulcers

Diagnoses

If your GP thinks you have an ulcer, they

will want to know if you’re taking non-steroidal anti-inflammatory drugs (NSAIDs) might test you for an Helicobacter pylori (H. pylori) infection

In some cases, you may be referred for a gastroscopy to look for an ulcer inside your stomach.


If your GP thinks your symptoms might be caused by an H. pylori infection, you’ll be offered a:

urea breath test stool antigen test – a small stool sample is tested for the bacteria blood test

Urea breath test

You’ll be given a special drink containing a chemical that’s broken down by H. pylori. Your breath is then analysed to see whether or not you have an H. pylori infection.

Blood test

A sample of your blood’s tested for antibodies to the H. pylori bacteria. Antibodies are proteins produced naturally in your blood to help fight infection.

This test’s now largely been replaced by the stool antigen test

More about blood tests

Treatments

You’ll be treated using antibiotics if your ulcer was caused by a H. pylori infection. This kills the bacteria and should prevent the ulcer coming back.

You’ll be treated using a proton pump inhibitor (PPI) if your ulcer was caused by NSAIDs. Your doctor will prescribe these and discuss whether you should keep using NSAIDs. Alternative medication to NSAIDs, such as paracetamol, may be recommended.

Most stomach ulcers take a few months to heal after treatment. However, stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.

More about treating stomach ulcers


If you have a stomach ulcer, your treatment will depend on what caused it.

With treatment, most ulcers heal in a month or two.


If your stomach ulcer’s caused by a Helicobacter pylori (H. pylori) bacterial infection, you’ll be given:

a course of antibiotics a medication called a proton pump inhibitor (PPI)

This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs).

Antibiotics

If you have an H. pylori infection, you’ll usually be prescribed a course of 2 or 3 antibiotics.

The most commonly used antibiotics are:

amoxicillin clarithromycin metronidazole

You should take these twice a day for a week.

Side effects

The side effects of these are usually mild, but can include:

feeling and being sick diarrhoea a metallic taste in your mouth

Further testing

You’ll be re-tested at least 4 weeks after finishing your antibiotic course to see if there are any H. pylori bacteria left in your stomach. If there are, a further course of eradication therapy using different antibiotics may be given.

Complications

Complications are rare but can be very serious and potentially life-threatening.

The main complications include:

bleeding at the site of the ulcer the stomach lining at the site of the ulcer splits open – known as perforation the ulcer blocks the movement of food through the digestive system – known as gastric obstruction

More about the complications of stomach ulcers


Complications of stomach ulcers are rare, but can be very serious.

The main complications are:

internal bleeding perforation – the lining of the stomach splits open gastric outlet obstruction – the stomach ulcer obstructs the normal passage of food through your digestive system