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What causes gastric cancer inspite of normal blood reports?

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General Surgeon
Practicing since : 2008
Answered : 1290 Questions
Hi, I'm not sure if you can see my two earlier posts, but this problem of mine has gone on for over two months now. The main thing is pain just below the sternum, sometimes intense, at random times of the day, but especially at around 4.00 am in the morning which wakes me up. Also had reflux, and omeprazole and other similar medications don't seem to work. Have felt like a lump in my throat sometimes too, and stool float and lighter in colour usually. After developing itchiness on arms and sometimes legs about 4 weeks ago, I also noticed I'm getting little bumps on my hands. I have about 10 or so of them. They are like little 1mm to 2mm warts, same colour as my skin. I looked up what these could possibly be when associated with stomach problems, on the internet, and it seemed to direct me mostly to "Florid cutaneous papillomatosis", which they say is always associated with gastric cancer. I'm really worried now. Two days ago I saw another doctor for a second opinion, and I even told her about these warts ( I wrote down the name "Florid cutaneous papillomatosis" for her). She said that with my blood test results (normal CBC and no h. pylori), that she was 99.9% sure that I wouldn't have gastric cancer, and that these warts are probably unrelated. She said if they were related to gastric cancer, my blood test results would not be normal. I'm still worried though. Is it true? If my blood tests were all good, is it impossible that they are not Florid cutaneous papillomatosis? I have an endoscopy in 8 days, but don't just want to wait if it's serious. I'm really panicking now and don't know what to do. I have seen 5 different doctors over the last two and a half months, and I think they just view me as a hypochondriac and maybe not take me seriously. So if I had these warts on my hands and they were due to gastric cancer, would something abnormal definitely show in my blood tests? Thanks for answering.
Posted Fri, 28 Mar 2014 in Digestion and Bowels
Answered by Dr. Ashish Verma 2 hours later
Brief Answer: be patient, in 8 days nothing will change Detailed Answer: Hi, Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. Stomach cancer does have a few abnormal blood tests, like decreased hemoglobin, deranged liver function tests...but these are at advanced stages... But cancers are usually slow growing and in eight days there will hardly be any change in you can patiently wait for your endoscopy... which will be almost definitive in detection or ruling out stomach cancer. Also as you have already shown to five doctors and they all think that there is no cancer and you should be assured that you are not having clinical examination has a great role in this. Finally regarding the nodules over your hand...though i cant comment on them without seeing them...but i would suggest that you show them to a dermatologist for an expert opinion. Hope, that i have answered to all your queries. If you have further queries, i will be glad to answer them. Be patient till your endoscopy and do tell the report. Regards Dr. Ashish Verma
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Follow-up: What causes gastric cancer inspite of normal blood reports? 2 days later
Hi, Also have one more question. My stool this morning was light brown-tannish in colour, but had lots of black little spots through it. Is this what they call coffee ground looking stools? Or is it just seeds or something from bread I ate? I've heard of people getting coffee ground looking stools before, but not sure what they look like. Are they all black, or can they be light brown with lots of black dots scattered through them? Also feel like there is food stuck in my oesophagus, even if there isn't, and I'm burping up bits of food every time I eat. Thanks.
Answered by Dr. Ashish Verma 1 hour later
Brief Answer: its normal stool. Detailed Answer: Hi, This is normal stool...mostly due to something that you ate. Coffee ground stoo is full black and is sticky.....that indicates upper intestinal bleeding. For your need to be on a combination of a lot ppi like pantaprazole and a prokinetic like levosulpride.... see your local doctor for the prescription. Regards Dr. Ashish Verma
Above answer was peer-reviewed by
Follow-up: What causes gastric cancer inspite of normal blood reports? 2 hours later
Thanks for your answer. I have one more query. I feel like a hypochondriac, but this is really worrying me. I have all the symptoms of stomach cancer, and they are not going away. The thing that really worries me is that even the highest doses of omeprazole(80mg per day), and then lansoprazole, haven't helped, which I've heard should help if it's just an ulcer. I've heard if these don't work then suspicion for gastric cancer is high? Also, in late December last year, I saw a doctor in Australia as I was on holiday, about this. He was worried that it may be my pancreas, so sent me for some tests. The first test was a ct scan where I drank some white drink first(I had to drink a glass of it every 5 mins for about half an hour). They then injected a XXXXXXX into my veins during the scan. This didn't pick up anything unusual, except for something in my liver. Because of the mass in my liver, the doctor ordered a second ct scan, which was called a triple phase scan with contrast, to look at the liver. It said that it was a calcified granuloma measuring about 2cm by 1 cm. Otherwise normal pancreas, spleen and no biliary dilatation. Some impaction in intestines was noted. No mention about the stomach. What I really want to know is, would either of the ct scans have picked up a cancer or an ulcer in the stomach? I've heard that these scans are not as sensitive for the stomach, and if so, how likely are they to miss something like cancer or ulcer in stomach? Is it 10 %, 20 %? Are there any figures? Did the scans not pick anything in the stomach up because the doctors may not have been looking for anything there? Also, if it was stomach cancer and had spread (like stage 4), would it have picked this up? Please, I just need to know either way as I'm panicking now. 6 days until my endoscopy and it seems like an eternity. Answers to these questions are much appreciated. Thank you.
Answered by Dr. Ashish Verma 49 minutes later
Brief Answer: you are not hypochondriac Detailed Answer: Hi, First of all, you are not hypochondriac, its normal to worry about onself, specially if you are not getting relief by medications. Secondly, a contrast ct scan would have surely picked up a stomach cancer if it was the scan was normal, so stomach cancer is ruled out. Third, yes a ct scan is not good at detecting ulcers in stomach, and for that endoscopy is the only you have to wait for it. Finally, there are a few conditions in which is even after maximal dose of omeprazole does not brings relief...first is hypergastrinoma, and second is h. pylori infection. Endoscopy is needed for the second...for the first you need to get a blood test....serum gastrin levels. You may get it till you are waiting for the endoscopy. Regards Dr. Ashish Verma
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