Gastric carcinoma, although rarely encountered in the western world (a little over 26,000 cases are estimated in the United States in 2016), is one of the most common cancers worldwide, as a very high number of cases is seen in South America, Eastern Europe, and Eastern parts of Asia [1] [2] [3]. In fact, almost 1,000,000 people are diagnosed each year, with more than 730,000 deaths, making it the second most common cause of death due to a malignant disease [1] [4] [5]. One of the reasons for such a poor prognosis is the insidious clinical presentation, particularly in the early stages of the disease. Dyspepsia is the principal complaint, which may be accompanied by mild and nonspecific abdominal pain, weight loss, and/or anorexia [6]. In the presence of larger tumors that obstruct normal passage of food or impair normal stomach function, nausea, vomiting, and early satiety might be reported, whereas hematemesis, melena, and possibly severe hemorrhage appear when ulceration of the tumor occurs [6]. Several risk factors have been established, such as male gender (male-to-female ratio ranging from 2-12:1), cigarette smoking, excess alcohol consumption, as well as genetic factors (a positive family history), Helicobacter pylori infection, and previous radiation [1] [4] [7]. Furthermore, gastric carcinoma of the cardia region is associated with obesity and gastroesophageal reflux disease (GERD) [2].

• Weight Loss

  The patient presented with chronic continuous abdominal pain and weight loss over a 6-month period. [ncbi.nlm.nih.gov]

  Dyspepsia is the principal complaint, which may be accompanied by mild and nonspecific abdominal pain, weight loss, and/or anorexia. [symptoma.com]

  She had been suffering of many inspecific symptoms, for a long period of time, such as abdominal pain and weight loss. [gastrointestinalatlas.com]

  Late-stage disease may present with gastric outlet obstruction (mechanical obstruction of the pyloric canal ), leading to weight loss and vomiting. Biopsy during endoscopy confirms the diagnosis. [amboss.com]

• Anemia

  Abstract In 1876 Quincke 1 first reported the occurrence of a carcinoma of the stomach in a patient suffering from pernicious anemia. [annals.org]

  Twenty days later, she presented with acute vomiting, a high fever, an increased heart rate, and severe anemia. [ncbi.nlm.nih.gov]

  "Chronic anemia due to watermelon stomach". Annals of Saudi Medicine. 30 (2): 156–8. doi : 10.4103/0256-4947.60524. PMC 2855069. PMID 20220268. ^ Rider, JA; Klotz, AP; Kirsner, JB (1953). [en.wikipedia.org]

  Inflammation in your gut called gastritis, a certain type of long-lasting anemia called pernicious anemia, and growths in your stomach called polyps also can make you more likely to get cancer. [webmd.com]

• Asymptomatic

  A 35-year-old male presented with a three-month history of multiple asymptomatic, indurated, pinky colored nodules of 2.5 to 4 cm in diameter, without any local and general symptoms. Nodule biopsy revealed an infiltrating signet ring cell carcinoma. [ncbi.nlm.nih.gov]

  In many cases, it is asymptomatic, even though postprandial abdominal pain or, during exercise, nauseas, vomiting, and weight loss could be found. [websurg.com]

  References: [7] [8] Clinical features Gastric cancer is often asymptomatic. Early signs are nonspecific and often go unnoticed. [amboss.com]

• Fatigue

  dyspnea, rash, neutropenia, anemia, and myalgia The most common adverse reactions associated with Herceptin in metastatic gastric cancer were neutropenia, diarrhea, fatigue, anemia, stomatitis, weight loss, upper respiratory tract infections, fever, [herceptin.com]

  Some symptoms of gastric cancer, such as early satiety (fullness), mild belly pain and fatigue are the same as or similar to the manifestations of other less serious and common conditions. [hopkinsmedicine.org]

  However, some people may choose not to go through PT because of fatigue or pain. [physio-pedia.com]

  […] symptoms of advanced stomach cancer are: nausea and vomiting frequent heartburn loss of appetite, sometimes accompanied by sudden weight loss constant bloating early satiety (feeling full after eating only a small amount) bloody stools jaundice excessive fatigue [healthline.com]

• Weakness

  A 55-year-old man presented with complaints of weakness, abdominal distention and anorexia for 3 months. He had pain in the upper abdomen, passage of blackish stool and an episode of hemoptysis later on. [ncbi.nlm.nih.gov]

• Vomiting

  Twenty days later, she presented with acute vomiting, a high fever, an increased heart rate, and severe anemia. [ncbi.nlm.nih.gov]

  The triad signs are sudden and severe epigastric pain, uncontrollable making of vomiting noises without actually vomiting, and the impossibility of passing a nasogastric tube through to the gut. [news-medical.net]

• Nausea

  A 67-year-old woman with a history of early-stage gastric cancer in remission was admitted to our hospital with 3 days of headache and nausea. [ncbi.nlm.nih.gov]

  In the presence of larger tumors that obstruct normal passage of food or impair normal stomach function, nausea, vomiting, and early satiety might be reported, whereas hematemesis, melena, and possibly severe hemorrhage appear when ulceration of the tumor [symptoma.com]

• Loss of Appetite

  We describe a case of a patient who presented with a 20-day history of vomiting, generalised weakness and loss of appetite and a 2-day history of altered sensorium. On examination, he was grossly emaciated and there were no palpable lymph nodes. [ncbi.nlm.nih.gov]

  If you experience any of the following symptoms for more than two weeks, it is advised that you see a gastroenterologist: Unexplained weight loss Severe abdominal pain Nausea and vomiting Loss of appetite Vomiting blood Tarry stool Difficulty or painful [hopkinsmedicine.org]

  They include: persistent indigestion and heartburn trapped wind and frequent burping feeling very full or bloated after meals persistent stomach pain Symptoms of advanced stomach cancer can include: blood in your poo, or black poo loss of appetite weight [nhs.uk]

  Some of the most common symptoms of advanced stomach cancer are: nausea and vomiting frequent heartburn loss of appetite, sometimes accompanied by sudden weight loss constant bloating early satiety (feeling full after eating only a small amount) bloody [healthline.com]

• Diarrhea

  Gastroenteritis is a disease characterized by abdominal pain, diarrhea, headache, and fever. 胃肠炎是以腹痛、腹泻、头痛和发烧为特征的一种疾病。 [ichacha.net]

  Most patients after total gastrectomy develop symptoms postgastrectomy syndrome, dysphagia, heartburn, reflux esophagitis, diarrhea and weight loss. [nardus.mpn.gov.rs]

  infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia The most common adverse reactions associated with Herceptin in metastatic gastric cancer were neutropenia, diarrhea, fatigue, anemia, stomatitis, weight [herceptin.com]

  These bacteria breaks down bile salts needed to properly digest fats, resulting in diarrhea and abdominal bloating. This condition can be treated with oral antibiotics. [cancersupportivecare.com]

  Mouth sores Diarrhea (may be severe) Less common (10–29% of patients) [ edit ] Poor appetite Nausea and vomiting Hair loss Elevated liver enzymes (temporary increase in alkaline phosphatase, lactate dehydrogenase, transaminase, and bilirubin ). [en.wikipedia.org]

• Dyspepsia

  Only mild symptoms of dyspepsia and abdominal pain are usually seen in the early stages. [symptoma.com]

  Long term follow up of a representative population of UK patients with uncomplicated dyspepsia is warranted. [gut.bmj.com]

  It often produces no specific symptoms when it is superficial and potentially surgically curable, although up to 50% of patients may have nonspecific gastrointestinal complaints such as dyspepsia 2. [radiopaedia.org]

• Hypotension

  Interrupt Herceptin infusion for dyspnea or clinically significant hypotension. Monitor patients until symptoms completely resolve. [herceptin.com]

  These can be removed by use of laparoscopic techniques, and the incidence of tracheobronchial injury, intra-operative haemorrhage and intra-operative hypotension can be brought down to almost zero and 3.7%, respectively. [journalofmas.com]

• Headache

  A 59-year-old man presented with headache three years after a total gastrectomy for signet-ring cell carcinoma. [ncbi.nlm.nih.gov]

  […] patients who received Herceptin and those who did not Most Common Adverse Reactions The most common adverse reactions associated with Herceptin in breast cancer were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache [herceptin.com]

  Gastroenteritis is a disease characterized by abdominal pain, diarrhea, headache, and fever. 胃肠炎是以腹痛、腹泻、头痛和发烧为特征的一种疾病。 [ichacha.net]

The nonspecific presentation and insidious course of gastric carcinoma make early recognition rather difficult. Nevertheless, the role of the physician in making the initial assumption through a detailed patient history and a complete physical examination is essential. In the presence of dyspepsia and associated gastrointestinal complaints in older individuals (particularly over 55 years of age), gastric carcinoma must be excluded [7]. Thus, the employment of imaging studies is the next step in the workup. Many authors have agreed that upper gastrointestinal tract endoscopy is the cornerstone when it comes to gastric carcinoma, and the technique is widely recommended for both screening and diagnostic purposes [1] [7]. An additional benefit of upper endoscopy is that it provides the ability to obtain a biopsy sample that will, after histopathological examination, confirm gastric carcinoma. As the treatment strategy (but also the prognosis) depends on the tumor stage, the extent of tumor invasion and dissemination must be assessed as well [8]. Various techniques have been described, but the use of computed tomography (particularly multiple detector CT -MDCT) in the evaluation of the pelvis, abdomen, and chest for the nodal or metastatic spread is the gold standard [7] [8]. Laparoscopy is also described as a tool for investigating the degree of local invasion and determining optimal treatment strategy [7].

• Helicobacter Pylori

  Transmission electron micrograph image of Helicobacter pylori taken by Dr. [microbewiki.kenyon.edu]

  LLGC was not associated with HER-2, chromogranin and synaptophysin positivity or Helicobacter pylori infection. [ncbi.nlm.nih.gov]

  Thirty seven patients had Helicobacter pylori gastritis: 23 of these had concomitant atrophic gastritis and/or intestinal metaplasia. It seems unlikely that 4% (38%×11%) of our patients will develop gastric cancer over the next 10 years. [gut.bmj.com]

  Several risk factors have been established, such as male gender (male-to-female ratio ranging from 2-12:1), cigarette smoking, excess alcohol consumption, as well as genetic factors (a positive family history), Helicobacter pylori infection, and previous [symptoma.com]

To date, there is no usable standardized treatment regimen for patients with advanced GC. [ncbi.nlm.nih.gov]

MTT, wound healing and Transwell experiments were conducted to study the effect of VEGF on tumor incidence, metastasis and prognosis. [ncbi.nlm.nih.gov]

One of the reasons for such a poor prognosis is the insidious clinical presentation, particularly in the early stages of the disease. [symptoma.com]

Sciatic nerve palsy may be caused by nondiscogenic etiologies that may be either intrapelvic or extrapelvic. It is important to image the entire course of the nerve to distinguish these etiologies quickly. [ncbi.nlm.nih.gov]

Pylori infection is a major etiologic factor in the development of intestinal type gastric cancer ( Parsonnet et al. 1991 ). [mycancergenome.org]

Etiology Gastric cancer continues to be one of the leading causes of cancer-related death. A significant development in the epidemiology of gastric carcinoma has been the recognition of the association with Helicobacter pylori infection. [radiopaedia.org]

Disease Gastric adenocarcinoma Etiology Helicobacter pylori H. pylori is the single most important etiological agent in the pathogenesis of gastric cancer. [atlasgeneticsoncology.org]

Epidemiology of gastric cancer. In: Correa P, Haenszel W, eds. Epidemiology of cancer of the digestive tract. The Hague, the Netherlands: Martinus Nijhoff, 1982:58–84. 6. Correa P, Cuello C, Duque E.. [nejm.org]

Keywords: gastric cancer, epidemiology, classification, risk factors, treatment This work is published and licensed by Dove Medical Press Limited. [dovepress.com]

Author information 1 1 Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. 2 2 Department of Epidemiology and [ncbi.nlm.nih.gov]

Valencia, Spain - 25 Oct - 26 Oct 2019 Learning objectives To learn about the fundamentals of epidemiology, aetiology, pathogenesis, molecular events and ethnic patterns as contributing factors to heterogeneity in gastric cancer To understand the essentials [esmo.org]

However, the pathogenesis and pathophysiology of this debilitating condition still remains obscure and no effective management was recommended. The present study aims to elucidate the pathophysiology of PTTM. [ncbi.nlm.nih.gov]

[…] of gastrointestinal obstruction Partial gastrectomies may be used in exceptional cases References: [13] Complications Malignant acanthosis nigricans A paraneoplastic syndrome seen in adenocarcinomas of GI origin, especially in gastric adenocarcinoma Pathophysiology [amboss.com]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 54. Gunderson LL, Donohue JH, Alberts SR. Ashman JB, Jaroszewski DE, eds. [pennstatehershey.adam.com]

Pathophysiological and clinical aspects of gastric hyperplastic polyps. World Journal of Gastroenterology. 2016;22(40):8883. doi:10.3748/wjg.v22.i40.8883 [ Links ] 23. Kamiya T, Morishita T, Asakura H, Miura S, Munakata Y, Tsuchiya M. [scielo.sa.cr]

"Hepatic encephalopathy: pathophysiology and emerging therapies". Med. Clin. North Am. 93 (4): 819–36, vii. doi : 10.1016/j.mcna.2009.03.009. [en.wikipedia.org]

Causes, Risk Factors, and Prevention Learn about the risk factors for stomach cancer and what you might be able to do to help lower your risk. Early Detection, Diagnosis, and Staging Know the signs and symptoms of stomach cancer. [cancer.org]

A preventive transcatheter arterial chemoembolization (TACE) was conducted at 4 weeks after hepatectomy. Another FOLFOX regimen was suggested, but was refused by the patient. [ncbi.nlm.nih.gov]

Explore the links on this page to learn more about gastric cancer prevention, screening, treatment, statistics, research, and clinical trials. [cancer.gov]

© iStock/magicmine Health Europa explored with United European Gastroenterology about the efforts regarding gastric cancer treatment, understanding and prevention. [healtheuropa.eu]

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