Gastric Cancer?

[Trooper2]

I am a white, 43-year old male. My concern is that for about 4 months now I have had this pain (level of pain: 1-2 out of 10)/"sensation of pain" midway between my navel and the bottom of my rib cage, about 2-3 inches to the right (RUQ), which comes and goes several times a day, but lasting only a second or two. It appears to be associated with delayed movement? I explained this to my GP who ordered hepatic blood tests, to check my liver. All came back fine. I then had an abdominal ultrasound and all (spleen, kidneys, pancreas, etc.) came back okay, with the exception of my gallbladder, which showed, multiple, mobile stones. I am to see a surgeon regarding a surgury consult (i.e. what to do). My doctor is not convinced (50/50), the pain I am experiencing is indeed gallbladder pain, he states if it is gallbladder, it is "atypical" gallbladder pain, but states we will start there and see what happens. My concern is gastric cancer, although I still have a relatively normal appetite, have not lost any significant weight, no vomiting or bloody stools that I can see. Is gastric cancer a strong possibility? Any input is greatly appreciated.

[Dennis MD]

Hi.
Abdominal ultrasound may be able to detect a large gastric mass, especially if it already extended to other parts of the abdomen like pancreas.  Though there are better modalities to diagnose gastric cancer like endoscopy and CT scan.
Weight loss is considered significant if more than 10% of the patient's usual weight is lost within 6 months.
The pain characteristic is not typical.  It can be constant or intermittent.  Even the pain severity varies from individual to individual.

[Trooper2]

Thank-you for your comments. Out of curiosity, if a gastric mass were large enough to cause pain, would this have been visible on the abdominal ultrasound? Also, in regards to weight loss, how much would be significant? Lastly, what type of abdominal pain would be characteristic of gastric cancer...constant and unrelenting, or intermittant and mild? Thank-you again for your comments.

[Dennis MD]

Hi.
Gallstones can present with abdominal pain, usually aggravated by intake of fatty foods.  Gastric cancer, on the other hand, may not present with early symptoms.  Usually, a patient becomes symptomatic when the gastric mass is already large.  Symptoms include early satiety, abdominal pain, weight loss,  vomiting, etc.