Gastric cancer is not specific in its early stages and can be difficult to recognize, and in China, about 90% of gastric cancer patients are already in the progressive stage when they are seen. However, even with progressive gastric cancer, nearly 30% of patients can survive for more than 5 years after surgery. Therefore, early detection and standardized treatment are very important to improve the outcome of patients with progressive gastric cancer. In this article, we’ll take a look at what symptoms may be indicative of progressive gastric cancer.
Persistent pain
Persistent pain
Patients with gastric cancer commonly have upper abdominal pain, which in the progressive stage mainly manifests as persistent distension, burning pain, and colic. Tumor invasion or metastasis to other sites may cause pain in the corresponding areas. For example, stomach cancer invading the pancreas may cause radiating pain in the lower back, lung metastasis may cause chest pain, implantation metastasis may cause lower abdominal pain, and bone metastasis may cause peripheral pain. Pain associated with metastases is often unusually severe and often unbearable for patients.
Nausea and vomiting
Loss of appetite, irregular nausea and vomiting may occur in the progressive stage of gastric cancer. Patients may have blood in their vomit.
Vomiting blood and black stool
Patients with gastric cancer often have upper gastrointestinal bleeding, caused by tumor erosion of blood vessels, and patients often have persistent black stools. When the tumor involves the esophagus causing rupture of blood vessels, there may be a lot of vomiting of blood.
Difficulty or obstruction of swallowing
When gastric cancer in the cardia area progresses to a certain stage and tumor growth causes narrowing of the entrance to the stomach or invades the lower part of the esophagus, patients may have difficulty swallowing and vomiting after eating.
Tumors in the lower part of the stomach are prone to pyloric obstruction when they progress to an advanced stage. Patients may experience upper abdominal distension and vomiting after eating, and some patients may observe the outline of a dilated stomach in the upper abdomen and may hear the sound of water vibrating, and sometimes a mass can be felt in the upper abdomen.
Abdominal masses
In patients with advanced gastric cancer, a mass may be palpable in the upper abdomen and painful when pressed. In women, a pushable mass felt in the lower and middle abdomen is often suggestive of Krukenberg’s tumor, a metastatic cancer of the ovary. If a mass is present around the umbilicus, it may be a tumor that has metastasized to the umbilicus.
Wasting
Patients with gastric cancer often experience progressive malnutrition due to pyloric obstruction, tumor depletion, and reduced eating, resulting in significant weight loss in a short period of time.
Jaundice
When liver metastases from gastric cancer occur or when the tumor directly infiltrates and compresses the common bile duct, patients may develop jaundice, which manifests as yellowing of the skin, mucous membranes, and sclera.
Anemia
Patients with gastric cancer often develop anemia in the late stage due to long-term upper gastrointestinal bleeding and tumor depletion, which manifests as pale skin and mucous membranes, fatigue and sleepiness, and depression.
Abdominal fluid
When liver metastases or peritoneal metastases occur in gastric cancer, patients may develop ascites. It is usually diagnosed by physical examination, ultrasound, CT, and laparotomy. The presence of ascites often indicates a poor outcome for the patient.
Superficial lymph node enlargement
A swollen lymph node felt on the left clavicle may be a metastatic tumor, and in a small number of patients with gastric cancer, a metastatic lymph node may be present in the left axilla.
Perforation
Pain throughout the abdomen when pressed and lifted by hand (pressure pain, rebound pain) and muscle tension in the abdominal wall are signs of acute peritonitis, which can occur in advanced gastric cancer with gastric perforation, and patients may have high fever, chills, and decreased blood pressure.
Other
The manifestation of intestinal obstruction may occur when small bowel or mesenteric metastasis occurs in gastric cancer. When the tumor invades the colon and forms a gastrocolic fistula, the patient may have a fecal odor in the mouth and undigested food in the stool.
Although these symptoms may not be progressive gastric cancer, it is important to pay attention to them and seek professional help for a definitive diagnosis.