DIGESTING THE TRUTHS ABOUT STOMACH CANCER
In a country that enjoys food so much it’s almost a national pastime, this cancer surprisingly flies under the radar. By Adelina Tan
The factors that increase your risk of developing it.
“Eh, what to eat today?” is a common and affectionate greeting here, where food is delicious and plentiful. With affordable options around every corner – be it a road-side warung or neighbourhood kopitiam – we often take for granted the simple pleasures of eating and the work our stomach does.
In Peninsular Malaysia, statistics show that stomach cancer – or gastric cancer as it’s also known – is the eight and tenth most common cancer in males and females, respectively. More alarmingly, the number of people diagnosed with this cancer is increasing. More than half of stomach cancer patients here are Chinese, followed by Malays and Indians. This has been attributed to the traditional Chinese diet, as stomach cancer is very common in Japan, South Korea and China – countries that share similarities in cuisine.
“Many factors combine to cause stomach cancer, but it often starts with some inflammation of the mucosa, which is the inner lining of the stomach,” says Dr Ang Soo Fan, a visiting consultant medical oncologist at Penang Adventist Hospital. Over time, if the inflammation becomes chronic, structural and DNA changes may happen to the mucosa. Inflammation is often caused by Helicobacter pylori (H. pylori), a kind of bacteria
that’s been classified by the World Health Organization as a class 1 carcinogen. It lives along the mucosa and when untreated, is the leading cause of stomach cancer. Here are other things you must know about stomach cancer.
#1 Your favourite foods may be slowly killing you
There’s a saying that the tastiest foods are never healthy and, sadly for our taste buds, it’s often true. “Food that’s barbecued, fried or prepared directly over a fire, such as satay, contains carcinogens,” points out Dr Ang. He also recommends avoiding or cutting back on processed red meats like sausages and bacon, as the nitrates in them have been linked to cancer. Too much salty food is also discouraged, as are preserved foods as they’re typically loaded with preservatives and colouring.
#2 More women are being diagnosed with it
While stomach cancer affects more men than women, Dr Ang says the number of incidences among women is higher than before – a fact that could be correlated to an increase in women smokers and alcoholics.
#3 Your risk for it increases with age
“The incidence of stomach cancer goes up sharply after 50, though these days more diagnoses are being made in those aged 30 and up,” shares Dr Ang. “Unfortunately, younger people tend to develop the aggressive form of this cancer, usually detected only when it’s pretty advanced and doesn’t respond very well to treatment.”
#4 Symptoms are often brushed aside as ‘gastric’
“The signs and symptoms of stomach cancer are non-specific and often mistaken for comparatively more benign problems such as heartburn, gastric and peptic ulcer disease. These include bloating, dyspepsia, a constant feeling of fullness, and discomfort or some pain in the upper part of the abdomen,” laments Dr Ang. Alarming symptoms that could hint at something more serious are also nausea and vomiting, loss of appetite, weight loss, and persistent pain.
He notes that often, the cancer isn’t diagnosed till much later as patients who go to a general practitioner may just be given pills or antacid to treat the gastric and protect the stomach wall. “Some patients had their diagnosis delayed for half a year to one whole year, so if your gastric problems keep happening, see a liver specialist for proper advice,” he strongly recommends.
#5 Early detection significantly improves the odds
As with other cancers, catching on to it early is essential for a more positive outcome. “In Japan, 64 per cent of stomach cancer patients were diagnosed at a very early stage. Only 15 per cent were diagnosed at stage 4, which is when it’s incurable. Meanwhile in Malaysia, 25 per cent of stomach cancers are only diagnosed at stage 3,” shares Dr Ang.
The reason for Japan’s high detection rate is attributed to their widespread screening programme. “The government there actively screens their population and if they detect the presence of H.pylori, one of the most important factors for stomach cancer, they will eradicate it.”
#6 It can be cured
Detected early, stomach cancer is curable. “When cancer is only confined to the stomach, surgery is done to either remove the whole stomach or part of it,” clarifies Dr Ang. Many patients will then require chemotherapy to kill off remaining cancer cells, while some may also need radiotherapy. However, at stage 4, surgery is not viable as the cancer is no longer contained.
Dr Ang notes that research has pinpointed what drives stomach cancer cells “crazy till they grow and spread so quickly”. 10 to 20 per cent of these cells express a receptor called her2, which can now be blocked with medication. “Last year, a new drug was introduced to block certain pathways and inhibit new blood vessel formation in the tumour itself, to contain the cancer and prolong life.”
Dr Ang Soo Fan, visiting consultant medical oncologist at Penang Adventist Hospital