The stomach cancer, also called gastric cancer, is currently the fourth leading cause of death globally, according to the World Health Organization. Due to its importance, the campaigns to detect it early and fight it in a timely manner are increasing, however, gastric cancer is a disease that in early stages can be asymptomatic.
The stomach cancer can manifest from a very small alteration in the gastric mucosa to a very large tumor occupying much of the stomach and generate other distant lesions (metastases). The goal of the doctor is to diagnose it early to offer the most appropriate treatment.
Symptoms of stomach cancer
It is important to explain to patients that there are other less aggressive gastrointestinal diseases such as gastritis, hiatal hernia, parasitosis and gallbladder stones, which can have symptoms similar to those produced by gastric cancer in advanced stages, so if you suffer from these symptoms you should consult a gastroenterologist.
Symptoms of gastric cancer include:
· Indigestion or indigestion
· Feeling of fullness after eating.
· Nausea and / or vomiting that appears after eating.
· Gastroesophageal reflux (feeling that food is being pushed back into the mouth after eating).
· Feeling of bitterness in the mouth.
· Some patients complain of difficulty swallowing (a symptom called dysphagia), however, this discomfort may correspond mainly to cancer of the esophagus.
· Marked weight loss that occurs in a short time.
· Night sweats.
· Loss of appetite
· General weakness
· Aversion to meat (person does not want to eat, see or smell red meat on their food plate)
· Upper gastrointestinal bleeding expressed in melena (dark stools) and hematemesis (presence of blood in vomiting).
· Palpable tumor in the abdomen.
· Presence of thick veins in the chest or abdomen.
· The presence of a left supraclavicular ganglion (called Virchow's ganglion) is indicative of a tumor pathology in the stomach.
When the disease progresses over time, there may be other associated symptoms such as pleural effusion, liver metastasis that generates hepatomegaly (increase in volume in the liver), ascites and esophageal varices (due to increased pressure in the liver circulation), in addition to compression of other structures such as the spleen and pancreas.
How is stomach cancer diagnosed?
Many people see their doctor for gastrointestinal symptoms. Sometimes they are usually temporary discomforts, associated with an inadequate diet, stress or gastrointestinal infections, such as intestinal parasites or gastritis related to Helicobacter pylori.
However, when these symptoms are related to an obvious deterioration of the patient, with weight loss or digestive bleeding, the doctor should suspect the presence of stomach cancer.
If the doctor suspects this diagnosis, he should request:
1. Complete hematology (or Hemogram): to show if there is anemia, since 3 out of 10 patients have low hemoglobin.
2. Blood chemistry: which includes liver function tests, to rule out alterations related to liver metastases.
3. Tumor markers: tumor markers, such as carcinoembryonic antigen (CEA for short) and CA 19-9, are often elevated in stomach cancer.
4. Imaging studies: The American Society for Clinical Oncology suggests that the gastroenterologist perform an upper digestive endoscopy, which is a study where he can visualize the esophagus, stomach and the first portion of the duodenum. Other tests that are performed include video endoscopy, abdominal ultrasound, chest X-ray, imaging studies using barium as contrast, MRI, and oral and intravenous contrast scans to stage cancer.
5. Biopsy: consists of the visualization and analysis of the structures of a tissue. If there is a tumor, the cells show altered and the pathologist can conclude if there are changes that suggest the presence of stomach cancer. Usually, this segment of tissue is taken from the stomach lining when endoscopy is performed. If the gastroenterologist sees any suspicious lesions or alterations in the gastric mucosa at endoscopy, then he proceeds to cut a small portion to send it for analysis.
It is important that if you have any gastrointestinal symptoms, do not underestimate them and always consult your doctor. The stomach cancer may be asymptomatic in the early stages, so some studies suggest that people with a family history of gastric cancer conducted medical checkups, with internists and gastroenterologists, with the aim of early detection of lesions suggestive of stomach cancer.
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