Written By Dr Ima Ekanem

KEY POINTS

1. Stomach cancer accounts for the 5th most commonly diagnosed cancer and the 4th leading cause of cancer-related deaths worldwide.
2. Stomach cancer does not present with specific symptoms in early stages, making it easily misdiagnosed.
3. Long-term and poorly treated Helicobacter pylori (H.pylori) infection is a known common cause of gastric cancer.
4. Early stages of stomach cancer are curable with surgery.
5. Gastric cancer can be prevented to an extent by reducing the risk factors that can predispose a person to it.

INTRODUCTION

One of the most common symptoms of the digestive tract is indigestion and bloating. A lot of people believe that indigestion and bloating ultimately equal peptic ulcer, but despite this being a common cause of indigestion and bloating, some cases may beg to differ.

Stomach cancer accounts for the 5th most commonly diagnosed cancer and 4th leading cause of cancer related deaths worldwide. The incidence of stomach cancer has been on decline for the past few years and this is related to better preventive measures being adapted in food processing and storage.

This article aims to shed more light on stomach cancer, its risk factors, signs and symptoms and preventive measures that would help protect against it.

What  is stomach cancer?

Stomach cancer, simply put is cancer that occurs in the stomach. It is also known as gastric cancer. Stomach cancer results when the cells that line the stomach begin to grow and divide uncontrollably. Stomach cancer develops slowly over a long period of time.

The stomach has different parts and stomach cancer can develop at any of these parts causing different symptoms however, the most common part for stomach cancer to occur is known as the body or distal part of the stomach. Because stomach cancers develop slowly over years, detecting it early may prove difficult since the signs and symptoms may be vague and simple as indigestion or bloating.

What causes stomach cancer?

There are certain conditions, habits and lifestyle activities that can increase the chances of developing gastric cancer. These factors may range from things that can be changed to those that cannot be changed and may differ in the parts of  the stomach they predispose to a risk. Causes and risk factors of gastric cancer include;

Factors that cannot be modified or changed

1. It is more common in men than women.
2. The risk for stomach cancer increases with older age.
3. Stomach cancer is more common amongst East Europeans, East Asians and South Americans.
4. Pernicious anaemia
5. Genetic factors. The risk of stomach cancer is increased in people that have certain genetically related conditions like
6. A first degree relative who has had stomach cancer.
7. Family cancer syndrome; which refer to certain conditions that herald cancerous growth that run in families. They include but are not limited to familial adenomatous polyposis, li-fraumeni syndrome, peutz-jeghers syndrome, heredity diffuse gastric cancer.
8. Blood group ‘A’.

 

Factors that can be modified or changed

1. Helicobacter pylori infection. This is said to be a known common cause of gastric cancer. H. pylori is a bacteria that can lead to ulcers and long-term inflammation in the stomach causing changes and loss of the stomach normal lining(atrophic gastritis) and with chronic or recurrent infections, it can increase the risk for stomach cancer.
2. Reflux disease. Chronic gastroesophageal reflux disease (GERD) can predispose to gastric cancer due to long term exposure of the junction where the stomach and throat meet to gastric acid..
3. Eating a diet with high salt content, smoked or are poorly preserved and diets low in vitamin A and C can predispose to stomach cancer.
4. Smoking and Alcohol consumption.
5. Ebstein-barr virus.
6. Environmental and occupational exposure. Those in the tin and coal mining, rubber producing or metal industries and those who are frequently exposed to radiation are at risk.

How do I know I have stomach cancer; Signs and Symptoms of stomach cancer.

Most times, the early stages of stomach cancers do not present with symptoms. However when they do, these symptoms are usually vague making it difficult to be detected early. When these early symptoms occur, they include:

• Persistent indigestion and heartburn.
• Stomach discomfort.
• Bloating or feeling full after small meals.
• Poor appetite.
• Feeling like vomiting.

More specific symptoms are usually seen when the cancer has spread i.e in the late stages of the disease. These symptoms may include:

• Vomiting (non-bloody or bloody)
• Black foul-smelling or bloody stools
• Losing weight without trying to
• Feeling weak and tired due to less red blood cells from bleeding from stools or vomiting(anemia).
• Difficulty swallowing.
• Swelling or build up of fluid in the abdomen.
• Yellowness of the skin and eyes (in cases where the cancer has spread to the liver).

These symptoms are not limited to the stomach alone but may be a pointer to the condition. Reach out to a doctor at Doctor on tap or one close to you if you have any of these symptoms.

 

How do doctors detect stomach cancer?.

If a person with any signs and symptoms as mentioned earlier sees a doctor, the doctor would take a detailed medical history, examine and decide to order some tests in order to confirm and make a diagnosis of stomach cancer. The doctor would;

• Ask about the symptoms and if you have any risk factors that could predispose you to stomach cancer in taking a detailed medical history.
• Conduct a general examination and an abdominal examination in order to identify any signs like swelling or mass.

Following these, lab tests may be sent in order to check the blood level of the red blood cells and any form of bleeding in the stool that may not be picked up by the naked eye. Then, tests that would help the doctors look into the stomach would be sent for, these include;

• Upper gastrointestinal(GI) endoscopy with Biopsy; This involves using a small thin flexible tube with a camera and a light source at the end to look into the stomach through the mouth. It is an invasive test and is commonly used. This test also allows for a piece of tissue to be collected from the stomach to be examined under the microscope for cancer cells(biopsy).
• Barium swallow: This test involves drinking a liquid containing barium which helps outline the throat, stomach and upper parts of the small intestine and then an x-ray is taken to view these areas. Also called an upper GI series. It is less invasive than the endoscopy however tissue for biopsy cannot be collected with this test.
• Endoscopic ultrasound, Computed tomography, Magnetic resonance imaging and Positron emission tomography (PET) scans can be used to assess how far the cancer has spread and stage the cancer.

 

What are the available treatment options for stomach cancer?

After a diagnosis of stomach cancer is made, depending on the stage of the disease i.e where the cancer is in the stomach and if it has spread beyond the stomach to other parts of the body, the health status of a person and some other individual factors various treatment options may be offered.

These treatment options may be surgery which is the only curative form of treatment for gastric cancer. Surgery is done as the first line of treatment for early stages of stomach cancer which have not spread, for those that have spread past the inner layer of the stomach but not to other parts of the body, surgery may also be done to remove part or whole of the stomach alongside the lymph nodes that are affected.

If the tumor is too big or has spread, chemotherapy(use of drugs that kill the cancer cells) and radiation therapy( use of radiation to kill the cancer cells) or chemotherapy alone may be done in order to reduce the size of the tumor and consider surgical removal. Chemotherapy is majorly used for cancers that have spread to other body organs alongside radiation therapy and newer drugs called immunotherapy.

If you have more concerning questions about stomach cancer, you can schedule  a consultation with any doctor on Doctor on tap , they would be happy to give answers to your questions and alleviate any worries you might have. If your care also involves travelling for treatment, DoctorOnTap facilitates medical tourism. You could also hire a caregiver through DoctorOnTap

 

Thinking about how to prevent and modify your lifestyle against stomach cancer, here are some helpful tips.

Don’t be scared, all hope is not lost, if you already have risk factors or are prone to developing stomach cancer, here are some healthy and practical tips that can help you reduce those risk factors from progressing into a full blown disease.

• Stop smoking and drinking alcohol.
• Exercise regularly.
• Consume diets high in Vit A and C like fruits and vegetables, and diets that are low in smoked foods, high salt content and are poorly preserved.
• Ensure regular check-ups or clinic visits. You can book an easy and quick consultation with a doctor at Doctor on tap for regular check-ups.

 

When is the right time to see a doctor?

It is important to identify and seek help as early as possible because when a diagnosis is made early:

• It increases survival rates. When gastric cancer is detected early, it can be treated with surgery successfully and the 5-year survival rate if detected early can reach up to 90%.
• It makes room for less aggressive treatment.
• It gives a chance for a better quality of life.

So, if you have any symptoms or high risk factors like a family history of gastrics cancers, the best time to see a doctor is NOW. With Doctor on tap you don’t have to stress or bother about going to the hospital because doctors are available to consult with you at your finger tips.

 

In conclusion…

Gastric cancer is a preventable and curative cancer if preventive measures and lifestyle modifications are made and if detected early. It is important to seek professional care as soon as any symptoms termed normal become persistent or alarming symptoms are noticed. Early detection definitely saves lives.

Frequently Asked Questions.

What is the no.1 risk factor in stomach cancer?

There is no single most important risk factor for stomach cancer. However ,prolonged helicobacter pylori infection which causes ulcers and inflammation has been found to be a common risk factor for stomach cancer.

How long can stomach cancer go undetected?

Stomach cancer can go undetected for years and this is usually because it does not present with symptoms or when it does with vague symptoms in the early stages. This could result in it being misdiagnosed a lot of times. This is why it is important to see a doctor the moment you have a so-called common digestive tract symptom that has persisted over a long time.

Is stomach cancer curable if caught early?

Yes! Stomach cancer is curable if caught early. Surgery is the only curable treatment and it is usually curable in very early stages of the disease where the cancer has not spread.

 

Further Reading

One of the lesser known cancers is Liver Cancer and more awareness needs to be done on it. It is important for everyone to know about it. To learn more about Liver Cancer, read LIVER CANCER: Understanding the symptoms and prevention

 

References

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