Diagnosis of stomach cancer

Diagnostics of a cancer of a stomach easy only when there have been expressed clinical manifestations of this disease. When coupled with increasing disorders General condition of the patient has pain in the epigastric region, evacuation disorders and other related disorders of the stomach; symptoms - belching, heartburn, nausea and others, and especially if you are able to touch in the stomach tumor. However, such expressed situation typical of advanced process.
Early diagnosis of stomach cancer represents unique challenges because in the initial stages of the disease development during its always latent. The first symptoms of the disease may appear only when the cancer has gone so far that surgical treatment it has already become impossible. Among all too late seeking medical attention, this category of patients is about 20%.
In addition, in most patients, even in the presence of very bright manifestations of the disease, the correct diagnosis is only after some time, sometimes very long. According to both domestic and foreign statistics, the majority of patients are brought to the surgeon more than six months since the first manifestations of the disease. From 5200 gastric cancer patients received over the past 25 years in our clinic, only 40% came before the expiration of 6 months from the moment of the first manifestations of the disease, others much later.
In some cases this is due to the late referral of the patient to the doctor because of inadequate attitude to their health or because of the fear of cancer detection, inspired wrong and unwise detailed information of the patient. But the main reason, which is celebrated in about 60% of all received too late for surgery patients, this diagnostic errors. Wrong diagnosis determines and wrong treatment. Putting the patient diagnosed with gastritis, duodenal ulcer, colitis, cholecystitis, or assessing complaints of the patient as the result of some other diseases, spend more or less vigorous treatment often for many months, until then, until a tragic error does not become absolutely doubtless because of the emergence of clear symptoms of advanced cancer. This applies particularly to those patients who in the past had suffered from any chronic disease of digestive organs. This will bring the patient even very characteristic signs of stomach cancer often erroneously interpreted as signs of exacerbation of pre-existing gastritis, cholecystitis, ulcer, etc., we Note that such errors occur even when already possible anywhere in the stomach to feel the lump which is taken for infiltration in the field of ulcers, gall bladder or pancreas.
However, a detailed study of patient complaints, carefully assembled history in such cases almost always gives investigating doctor sufficient grounds to suppose the possibility of developing in a patient with stomach cancer. Often the first signs of cancer, especially ulcerative-infiltrative, very similar to the picture of ulcers stomach and duodenal ulcer. In the beginning of the disease is necessary to observe seemingly typical picture of ulcers: "hungry" pain occurring at night and disappearing after ingestion of small amounts of food, heartburn and regurgitation, stopping after taking alkalis, characteristic for ulcer pain on palpation in epigastrium, increasing the number of hydrochloric acid in the gastric contents. Further pain, usually very acute ulcers, made less acute and the dependence of their appearance food becomes less pronounced. They gradually take on the character constant, sometimes unbearable and not giving any treatments. The acidity of gastric contents steadily decreasing to a full ahilii. This pattern may be in a rapidly developing malignancy initially little concern to the patient stomach ulcers.
External examination of the patient gives some grounds for diagnosis only in far comes process. It may be noted a significant depletion of the patient, flabbiness of muscles and skin turgor are dramatically reduced. Gray-ash or clay, slightly yellowish colour of the skin, dull eyes weary and his sunken eyes. Sometimes the skin is pale and shiny due to swelling of the tissue that develops as a result of anemia and gipoproteinemii. During examination of the abdomen in a severely malnourished patients in the epigastric region are seen moving with the breath-like formation, which are easily palpated. If still quite a thick layer of subcutaneous fat, which is quite often even with a significant decrease in body mass, not only to see the tumor, but also to probe it can not always, even when you localize it in the output section. You should always keep in mind the possibility of distant metastases. And so each patient, the condition of which presupposes at least a small suspicion of a cancer of a stomach, you need to carefully examine all available palpable lymph nodes, producing carefully digital examination of the rectum in order to detect metastases in dopasowa space.
Stomach cancer, even very launched, often mistaken for other disease, symptoms of which are more or less similar. For example, in stomach cancer with metastases in the liver diagnosed with primary liver or gall-bladder - liver cirrhosis, gallstones, cholecystitis, etc. When cardiac cancer, calling reflex heart disorder, is diagnosed with angina; in lung metastasis - wrongly diagnosed with pneumonia, tuberculosis, with the disease of the ovaries is mistakenly diagnose primary tumor of the ovary, or a cyst. Since distant metastases may be the first manifestation of stomach cancer, such mistakes are understandable. However, they can occur while there are pronounced gastric symptoms, which, however, can be set aside on the back burner because of severe infringements, caused by the development of metastases. Together with this, a number of diseases proceeds from this picture, which often leads to the erroneous diagnosis of stomach cancer. This variety of diseases that cause depletion of the patient, dyspepsia, chronic progressive anemia and other characteristic of gastric cancer, painful conditions.
Thus, on the basis of clinical manifestations confidently diagnose cancer of the stomach is possible only in some patients, of which many of the diagnosis is delayed. Therefore, each patient, especially after the age of 40 when it occurs, the smallest suspicion on the possibility of stomach cancer, should be of special investigations, which now allow to identify stomach cancer even at the very beginning of its development.
This includes laboratory tests (study of gastric contents, stool, blood), fibrogastroscopy, x-ray study.