Unfortunately there is rarely any symptom that is attributable to the existence of early carcinoma of the stomach. Symptoms usually depend on the situation, extent and type of the growth.
Cancers at the inlet or outlet of the stomach may be clinically silent or produce vague symptoms such as anorexia or epigastric uneasiness. A large polypoid cancer on the greater curvature may grow exuberantly without giving warning of its presence.
The common symptoms presented by patients with cancer of the stomach according to the order of frequency are as follows:
- Epigastric pain and indigestion
- Loss of weight
- Vomiting and/or hematemesis (vomiting of blood)
- Melena (blood in stool)
- Dysphagia (difficulty in swallowing)
Types Of Stomach Cancer And Symptoms
Following are the type of presentation
Group I – New dyspepsia: Vague but persistent indigestion occurring in a patient over 40 years of age should arouse suspicion of stomach cancer.These patients usually do not give any history of previous stomach trouble. This dyspepsia is more often due to chronic gastritis and atrophic gastritis with hypochlorhydria or achlorhydria (reduced hydrochloric acid in gastric secretion) rather than due to cancer itself.
Group II – Insidious onset: This type is mainly caused by the growth arising from the greater curvature or the body of the stomach. The early symptoms are epigastric pain and discomfort, nausea, anorexia and loss of weight. These patients usually bleed either obvious hematemesis and/or melena or in the form of invisible loss, so the anemia becomes the main feature.Anemia may be of the microcytic type or rarely of the macrocytic form.
Group III – Pain: This is a common first symptom and has been observed in about 95% of patients by the time a diagnosis of gastric carcinoma is made. This pain is more or less continuous abdominal pain or epigastric discomfort, without any periodicity. This is not relieved by food. Weight loss is almost always present. Patient may complain of vomiting, but this does not relieve pain. Vomitus is of coffee-ground character.
Group IV – Obstructive types: Carcinoma in more common near the pylorus and pyloric obstruction is not an uncommon feature. This is usually associated with fullness, belching and vomiting. Carcinoma of the cardiac region is always present with dysphagia.
Group V – Lump: In about 1/4th of the cases incidental discovery of lump in the epigastria becomes the only presenting feature.
Group VI – Symptoms from metastasis: Occasionally the primary disease remains silent, till symptoms appear due to metastasis. These patients may complain of abdominal swelling from ascites caused by hepatic or peritoneal metastasis. Pleural effusion and dyspnoea may be caused by pulmonary metastasis.