Early Symptoms Are Commonlyoverlooked
Early stomach cancer symptoms are typically so unremarkable that they go completely unnoticed.
Stomach cancer is one of those tricky diagnoses where most people may have retrospectively felt symptoms, but theyre usually vague symptoms that can be confused with many other benign gastrointestinal disorders.
Some of these early symptoms include:
- A general feeling of discomfort.
Because these symptoms tend to be dismissed as normal GI issues and they are for most people when stomach cancer is finally diagnosed, its often in the advanced stages.
What Are The Symptoms Of Stomach Cancer
Symptoms of stomach cancer in the early stages are similar to symptoms of a number of common disorders of the digestive system.
The most common symptoms of stomach cancer are:
- indigestion or heartburn also known as dyspepsia
- feeling full or bloated even after eating small amounts
- pain in the stomach or abdomen
- unexplained weight loss
- difficulty swallowing also known as dysphagia
There are a number of conditions that may cause these symptoms, not just stomach cancer. If any of these symptoms are experienced, it is important that they are discussed with a doctor.
While looking forward to finishing their cancer treatment and getting on with life, for some people, the end of treatment can also be a confusing or worrying time.
Effects On Pituitary System
commonly develops after radiation therapy for sellar and parasellar neoplasms, extrasellar brain tumours, head and neck tumours, and following whole body irradiation for systemic malignancies. Radiation-induced hypopituitarism mainly affects and . In contrast, and deficiencies are the least common among people with radiation-induced hypopituitarism. Changes in -secretion is usually mild, and vasopressin deficiency appears to be very rare as a consequence of radiation.
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Bloating Constipation And Diarrhea
Bloating, constipation and Diarrhea are also the symptoms of stomach cancer. When cancer cells starts growing in your stomach it may mess with your bowel movements. It is not necessary that you have stomach cancer having these symptoms. You may consult your doctor if problem persists for a long time.
Gastric Cancer Is A Disease In Which Malignant Cells Form In The Lining Of The Stomach
The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients in foods that are eaten and helps pass waste material out of the body. Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.
The wall of the stomach is made up of 5 layers of tissue. From the innermost layer to the outermost layer, the layers of the stomach wall are: mucosa, submucosa, muscle, subserosa , and serosa. Gastric cancer begins in the mucosa and spreads through the outer layers as it grows.
Stromal tumors of the stomach begin in supporting connective tissue and are treated differently from gastric cancer. See the PDQ summary on Gastrointestinal Stromal Tumors Treatment for more information.
For more information about cancers of the stomach, see the following PDQ summaries:
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What Are Symptoms Of Gastric Cancer
Stomach cancer may not cause any symptoms in its earlier stages. Some symptoms of stomach cancer, such as early satiety , mild belly pain and fatigue are common, and similar tosymptoms of other, less serious conditions.
However, some symptoms are more suggestive of stomach cancer. If you experience any of the following symptoms for more than two weeks, you should see a gastroenterologist:
Other diagnostic procedures include endoscopy with biopsy and endoscopic ultrasound.
Other Types Of Stomach Cancer
There are some less common and rare types of stomach cancer which include:
- Lymphomas. These are cancers which arise from the lymphatic tissue within the wall of the stomach.
- Sarcomas. These are cancers which arise from the muscle or connective tissue within the wall of the stomach.
- Carcinoid cancers. These are cancers which arise from cells in the stomach lining which make hormones.
The rest of this leaflet only discusses adenocarcinoma of the stomach.
See separate leaflet called Cancer for more general information about cancer.
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Age Diet And Stomach Disease Can Affect The Risk Of Developing Gastric Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for gastric cancer include the following:
- Having any of the following medical conditions:
- Eating a diet high in salted, smoked foods and low in fruits and vegetables.
- Eating foods that have not been prepared or stored properly.
- Being older or male.
- Having a mother, father, sister, or brother who has had stomach cancer.
What Is Oesophageal Cancer
Oesophageal cancer impacts the gullet which is the long tube that carries food from the throat to the stomach.
Each year in the UK there are around 9,100 cases of this cancer and just 15 per cent of patients survive the cancer for five years or more.
There are many possible symptoms of oesophageal cancer, but they might be hard to spot.
They can affect your digestion, such as:
- having problems swallowing
- symptoms of indigestion, such as burping a lot
Other symptoms include:
- a cough that is not getting better
- a hoarse voice
- loss of appetite or losing weight without trying to
- feeling tired or having no energy
- pain in your throat or the middle of your chest, especially when swallowing
The elevated risk was seen across people regardless of their gender, whether they smoked or drank booze other risk factors for certain cancers.
Dr Abnet and colleagues estimated that approximately 17 per cent of cancers of the voice box or oesophagus in adults aged between 50 and 71 years old are linked with acid reflux.
They wrote in their paper that their results add robust prospective evidence for the link between GERD and oesophageal cancer.
The paper said it was possible that leftover acid in the oesophagus could be injuring delicate tissue and causing cancer, among other explanations.
Over time, the chronic inflammation in the oesophagus caused by GERD is already known to lead to narrowing, ulcers and damage to the tissue lining.
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Symptoms Of Stomach Cancer
Stomach cancer may not cause any signs or symptoms in its early stages because the tumour is small. Also, the abdomen and stomach are large structures that are able to expand, so a tumour can grow without causing symptoms. Symptoms often appear once the tumour grows into surrounding tissues and organs. Other health conditions can cause the same symptoms as stomach cancer. See your doctor if you have these symptoms.
The signs or symptoms of stomach cancer include:
- abdominal pain or discomfort
- weight loss
- changes in digestion, including loss of appetite, feeling full after a small meal , heartburn or nausea
- difficulty swallowing or pain when swallowing
- vomiting, with or without blood
- abdominal bloating, especially after eating
- blood in the stool
- buildup of fluid in the abdomen
- a lump in the abdomen that can be felt during a physical exam
- a lump on the ovary
- a lump in the pelvis , which may be felt during a rectal exam
- a lump in the area of the belly button, or navel
- a lump above the left collar bone
- a lump in the left armpit
- darkening of the skin on body folds and creases
- wart-like growths on the skin
Hematogenous And Lymphatic Spread
Understanding the vascular supply of the stomach allows understanding of the routes of hematogenous spread. The vascular supply of the stomach is derived from the celiac artery. The left gastric artery, a branch of the celiac artery, supplies the upper right portion of the stomach. The common hepatic artery branches into the right gastric artery, which supplies the lower portion of the stomach, and the right gastroepiploic branch, which supplies the lower portion of the greater curvature.
Understanding the lymphatic drainage can clarify the areas at risk for nodal involvement by cancer. The lymphatic drainage of the stomach is complex. Primary lymphatic drainage is along the celiac axis. Minor drainage occurs along the splenic hilum, suprapancreatic nodal groups, porta hepatis, and gastroduodenal areas.
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Inflammation Gastritis And Ulcer
Helicobacter pylori harms the stomach and linings by several mechanisms. The ammonia produced to regulate pH is toxic to epithelial cells, as are biochemicals produced by H. pylori such as , vacuolating cytotoxin A , and certain . Cytotoxin associated gene CagA can also cause inflammation and is potentially a carcinogen.
Colonization of the stomach by H. pylori can result in chronic , an inflammation of the stomach lining, at the site of infection. Helicobacter cysteine-rich proteins , particularly HcpA , are known to trigger an immune response, causing inflammation.H. pylori has been shown to increase the levels of COX2 in H. pylori positive gastritis.Chronic gastritis is likely to underlie H. pylori-related diseases.
Ulcers in the stomach and duodenum result when the consequences of inflammation allow stomach acid and the digestive enzyme to overwhelm the mechanisms that protect the stomach and duodenal . The location of colonization of H. pylori, which affects the location of the ulcer, depends on the acidity of the stomach.In people producing large amounts of acid, H. pylori colonizes near the to avoid the acid-secreting at the . In people producing normal or reduced amounts of acid, H. pylori can also colonize the rest of the stomach.
When H. pylori colonizes other areas of the stomach, the inflammatory response can result in of the stomach lining and eventually ulcers in the stomach. This also may increase the risk of stomach cancer.
Adaptation Of H Pylori To High Acidity Of Stomach
As mentioned above, H. pylori produce large amounts of urease to produce ammonia as one of its adaptation methods to overcome stomach acidity. Helicobacter pylori arginase, a bimetallic enzyme binuclear Mn2-metalloenzyme arginase, crucial for pathogenesis of the bacterium in human stomach, a member of the ureohydrolase family, catalyzes the conversion of L-arginine to L-ornithine and urea, where ornithine is further converted into polyamines, which are essential for various critical metabolic processes.
This provides acid resistance and is thus important for colonization of the bacterium in the gastric epithelial cells. Arginase of H. pylori also plays a role in evasion of the pathogen from the host immune system mainly by various proposed mechanisms, arginase competes with host-inducible nitric oxide synthase for the common substrate L-arginine, and thus reduces the synthesis of NO, an important component of innate immunity and an effective antimicrobial agent that is able to kill the invading pathogens directly.
Alterations in the availability of L-arginine and its metabolism into polyamines contribute significantly to the dysregulation of the host immune response to H. pylori infection.
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Cancer May Spread From Where It Began To Other Parts Of The Body
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if gastric cancer spreads to the liver, the cancer cells in the liver are actually gastric cancer cells. The disease is metastatic gastric cancer, not liver cancer.
Cytotoxics And Targeted Therapies
are a relatively new class of cancer drugs that can overcome many of the issues seen with the use of cytotoxics. They are divided into two groups: small molecule and antibodies. The massive toxicity seen with the use of cytotoxics is due to the lack of cell specificity of the drugs. They will kill any rapidly dividing cell, tumor or normal. Targeted therapies are designed to affect cellular proteins or processes that are utilised by the cancer cells. This allows a high dose to cancer tissues with a relatively low dose to other tissues. Although the are often less severe than that seen of cytotoxic chemotherapeutics, life-threatening effects can occur. Initially, the targeted therapeutics were supposed to be solely selective for one protein. Now it is clear that there is often a range of protein targets that the drug can bind. An example target for targeted therapy is the BCR-ABL1 protein produced from the , a genetic lesion found commonly in and in some patients with . This has enzyme activity that can be inhibited by , a drug.
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Surgery To Ease Your Symptoms
If your stomach cancer has spread beyond your stomach, it may not be possible to remove it using surgery.
However, if your stomach has been significantly affected by cancer it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and feeling very full after eating.
If your stomach is blocked, there are a few options:
- stenting a stent is a plastic or wire mesh tube inserted through the oesophagus using an endoscope under local anaesthetic after being inserted, the stent will be expanded and open up the stomach
- partial or total gastrectomy to remove the blockage and improve your symptoms
Detecting Stomach Cancer Early
To find out whether stomach cancer is at the root of your digestive symptoms, you will need investigations such as an endoscopy and biopsy. This involves having a thin camera put down your throat, allowing doctors to look into your stomach and take a small tissue sample.
Since stomach cancer is quite uncommon, routine screening is not offered in most places. However, catching the cancer early will give you a much better chance of making a recovery. This is why it is important to be familiar with the symptoms of stomach cancer, and see your doctor if you have any of them for three weeks or more. The chances are it will be nothing serious, but there is only one way to know for sure.
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Signs And Symptoms Of Stomach Cancer Can Include
- A sense of fullness after eating small amounts
- Discomfort or pain in the upper abdomen
- Nausea and vomiting and/or bloating after meals
- Loss of appetite and/or unexplained weight loss
- Indigestion, heartburn, or difficulty swallowing
- Vomiting blood or blood in the stool or
- Weakness and fatigue
Most of these symptoms may be caused by things other than stomach cancer. However, dont ignore your symptoms. If you see blood or have these symptoms for more than three or four weeks , you should see a gastroenterologist or your Family Medicine doctor for further investigation.
About the Author: Dr Neil Galletly is a UK-trained senior Consultant in Gastroenterology and Hepatology with over 24 years of experience investigating and treating GI and liver problems. He performs a wide range of diagnostic and therapeutic GI endoscopy, including gastroscopy, colonoscopy, ERCP, luminal stent placement and feeding tube placement. Dr. Galletly is a Fellow of the Royal College of Physicians UK , a Fellow of the American College of Gastroenterology and a Fellow of the European Section and Board of Gastroenterology and Hepatology . He serves on the International Relations Committee of the American College of Gastroenterology.
Having Another Type Of Cancer
Your risk of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma .
For men, the risk of getting stomach cancer is increased after having prostate cancer, bladder cancer, breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer, breast cancer or cervical cancer.
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Feeling Full Quickly Or Loss Of Appetite
When you are suffering from Stomach Cancer you starts feeling full very quickly and this feeling is known as early satiety. After partaking just few bites, you feel like you are done. The food cannot allure you in such conditions. Most of the cancer patients experience fullness in the upper abdomen after partaking small meals.
What Are The Symptoms Of Stomach Cancer In A Woman
Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach. Stomach cancer tends to develop slowly over many years. Early stages rarely cause symptoms, so they are often undetected. Symptoms of stomach cancer in women are the same as those in men.
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Indigestion That Doesn’t Go Away And Burping
You can get indigestion when acid from the stomach goes back up into the food pipe . Or you can get it if you have any irritation in your stomach. This often happens after eating .
Remember, indigestion is common and it’s not usually caused by cancer. Indigestion and heartburn can be very painful, even if nothings seriously wrong. See your doctor if youve had heartburn most days for 3 weeks or more.