1. There are no obvious symptoms of early-stage gastric cancer over 70 years old. As the disease progresses, non-specific symptoms similar to gastritis or gastric ulcer may gradually appear, including upper abdominal fullness and discomfort or dull pain, and pantothenic acid. , belching, nausea, occasionally vomiting, loss of appetite, indigestion, melena, etc. 2. Symptoms of advanced gastric cancer include pain in the stomach area, which is often biting and has no obvious relationship with eating. It can also be similar to peptic ulcer pain, which can be relieved after eating. Fullness, heaviness in the upper abdomen, anorexia, abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, edema, fever, etc. Cardiac cancer mainly manifests as subxiphoid discomfort, pain or retrosternal pain, accompanied by a sense of obstruction in eating or difficulty swallowing; cancer in the fundus of the stomach and subcardia often has no obvious symptoms until the tumor is huge and necrosis and ulceration occurs, causing upper gastrointestinal bleeding. Attention is only drawn to the patient, or attention is paid only after the tumor infiltration extends to the cardia opening and causes dysphagia; the expansion type of cancer is more common in the body of the stomach, and the pain and discomfort appear later; the ulcer type cancer is the most common in the lesser curvature of the gastric antrum, so Symptoms of upper abdominal pain appear earlier. When the tumor extends to the pylorus, it can cause symptoms of pyloric obstruction such as nausea and vomiting. The spread and metastasis of cancer can cause ascites, hepatomegaly, jaundice, and metastasis to the lungs, brain, heart, prostate, ovary, bone marrow, etc., resulting in corresponding symptoms. (2) Signs of gastric cancer patients: The vast majority of gastric cancer patients have no obvious signs, and some patients have mild tenderness in the upper abdomen. In advanced gastric cancer located in the pyloric antrum or gastric body, a mass can sometimes be palpated. The mass is often nodular and hard. When the tumor infiltrates into adjacent organs or tissues, the mass is often fixed and cannot be pushed. In female patients, the mass can be palpated in the middle and lower abdomen. and lumps often suggest the possibility of Krukenbe tumor. When gastric cancer metastasizes to the liver, nodular masses can be palpable in the enlarged liver. Obstructive jaundice can occur when a metastatic mass in the abdominal cavity compresses the common bile duct. In patients with pyloric obstruction, a dilated stomach can be seen in the upper abdomen, and the sound of shaking water can be heard. Cancer may metastasize through the thoracic duct and the left supraclavicular lymph node may be swollen. When advanced gastric cancer has pelvic implants, nodules can be palpable in the bladder (uterus) and rectal fossa during digital rectal examination. Ascites may occur when there is peritoneal metastasis. Narrowing of the intestinal lumen due to small intestinal or mesangial metastasis can lead to partial or complete intestinal obstruction. When perforation of cancer leads to diffuse peritonitis, peritoneal irritation symptoms such as stiffness of abdominal muscles and abdominal tenderness may occur. It may also infiltrate adjacent organs of the cavity to form internal fistulas. (3) Common complications of gastric cancer 1. When gastrointestinal bleeding is complicated, dizziness, palpitations, tarry stools, and brown vomiting may occur. 2. When abdominal metastasis of gastric cancer puts pressure on the common bile duct, jaundice and clay-colored stool may occur. 3. Combined with pyloric obstruction, vomiting may occur, a dilated stomach shape can be seen in the upper abdomen, and water shaking can be heard. 4. Diffuse peritonitis caused by cancer perforation may cause abdominal muscle stiffness, abdominal tenderness and other peritoneal irritations. 5. Formation of gastrointestinal fistula, resulting in discharge of undigested food.

Treatment of gastric cancer The treatment of gastric cancer is the same as the treatment of other malignant tumors. Surgery should be the first choice. At the same time, chemotherapy, radiotherapy, traditional Chinese medicine, immunotherapy and other comprehensive treatments should be reasonably combined according to the situation. According to the TNM staging, the current comprehensive treatment plan is roughly as follows: Stage I Gastric cancer is an early-stage gastric cancer, and surgical resection is the main method. Individual patients with types IIa and IIc that invade and metastasize to the submucosal lymph nodes should receive certain chemotherapy. Stage II gastric cancer is an intermediate-stage gastric cancer, and surgical resection is the main method. Some adjuvant chemotherapy or immunotherapy may be used. Stage III gastric cancer Although surgical resection is the main method when multiple invasions into surrounding tissues and extensive lymph node metastasis occur, it should be treated with chemotherapy, radiotherapy, immunotherapy, and traditional Chinese medicine. Stage IV gastric cancer is in the advanced stage and non-surgical treatments are often used. For those who are suitable for surgery, try to remove the primary tumor and metastases. Lesions combined with chemotherapy, radiotherapy, immunity, traditional Chinese medicine (TCM) comprehensive therapy (1) Surgical treatment Surgical treatment is divided into radical surgery, palliative surgery and short-circuit surgery 1. Radical surgical resection: This concept is relative and refers to the subjective judgment that the tumor has been removed. In fact, only part of the therapeutic effect can be cured. 2. Palliative resection: It refers to the subjective judgment that the tumor cannot be completely removed, but the main tumor mass can be resected. Resection of the tumor can relieve symptoms and prolong life, creating conditions for further comprehensive treatment. 3. Short circuit Surgery: Mainly used for cases with pyloric obstruction where surgical resection is impossible. Gastrojejunostomy can alleviate the obstruction. (2) Radiotherapy 1. Preoperative radiotherapy: refers to the clinically palpable masses of some advanced gastric cancers. Preoperative local irradiation to increase the resection rate is 200cGY 5 times/week for 4 weeks. The total dose is 4000cGY for 4 weeks. Surgery performed 1 to 14 days after stopping radiotherapy can increase the local resection rate but cannot affect the degree of lymph node metastasis. The preoperative time is 6 weeks. Therefore, the impact on 5-year survival is difficult to estimate. 2. Intraoperative radiotherapy: refers to a large-dose irradiation to the surgical field centered on the celiac artery before establishing gastrointestinal anastomosis after tumor resection, preferably 3000~3500cGY, which can improve the treatment of advanced gastric cancer. The 5-year survival rate is about 10%. During the operation, ensure that the intestine is isolated from the irradiation field to prevent the occurrence of radioactive complications. 3. Postoperative radiotherapy: Most scholars believe that it is ineffective. (3) Chemotherapy is not required for early gastric cancer. Except for other advanced gastric cancer, appropriate chemotherapy should be performed.