Stomach cancer is one of the malignant tumors that usually wins us the game. Although it takes time noticing its symptoms, the person who suffers it, usually delays consulting with a doctor. Majority of the time this cancer has already advanced too much when its diagnosed. So, here is a list of symptoms that you should look out for.
The most common symptom of a stomach cancer that has not spread outside the organ is abdominal pain. It is a pain that begins as a nuisance, poorly defined and poorly localized in the abdomen. It’s similar to the feeling of indigestion, or the abdominal disturbance of people with gastritis. Over time it’s accentuated, and tends to be located in the central part of the belly, just below the ribs. Unlike the pain of gastric or duodenal ulcer, the pain due to stomach cancer doesn’t usually change significantly neither with food ingestion, nor with taking antacids.
When stomach cancer is located in the region of entry of food from the oesophagus to the stomach in an area called cardia, the tumour can hinder the entry of food we have eaten, producing two symptoms:
- Getting food stuck in the chest as you are swallowing food. When this happens, we will have to swallow water to help the bolus get into the stomach.
- Bitter water may start coming to the mouth. This gastroesophageal reflux appears because stomach cancer is very close to the lower esophageal sphincter, which can cause it to incompletely close. When this happens, food with gastric juices can escape from the stomach upwards, towards the esophagus, causing the acid reflux.
When stomach cancer is located at the pylorus, which is the region of the stomach that drives food into the small intestine, it may obstruct or even close this natural outlet of the gastric content. Especially after having enough food in our stomach, gastric content can be detected if the stomach is not emptied. Especially after having enough food in our stomach.
Therefore, it informs the brain thus triggering the sensation of nausea and starts the vomiting reflex. After that, the stomach wall will have contraction. This will cause the expulsion of the food with gastric juices upwards, into the oesophagus and mouth. We’ll then vomit what we have ingested.
The less common variety of stomach cancer is the diffuse variety. It affects the entire stomach, not just one of its parts. Once the entire stomach is infiltrated by tumor cells and affected, the distensibility of the stomach wall will be reduced. That is when if we start taking food, the stomach will not distend properly, so it’s full too soon. This filling communicates to the brain the satiety sensation, so the person with this type of gastric cancer stops eating.
Either because of a stomach ache or because food is stuck when it enters the stomach, or because of the vomit, or because stomach fits little food, the person with gastric cancer begins to eat fewer calories. Gradually the person with stomach cancer will get thinner and thinner.
If tumor breaks the stomach lining and thus a blood vessel, either from the stomach or from the tumor itself, the person with stomach cancer may start bleeding without knowing it. “Upper gastrointestinal bleeding” is what its called. When bleeding is minor, symptoms won’t be noticed. But if bleeding is constant and with certain intensity, it may triggers an anaemia, with a progressive fatigue that goes with it. Depending on the destination of this blood and the bleeding intensity, the person with stomach cancer may realize the bleeding. This is due to the presence of one or both of these signs:
- If the elimination of the blood is done through the mouth, the person will vomit gastric content mixed with blood. This is called “hematemesis”.
- However, if the elimination of the blood is done through the anus, the person who’s bleeding from the stomach due to gastric cancer may see the stools are black. The black stools are called “melena”.
When the tumor is already out of the stomach, it may be because it has escaped through one or more of these three ways:
- Tumor breaks peritoneum and goes to the abdominal cavity
- The tumor escapes through the lymphatics
- The tumor enters the blood stream.
When the tumor grows, it can break out the stomach wall. This rupture causes gastric cancer cells fall into the peritoneal cavity and swims in peritoneal fluid. They then ended up settling on the surface of any abdominal viscera. These peritoneal implants can cause peritoneal irritation that will be perceived as symptoms of peritonitis with diffuse abdominal pain. The growth of multiple tumor implants on the peritoneal surface is called “peritoneal carcinomatosis”.
The stomach cancer cells that are dispersed by the peritoneum may also colonize the liver in its outer zone. Thus irritating the capsule that surrounds it. Due to the irritation caused by these implants, it may create a localized pain in the upper right abdomen.
If tumor implants are placed in the outside wall of the small intestine, they can cause cessation of transit of intestinal contents. This is because of the compression of the tube from the outside. They produce a partial bowel obstruction, or a complete intestinal obstruction. Although it can appear in many tumors of the abdominal and pelvic viscera, when tumor cells travel to the navel they can settle there. Hence creating lumps called “nodules of Sister Mary Joseph”. It is more visible from the outside. Usually they are a sign that the cancer is in an advanced stage.
When choosing the lymphatic route to escape the body, the stomach cancer cells tend to accumulate first on the lymph nodes. It will first start surrounding the stomach itself. Due to this accumulation of tumor cells, some symptoms can appear or become more pronounced. Such as a decreased capacity of the stomach, early satiety and even nausea and vomiting.
From lymph nodes close to the stomach, tumor cells can spread to more distant lymph regions. For example, the one situated behind the pancreas, peritoneum and the region of the side of the aorta. If they are located in this area, most often they do not cause symptoms. But usually they can cause pain, nerve compression of neighbouring structures, such as the celiac plexus.
After the tumor breaks through the stomach walls, the cells of stomach cancer can enter the bloodstream. This is because within the cancer itself some cells penetrate a blood vessel, after breaking its wall. Once in the blood, these stomach cancer cells can stay anywhere in the body. Thus, causing various symptoms depending on its location. The most common sites where stomach cancer that has escaped the blood can cause metastases are the liver, brain and lungs.
When stomach cancer cells go to the liver and begin to grow, they begin to crush healthy liver cells. If broken, liver contents which are transaminases, will be poured into the blood stream. This will increase their blood concentration (as detected in a blood test). If rapidly growing stomach cancer cells compress small channels within the liver that bile uses to travel, it can accumulate. This increases the indirect bilirubin concentration in the blood, which may lead to making the skin gets a yellow tone. This phenomenon is called Jaundice.
When groups of tumor cells start growing within the brain, they can form metastases. This will become increasingly large. By pushing neighbouring neurons, these neurons begin to function in an altered way. Therefore two types of symptoms may occur:
- Irritative symptoms: Neurons fire pushed uncontrolled flashes causing epilepsy or convulsive crisis.
- Deficit Symptoms: Neurons stop working and while their work are not done, it causes loss of mobility, loss of vision, lose feeling in any area of the body, and so on.
In both cases, if there are plenty of tumors in the head. Due to the fact that there is not enough room for so many cells because the skull is a closed cavity with a single large outlet. When this happen, you’ll start having headaches. These headaches will gradually go up in intensity and frequency.
When tumor cells choose to live within the lungs, they usually form separate groups. Therefore, multiple metastases appears. If they suppress enough lung function, difficulty breathing (a symptom called “dyspnoea”) can appear. However, if they touch a breathing tube (bronchus or their branches), they can irritate them, causing a very annoying dry cough. Coughing a little blood will happen if the blood vessel near the lung metastases break.
As you can see, stomach cancer can cause the appearance of many signs and symptoms. If do have these symptoms do check them with your doctor.