We all get stomach aches from time to time, but pain is usually not the first symptom of stomach cancer.

So what should be considered instead?

General surgeon Daniel Joyce, MBBCh, shares what symptoms you may experience and when to see your doctor.

What is stomach cancer?
Stomach cancer, also known as gastric cancer, affects your stomach. Located in the upper part of your abdomen (gastrointestinal or GI tract), your stomach digests the food you eat. Stomach cancer occurs when abnormal cells grow in the stomach.

Over the past 10 years, doctors have seen a decline in the incidence of stomach cancer. According to the American Cancer Society, stomach cancer accounts for about 1.5 percent of all new cancer diagnoses in the United States each year.

The main reason for the decrease is that Helicobacter pylori infection, a type of bacteria known as H. pylori, is being diagnosed earlier than before. H. pylori causes chronic inflammation of the gastric mucosa, as well as ulcers, and is considered one of the main causes of gastric cancer.

“Now we can diagnose H. pylori and treat patients with antibiotics when they are symptomatic, killing the infection and reducing the overall risk of stomach cancer,” explained Dr. Joyce.

But he warns that a particular type of stomach cancer called gastroesophageal nodular adenocarcinoma is on the rise. This cancer starts in the esophagus, the tube that connects your mouth to your stomach.

Dr. Joyce said, “There is an obesity problem in the United States. “This causes more acid reflux into the esophagus, which leads to a condition called Barrett’s esophagus, which can eventually lead to cancer.”

Early warning signals
The early symptoms of stomach cancer are usually not noticed because there are no special symptoms.

Stomach cancer is one such complex diagnosis. Most people may experience symptoms, but they are often not obvious. These symptoms can be confused with many other benign (non-malignant) gastrointestinal (GI) disorders.

When stomach cancer is finally diagnosed, these symptoms are not considered normal GI problems and occur in most people.

But there are some early warning signs:

Your stomach may feel bloated and tight, says Dr. Joyce.

“Gastric cancer makes the stomach wall very hard and reduces its ability to retain food,” he notes. “When stomach cancer spreads to the lining of the abdomen, it can cause fluid to build up in the abdomen.”

This can cause you to bloat so much that you look like you’re nine months pregnant.

Has anyone not had a heart attack, especially after a night of hot wings and pizza?

Heartburn with burning in the chest and upper throat is common, says Dr. Joyce, and is usually nothing to worry about.

But if you have persistent heartburn that doesn’t go away with antacids or other medications, there may be cause for concern.

“If there’s a lot of cancer at the exit point of the stomach, fluid can accumulate and the path of least resistance may be up the esophagus/esophagus,” says Dr. Joyce.

Nausea and vomiting
Another sign of a growth blocking the bowel? Feelings of nausea and even vomiting.

The food you eat and the fluids you drink cannot reach the first part of the intestine, the duodenum.

Dr. Joyce said, “Once you eat, you have nowhere to go. “It sends a signal to your brain that makes you feel nauseous.”

General discomfort
You may just feel like something is off. This general discomfort may be due to stomach cancer spreading to the lining of your abdomen.

“It may feel like bloating,” says Dr. Joyce. “Your stomach might feel heavy.”

Sudden weight loss
If you experience nausea, vomiting, or other symptoms such as bloating, do not eat frequently to avoid getting sick.

“People stop being hungry and eventually start losing weight without even trying,” says Dr. Joyce. “That’s probably the most telling symptom.”

According to Dr. Joyce, this can be caused by prolonged bleeding, which, along with sudden weight loss, can be a sign of cancer.

Bleeding can lead to anemia and a low red blood cell count, which may be the source of your fatigue.

Blood in your stool or vomiting
This symptom is much less common, but it can happen if you bleed a lot. You may notice a change in your stool to a very dark stool called melena.

“If it’s bleeding for a very long time, you may not notice anything in your stool,” says Dr. Joyce.

The feeling of being blown away
Even if you eat a small amount, you feel full. You can’t eat an entire meal without feeling full because of what’s called “early satiety.”

“It’s what you used to eat

. Joyce.

How to tell if your symptoms are serious
Most of the time, these symptoms are caused by something else, but it’s best to get them checked out, so if you do need treatment, you can get it as soon as possible.

If you experience nausea, bloating, weight loss and lack of appetite, Dr. Joyce recommends you see your doctor for testing.

Other factors can increase your risk of developing stomach cancer, too, like:

Helicobacter pylori (H. pylori) infection.
Age (your risk goes up as you get older).
A diet high in smoked foods, salted fish and cured meats.
A family history.
When to call your doctor
If your symptoms persist, don’t hesitate to see your doctor.

“Your doctor will do a comprehensive evaluation and ask about your family history to determine whether further investigation is required,” says Dr. Joyce.

If more testing is needed, there are a few options available:

An upper endoscopy. A thin tube with a tiny camera attached is inserted through your mouth and into your stomach. A biopsy, or sample of tissue, of any area in question will be taken.
Endoscopic ultrasound. A thin tube with an ultrasound probe is placed in your stomach through your mouth. By getting a visual of your stomach, your doctor can help determine the stage of your cancer.
CT scan or MRI. If the tumor is large enough, these radiological tests will detect it.
To treat stomach cancer, your doctor may recommend chemotherapy, immunotherapy and radiation. Surgery is an option, but your doctor may opt for other routes first. Some very early gastric cancers can be treated endoscopically (a thin tube with a camera on the end, and tiny instruments), too, but that’s a rare situation in the U.S.

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