In a coun­try that en­joys food so much it’s al­most a na­tional pas­time, this can­cer sur­pris­ingly flies un­der the radar. By Adelina Tan

Herworld (Malaysia) - - CONTENTS -

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

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