Symptoms of Gastric Cancer
Gastric cancer often presents with symptoms that can be subtle or easily mistaken for other gastrointestinal issues, especially in its early stages. As the disease progresses, symptoms may become more pronounced. Here are some common symptoms of gastric cancer:
Early Symptoms
- Indigestion or Heartburn: Persistent discomfort or burning sensation in the chest or upper abdomen.
- Nausea and Vomiting: Frequent episodes of nausea, sometimes accompanied by vomiting, which may include blood or material that looks like coffee grounds.
- Loss of Appetite: A noticeable decrease in appetite, often accompanied by a feeling of fullness after eating only a small amount of food.
- Bloating: Abdominal bloating or a feeling of fullness, which may be persistent or come and go.
Advanced Symptoms
- Abdominal Pain: Persistent or severe pain in the upper abdomen, which may be dull or sharp.
- Difficulty Swallowing (Dysphagia): A sensation that food is getting stuck in the throat or chest.
- Weight Loss: Unintentional weight loss, which can be significant and noticeable over time.
- Fatigue and Weakness: General feelings of tiredness and lack of energy, which can be due to the cancer itself or related to anemia.
Other Symptoms
- Dark or Black Stools: This can indicate bleeding in the stomach, which may lead to black, tarry stools.
- Jaundice: Yellowing of the skin and eyes, which can occur if the cancer spreads to the liver and affects its function.
- Swelling in the Abdomen: Accumulation of fluid in the abdominal cavity, known as ascites, which can cause swelling and discomfort.
- Persistent Cough or Hoarseness: If the cancer has spread to the lungs or nearby structures, it can cause coughing or a hoarse voice.
Systemic Symptoms
- Anemia: Low red blood cell count, leading to symptoms like paleness, shortness of breath, and dizziness.
- Persistent Fever: Unexplained fever that doesn’t resolve with usual treatments.
Diagnostic Testing for Gastric Cancer
Upper Endoscopy (Gastroscopy):
- What It Is: A procedure where a thin, flexible tube with a camera (endoscope) is inserted through the mouth to look inside the stomach.
- Purpose: To see the inside of the stomach, check for abnormal areas, and take a small tissue sample (biopsy) if needed.
Biopsy:
- What It Is: A small sample of tissue taken from the stomach during an endoscopy.
- Purpose: To check under a microscope if the cells are cancerous and determine the type of cancer.
Endoscopic Ultrasound (EUS):
- What It Is: A special endoscope with an ultrasound probe is used to create detailed images of the stomach and surrounding tissues.
- Purpose: To see how deep the cancer has grown into the stomach wall and if it has spread to nearby lymph nodes.
Abdominal Ultrasound:
- What It Is: An imaging test that uses sound waves to create images of the organs in the abdomen.
- Purpose: To check if the cancer has spread to the liver or other organs.
CT Scan (Computed Tomography):
- What It Is: An imaging test that takes detailed cross-sectional pictures of the body using X-rays.
- Purpose: To see if the cancer has spread to other parts of the body, like the liver, lungs, or lymph nodes.
MRI (Magnetic Resonance Imaging):
- What It Is: An imaging test that uses strong magnets and radio waves to create detailed images of the inside of the body.
- Purpose: To get detailed images, especially useful if a CT scan isn’t clear or if there's a concern about the liver.
Blood Tests:
- What They Are: Tests that check various aspects of your blood.
- Purpose: To look for signs of anemia (low red blood cells), liver function, and sometimes specific substances that may be elevated with cancer
Chemotherapy
chemotherapy is a systemic approach that uses cytotoxic agents to target and destroy cancer cells throughout the body. It can be administered before surgery (neoadjuvant) to shrink tumors, after surgery (adjuvant) to eliminate remaining cancer cells, or for advanced stages (palliative) to manage symptoms and slow disease progression. Chemotherapy can be delivered intravenously in a clinical setting or orally in pill form.
Radiation Therapy
radiation therapy utilizes high-energy radiation to damage the DNA of cancer cells, leading to their destruction. This therapy may be used preoperatively in conjunction with chemotherapy to reduce tumor size, postoperatively to target any residual cancer cells at the surgical site, or palliatively to relieve symptoms like pain, bleeding, or obstruction. The radiation is delivered externally from a machine focused on the tumor area.
Targeted Therapy focuses on specific molecular pathways or genetic alterations within cancer cells. This can include targeting receptors overexpressed in some gastric cancers or inhibiting the formation of blood vessels necessary for tumor growth. The therapy employs monoclonal antibodies or tyrosine kinase inhibitors to interfere with cancer cell proliferation.
Immunotherapy enhances the immune system’s ability to recognize and attack cancer cells. It is particularly useful for advanced gastric cancer with high microsatellite instability (MSI-H) or specific immune checkpoint markers. This approach includes checkpoint inhibitors that boost the immune response by blocking proteins that normally inhibit immune activity against cancer cells.
Supportive (Palliative) Care is aimed at improving the quality of life by managing symptoms and providing comprehensive support. This includes pain management strategies, nutritional support to address issues such as malnutrition and feeding difficulties, psychosocial support through counseling and social services, and overall symptom management to enhance comfort and functional status
