Physical signs of gastric cancer patients

Most patients with gastric cancer have no obvious signs, but some patients have mild tenderness in the upper abdomen. In advanced gastric cancer located in the pyloric antrum or gastric body, a mass can sometimes be palpated, which is often nodular and hard. When the tumor infiltrates adjacent organs or tissues, the mass is often fixed and cannot be moved, indicating that surgical resection is less likely.

In female patients, a movable mass in the middle and lower abdomen is often a sign of Krukenberg tumor. When gastric cancer metastasizes to the liver, a nodular mass can sometimes be felt in the enlarged liver.

When the hepatoduodenal ligament, the posterior pancreaticoduodenal lymph nodes metastasize, or the primary lesion directly infiltrates and compresses the common bile duct, obstructive jaundice may occur. In patients with pyloric obstruction, a dilated stomach can be seen in the upper abdomen, and a splashing sound can be heard. When gastric cancer metastasizes to the umbilicus through the round ligament, a hard nodule can be felt at the umbilicus. Metastasis through the thoracic duct may cause enlargement of the left supraclavicular lymph nodes.

When advanced gastric cancer has pelvic implants, a nodule can be palpated in the bladder (uterus) rectal fossa during rectal examination. When there is peritoneal metastasis, ascites may occur. Small intestinal or mesenteric metastasis can narrow the intestinal cavity and lead to partial or complete intestinal obstruction. When the cancer perforates and causes diffuse peritonitis, symptoms of peritoneal irritation such as stiff abdominal muscles and abdominal tenderness may occur. It may also spread to adjacent cavity organs and form internal fistulas. For example, in patients with gastrocolonic fistulas, undigested food is discharged after eating. All these symptoms and signs mostly indicate that the tumor has reached an advanced stage and the chance of cure has often been lost.