What are the clinical manifestations of gastric cancer?

In the case of micro-cancer or early-stage gastric cancer, there are usually no obvious subjective symptoms clinically, and some of them are manifested as symptoms of indigestion, such as upper abdominal discomfort, abdominal bloating, nausea, belching, abdominal pain, and decreased appetite. These symptoms are not specific and can easily be confused with benign lesions of the upper gastrointestinal tract. They are usually diagnosed as benign diseases such as chronic gastritis and functional dyspepsia in clinical practice, which delays diagnosis. As the lesion progresses, the tumor enlarges, and bleeds, gastric function or systemic condition is affected, and subjective symptoms of varying degrees appear. However, these symptoms are not unique to gastric cancer, and no special examinations are performed. They are generally treated as benign gastric diseases. When upper gastrointestinal symptoms worsen, upper abdominal pain after eating intensifies, and there is loss of appetite, anemia, black stools, weight loss and fatigue, and then there are late-stage symptoms and signs such as abdominal mass, pyloric obstruction, supraclavicular lymphadenopathy, and abdominal metastasis, the opportunity for effective radical cure has been lost.

Generally, there are no obvious signs of gastric cancer:

(1) Upper abdominal tenderness Some patients experience mild tenderness on the right side of the upper abdomen. When the lesion is large and the ulcer involves the muscular layer, serosa, or outer serosa, the patient will refuse to press on the upper abdomen and may experience muscle tension and rebound pain.

(2) Abdominal masses: The mass can be palpated anywhere in the upper abdomen, and gastric antral cancer is more common in the right upper abdomen. The mass is firm and nodular. When the tumor infiltrates the surrounding tissues, the range of motion is significantly limited. If the primary tumor is accompanied by peripheral lymph node metastasis or pelvic tumor implantation, the bladder or uterine rectal metastatic nodules can be palpated through the anus and rectum.

(3) In addition to the peri-tumor lymph nodes in the abdomen, the left supraclavicular lymph nodes have the highest metastasis rate, which can reach about 10%, and the axillary lymph nodes account for about 2%.

(4) Extensive implantation and metastasis In the late stage of gastric cancer, hematogenous metastasis to the liver, lungs, bones, kidneys and nervous system may occur. When the tumor invades the serosa and cancer cells fall off to form extensive peritoneal implantation and metastasis, ascites may occur and cancer cells may be found. If the condition worsens further, weight loss, bleeding, anemia, pyloric obstruction, hepatomegaly, jaundice, ascites and cachexia may occur.