From the Guidelines
Gastric tumor symptoms often include persistent upper abdominal pain, unexplained weight loss, feeling full after eating small amounts of food, nausea, vomiting, and difficulty swallowing, as confirmed by the most recent guidelines 1. These symptoms typically develop gradually and may be accompanied by fatigue, weakness, and blood in the stool (which may appear black and tarry) or vomit (which may look like coffee grounds). Anemia can develop due to chronic bleeding, causing additional symptoms like shortness of breath and pale skin. Some key points to consider when evaluating gastric tumor symptoms include:
- Early gastric tumors may cause no symptoms at all, which is why they're often diagnosed at advanced stages 1.
- Symptoms tend to worsen as the tumor grows and may spread to involve heartburn, loss of appetite, and jaundice if the cancer has metastasized to the liver.
- Anyone experiencing persistent digestive symptoms, especially those over 50 or with risk factors like family history, H. pylori infection, or smoking, should seek medical evaluation promptly.
- Early detection significantly improves treatment outcomes for gastric tumors, as surgical removal of localized tumors offers the best chance for cure, and diagnosis is usually done by upper gastrointestinal (GI) endoscopy, with staging including contrast-enhanced thoracoabdominal multidetector-row computed tomography (MDCT) 1. Key diagnostic considerations include:
- Location, size, macroscopic appearance, and actual complications of the tumor, as well as biopsies to confirm histology and classify the tumor 1.
- The use of chromoendoscopy, biopsies of the gastric mucosa far from the tumor, and suspicion of Barrett’s esophagus should be specified and eventually confirmed by separate biopsies 1.
- Endoscopic ultrasound (EUS) and staging laparoscopy may also be useful in certain cases, particularly in discriminating T1a from T1b or T2, or in case of an inadequate CT examination 1.
From the Research
Gastric Tumor Symptoms
- Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis of gastric cancer 2
- Early gastric cancer is often asymptomatic, leading to frequent delays in diagnosis 2
- High-risk symptoms do not predict gastric cancer precursors, such as gastric intestinal metaplasia (GIM) 3
- Gastric cancer is usually detected in advanced stages, making early and fast diagnosis crucial for good patient outcomes 4
Diagnosis and Detection
- Endoscopy plays an important role in the diagnosis of gastric cancer, with emerging adjunct technologies such as image-enhanced endoscopy and magnification endoscopy aiding in early cancer detection 5
- Endoscopic ultrasonography is a useful tool for preoperative staging 5
- Biomarkers, including microRNAs, exosomes, circulating tumor cells, circular RNAs, cell-free DNAs, and various proteins, can be used as diagnostic biomarkers in patients with gastric cancer 4
- Serum carcinoembryonic antigen (CEA) is considered a complementary test, but it is not sufficient to diagnose early gastric cancer 6
Treatment and Prevention
- Treatment options for advanced gastric cancer include surgery and chemotherapy, with the first line chemotherapy consisting of doublet therapy with a combination of platinum and fluoropyrimidines 2
- Trastuzumab, a monoclonal antibody, is used in the treatment of human epidermal growth factor 2 positive gastric cancers 2
- Prevention strategies for gastric cancer include Helicobacter pylori eradication and adoption of a healthy diet consisting of fruits and vegetables 2