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
-loss of appetite (=anorexia)
-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.
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).
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