Unfortunately early cancer of the stomach does not display stomach cancer symptoms. When symptoms occur, they are already an indication that there is something “majorly wrong”.
Signs and symptoms of stomach cancer
-weight loss
-loss of appetite (=anorexia)
-tiredness
-upper abdominal discomfort
Weight loss is associated with a more advanced stage of stomach cancer, which in turn is associated with a significantly shorter survival than patients with stomach cancer who do not have weight loss (Ref.1 ,p.825). If the cancer is located close to the entrance of the esophagus into the stomach, swallowing problems might be present.
If the cancer is located close to the outlet of the stomach, there might be frequent vomiting early on and a prompt referral to a specialist is needed. Only in a minority of cases (about 10 or 15%) there is acute vomiting of blood, called “hematemesis”. There might be some pressure feeling or discomfort in the mid upper abdomen associated with a distaste for food.
Late symptoms are a protruding abdomen due to fluid accumulation (ascites). This is due to metastases in the abdomen or due to liver metastases that lead to seepage of fluid from the surface of the liver into the abdomen. In this latter case the patient often is also jaundiced from obstruction of bile ducts by liver metastases. The physician might feel a large hard mass in the upper abdomen, which indicates a late stage of the cancer. With late stomach cancer there can be a fistula between the stomach and the colon. Such a fistula occurs due to direct invasion of the cancer from the stomach into the wall of the colon. The cancer acts like a local acid burn that eats a hole first into the stomach and then into the adjacent transverse colon.
Stomach Cancer Symptoms
Associated with this tumor spread there are metastases in the connective tissue between the small bowel and the lymph glands behind the abdominal wall. Small bowel obstruction is common as are metastases into the ovaries in women and into the rectum via the abdominal cavity in both sexes leading to rectal obstruction.
Lymph glands in the left axilla and in the area above the collar bone (supraclavicular areas) are common. Also, the stomach cancer may metastasize into the soft tissue around the belly button (peri-umbilical metastasis).
References:
1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Cancer of the stomach.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the stomach.
3. J Sun et al. Eur J Cancer Prev 2001 Feb;10(1):61-67.
4. SS Mirvish et al. Nutr Cancer 1998;31(2):106-110.
5. JM van Maanen et al. Cancer Detect Prev 1998;22(3):204-212.
6. JM van Maanen et al. Environ Health Perspect 1996 May;104(5):522-528.
7. B. Sears: “The age-free zone”.Regan Books, Harper Collins, 2000.
8. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
9. K Murakami et al. Am J Clin Pathol 2001 Feb;115(2):224-34.
10. Y Tsubono et al. N Engl J Med 2001 Mar 1;344(9):632-636.
11. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
12. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc
