Certain Central American countries, especially Nicaragua, have very high rates of stomach cancer. They also have endemic infections with Helicobacter pylori, the bacterium associated with gastric and duodenal ulcers (peptic ulcer disease). There are very high rates of stomach cancer in parts of South America, especially Chile, Japan, and parts of the former Soviet Union. In the United States, Canada, and Europe, stomach cancer is the fifteenth most common form of cancer, but there are so many cases of stomach cancer in a few countries that is the fourth most common cause of cancer deaths worldwide.
That doesn't mean, however, that everyone who gets stomach (gastric) cancer dies of it. Chances of survival increase with early diagnosis. The problem with early diagnosis is that some cases of stomach cancer don't present symptoms at early stages of diagnosis, and others just present one or two symptoms from the following list:
- Dysphagia, or inability to swallow food or drink.
- Feeling full after eating.
- Hematemesis, vomiting up blood.
- Post-prandial (after a meal) fullness.
- Nausea and/or vomiting.
- Melena (black or tarry feces).
Only as the tumor or tumors begin to grow and spread will symptoms possibly include:
- Pleural effusions, accumulation of fluid in the space around the lungs.
- Pressure causing obstruction of either the gastric outlet, where the stomach empties into the small intestine, or the small intestine itself.
- Inanition, exhaustion from lack of nourishment.
- Jaundice as tumors cause hepatomegaly (enlargement of the liver).
- Cachexia, leading to wasting of the muscles as the body burns calories at a faster rate even while it receives calories at a slower rate.
People come in with what they think is a different complaint, because they have just one or maybe two of the symptoms most often associated with stomach cancer, and then the doctor discovers that cancer is the problem. However, there are other conditions that present some of the same symptoms. These conditions include:
- Acute gastritis, inflammation of the lining of the stomach, usually caused by Helicobacter pylori. This is a burning or gnawing pain that may either improve or get worse after eating.
- Chronic gastritis, which may also be caused by Helicobacter pylori infection, but which causes neurological symptoms due to the inability to the digestive tract to receive vitamin B12. Chronic gastritis can also cause anemia.
- Esophageal cancer, cancer of the tube between the throat and stomach. Before 1990, the most common predisposing factor for esophageal cancer was smoking. Now, it most commonly occurs in people who have gastroesophageal reflux disease, also known as GERD.
- Esophageal stricture, a narrowing of the esophagus, which may also cause odynophagia (painful swallowing), dysphagia (inability to swallow, at first an inability to swallow solid foods followed by an inability to swallow liquids), and asthma and cough, due to acid coming up through the esophagus when swallowing is successful.
- Esophagitis, inflammation of the esophagus, which may be caused by a yeast infection or GERD. Symptoms include water brash, a bad taste in the mouth, and intense heartburn. Symptoms are made worse by bending at the waist or wearing tight clothes.
- Non-Hodgkin's or Burkitt's lymphoma, which will also tend to cause night sweats. In these conditions, the problem is an abdominal mass, which may cause protruding belly even without weight gain.
- Peptic ulcer disease (gastric or duodenal ulcers), which tends to produce symptoms that are worse at night, or that cycle over the course of 24 hours, and intolerance of fatty foods.
- Viral gastroenteritis, which normally clears up in a week or less even without treatment.
Symptoms that could mean stomach cancer usually don't mean stomach cancer. It's unusual to be diagnosed with the condition, especially outside of Latin America or Japan. The only way to know for sure that you don't have stomach cancer, however, is to seek a medical diagnosis, preferably as soon as possible after you notice symptoms.
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