This is a continuation of my previous post, "Tend well, your trees". In this I will describe what I have been observing in my father in the last few years, that should have raised red flags, but didn't. Even if I had doubts, I rationalized them away, thinking his symptoms were due to other causes. I wish I hadn't, but hindsight is always 20/20, as they say.
While you read through this, remember that there may be variations in symptoms and this is being written by a non-medical person who is writing only what she saw and understood from the situation. I do not claim medical accuracy. All I am writing is the truth as I know it.
My father has stomach cancer (adenocarcinoma), in the lower part of the stomach called the pyloric antrum. This is near the point where the stomach meets the intestine. The tumor is like an all-round swelling of the stomach wall, gradually thickening and blocking the path to the intestine. Think of it like a water pipe getting constricted, so that water flow is reduced. That's how it is. The cancer has also started spreading to the liver.
From all the articles I've been reading about this, I understand that stomach cancer takes time to grow. First, the inner lining of the stomach gets inflamed. Slowly, the inner lining may get some abnormal cells. Gradually some precancerous polyps may grow that then become cancerous. Initial symptoms can include heartburn, indigestion, abdominal pain - and these can be easily mistaken for other problems. Usually by the time stomach cancer gets diagnosed, the cancer is in the advanced stage.
The first sign that should've warned me is that my father complained of losing his sense of smell. He could detect strong smells, or if the smell lingers a bit longer, but he was missing short-time smells like say, a whiff of jasmine. I don't know how many patients have this, but this was definitely not normal. I am told that when it comes to food, smell is a large percentage of how we perceive the flavor of the food. So this itself should've been a warning.
He continued to have stomach problems - heartburn, gas, trapped air getting released as long burps. But since he was traveling a lot due to his business, we put it down to the effects of eating food outside. I'm saying this to illustrate how much people can be fooled by or rationalize symptoms. But those symptoms were there.
After a few months, say a year, he said that he was losing food cravings. This is a person who loves food, and strong flavors. Now he was saying that he eats to satisfy his hunger, but strangely, has no desire to eat this or that type of food.
We attributed that to stress, as he has a lot of work-related stress.
He was also losing weight. The rate at which he was losing weight was almost abnormal. Each year I saw him, he was fading. This is a person, who on a normal day, is 5 foot 11 inches tall, broad-shouldered, well-built and ruddy cheeked. He is the picture of health, someone who rarely falls sick, is usually a very energetic person, not to mention one of the most handsome men I know. And yet he was fading.
We attributed that to his borderline high blood sugar. I, living far away, rationalized it to his nighttime wheat diet. But something in me kept telling this is abnormal. The dreaded cancer word reared its head in my mind. It did. Several times. Call it intuition, or the connection I have and feel with my father.
So I kept insisting on yearly check-ups. Year after year I nagged him. They tested his heart, lungs, blood and other body fluids. Everything was normal. The blood sugar was a bit high, but they just asked him to take walks and modify his diet. I stupidly thought that if he had cancer, a blood test would have revealed it.
Well - this may be news to you as it was to me: A blood test does not really reveal the presence of cancer. Not always, anyway - usually, it may reveal some abnormality like low RBC/WBC count. That's it.
Soon, my father was saying that he has no appetite, and feels full after small meals. In retrospect, we realize that this is because the tumor was blocking the path to the intestine, so food passed to the intestine much more slowly than before. Food being retained in the stomach was causing this fullness, as also the growing tumor which shrank the space. He has talked to his family physician, and the guy dismissed that symptom, saying it was due to old age. Appa also described weight loss, to which the doctor said "Be happy. Lots of people are wanting to lose weight - you're accomplishing this effortlessly!". Words cannot describe my rage at the physician's incompetence, but that's besides the point.
Point is, unexplained weight loss and loss of appetite are symptoms to watch out for, in many cancers, not just abdominal cancers.
A lot of cancers of the alimentary canal - esophageal, stomach, liver, pancreas - cannot be found by a blood test. They can only be found by internal screenings, such as an endoscopy, a CT scan, or Magnetic Resonance Imaging (MRI).
Endoscopy is where a thin lighted tube is passed via a person's mouth, while the other end is attached to some kind of TV screen. On this TV screen, you can see the inner linings of stomach, esophagus etc. Imagine somebody shining a flashlight in the stomach and examining what it shows on a TV screen - its like that. Endoscopy should tell the doctor if there's an abnormality, or even something relatively benign like a peptic ulcer. The endoscopy report is like a color printout of the area examined.
MRI's are scans using magnetic rays/fields. An MRI picture is a 3D computer image of internal organs, that can show abnormalities.
The other diagnostic tool I mentioned is a CT scan. A CT scan report looks like an X-ray report, showing internal organs, and any abnormalities in them.
Cancers of the stomach have symptoms that can include any or all of the following:
- loss of appetite
- unexplained weight loss
- feeling of fullness after small meals
- decreased energy
- heartburn, gas
- abdominal pain
- irregular bowel movements or alternating phases of constipation/diarrhea
Microscopic, or small quantities of blood from the tumor may also pass in stools, undetected. A fecal occult test may indicate this, but on a regular day, the bleeding may go unnoticed.
In advanced cases, the symptoms include
- vomiting blood, or passing bloody, tarry, stools (due to internal bleeding from the tumor)
- continuous fever day after day
- extreme fatigue due to loss of hemoglobin
My father was diagnosed only at this advanced stage. He had lost so much blood, that he had to undergo transfusions. Any more blood loss, and his heart wouldn't have been able to function. My heart goes out to all the known and unknown people who donated blood. They have inspired me to donate blood on a regular basis.
I have made this post more detailed and personal than I had originally intended to, but will leave it as is. It may go to prove how much some or all of the symptoms can get rationalized away, or go unnoticed. How people may have misconceptions, such as the one I had - that a blood test can show the presence of cancer.
In the next post, I will describe some of the risk factors I learned about stomach cancer, and some cancer myths and attitudes to cancer, that make us overlook this disease until it becomes advanced.
Read Part 3 of article here
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