Stomach cancer was the sixth commonest cancer in Hong Kong in 2019, accounting for 3.7% of all new cancer cases. The early symptoms of stomach cancer are very non-specific, and many people may take these gastric symptoms lightly, therefore the diagnosis of stomach cancer is often delayed. If you are suffering from stomach conditions, stop disregarding them and visit the doctor right now! They can be a sign of stomach cancer!
Stomach Cancer: What is it?
Stomach cancer (also referred to as Gastric cancer) is a disease in which malignant (cancerous) cells form in the stomach. Stomach is a part of our digestive system, it secretes acid and enzymes to help break down large pieces of food into smaller pieces. The stomach muscles will also contract periodically to help grind the food, which allows the food to enter the intestine for further digestion. When stomach cells mutate and develop into cancerous cells, the cell starts growing out of control, resulting in stomach cancer.
Stomach Cancer causes and risk factors
Stomach cancer is a disease of mutation and growth of cancerous stomach tissue cells. The exact cause of the genetic mutation is still unknown. However, many factors could increase the risk of getting stomach cancer, including:
- Gender – male has a higher risk than female
- Increasing age – most stomach cancer patients are over the age of 50
- Consumption of high-salted, pickled and smoked food
- Infection with Helicobacter pylori (H. pylori)
- Chronic gastritis, long term stomach inflammation
- Stomach polyps
- Pernicious anemia, anaemia resulted from vitamin B deficiency
- Family history of stomach cancer – twice as likely to develop cancer than others
Stomach Cancer symptoms and signs
Symptoms of stomach cancer are very non-specific and may overlap with many other more common illnesses such as acid reflux, gastritis or gastric ulcers. If in doubt, you should seek medical advice as soon as possible.
- Persistent indigestion
- Loss of appetite
- Unintentional weight loss in a short period of time
- Chronic abdominal pain or stomach discomfort
- Blood in stool, or even black stools
- Fatigue, weakness
Stomach Cancer diagnosis
Stomach cancer has few or very non-specific symptoms in the early stages, making early detection difficult. If the above symptoms persist, you should consult your doctor as soon as possible and undergo further investigation such as:
- Abdominal ultrasound
- Upper endoscopy – insertion of a long, thin, flexible tube with a small camera (endoscope) into the mouth and pass down into the stomach, allowing visualization of the interior of the stomach. Tissues samples (biopsy) may be taken from the stomach for pathological examination.
If the diagnosis of stomach cancer is confirmed, other tests will be arranged to check if the cancer has spread elsewhere (metastasis). Such as:
Stomach Cancer staging
Stomach cancer staging can be categorised into 2 different ways: the TNM system and the number system.
TNM stands for Tumour, Node and Metastasis. It describes the size of the cancer (T), whether there are any involvement of the lymph nodes (N) and if cancer has spread to other parts of the body (M).
- Stage 0 – High grade dysplasia.
- Stage I – The stomach cancer hasn’t spread beyond the thick muscle in the stomach wall. With no lymph nodes involved, nor spread to other areas of the body.
- Stage II – The stomach cancer may have spread into the inner, supportive or muscle layer of the stomach and nearby lymph nodes. But hasn’t spread to other areas in the body.
- Stage III – The stomach cancer has grown into or through the outer layer of the stomach and spread to nearby lymph nodes. But hasn’t spread to other areas in the body.
- Stage IV – The stomach cancer has spread through the outer lining of the stomach and spread to other areas of the body (such as the liver or lungs).
Stomach Cancer treatment
Stomach cancer treatment depends on the stage of cancer, the patient’s general health condition as well as the patient’s preference. Stomach cancer can be difficult to treat but it is often treatable.
If the patient is diagnosed of stomach cancer, doctors will suggest the following treatment:
Stomach cancer treatment: surgery
Stomach removal surgery (Gastrectomy) is the most common form of treatment for stomach cancer. The cancerous part of the stomach and affected lymph nodes will be removed. The cure rate of stomach removal surgery can be as high as 90%.
Stomach cancer treatment: radiotherapy
Radiotherapy uses high-powered radiation beams to destroy cancerous cells. It may be used together with chemotherapy after surgery to destroy remnants of the cancerous tissues that were not removed during surgery. It is useful in preventing recurrence and enhancing the survival rate.
Stomach cancer treatment: chemotherapy
Chemotherapy is an anti-cancer drug injected into a vein or taken orally by mouth, which can kill cancerous cells and stop them from growing and dividing. It is commonly used after surgery to prevent recurrence and enhance survival rate.
Chemotherapy can also be used as a palliative treatment for advanced stomach cancer to relieve symptoms and prolong the quality of life.
Stomach cancer treatment: targeted therapy
Some stomach cancer has a growth-promoting protein called HER2 on the surface of the cancer cells. Targeted therapy is antibodies that specifically target the HER2 protein, which can destroy the HER2-positive cancerous cells in the stomach.
Stomach Cancer complications
The common complications of stomach cancer are:
- Gastrointestinal bleeding – leads to dizziness, black tar-looking stool, coffee ground-looking vomit
- Pylorus obstruction – pylorus is the end bit of the stomach, when it is blocked by the tumour, food cannot pass through which may lead to upper abdominal pain and vomiting
- Biliary tract obstruction – the spread of cancer to other areas in the abdomen can cause pressure to the bile duct, leads to yellowing of the eye and skin (jaundice)
Stomach Cancer survival rate
According to the American Cancer Society, the 5-year survival rate for localized stomach cancer is around 70%, meaning that people who have localized stomach cancer are about 70% as likely to live for at least 5 years after being diagnosed.
However, survival rate can only provide an idea of the percentage of people (with the same type and stage of cancer) who are still alive a certain amount of time after being diagnosed. It is not an indicator of how long a patient with stomach cancer will live. Other contributing factors such as the stage of cancer, patient’s overall health, age and response to treatment can also affect the outlook of the disease.
Stomach Cancer prevention
Here are some actions we can take to reduce the risk of developing stomach cancer, including:
- Eat more fresh fruits and vegetables
- Eat less high-salted, deep-fried, pickled, and smoked food
- Maintain healthy body weight
- Reduce alcohol consumption
- Regular check-up for those with higher risk factors – For those who are over 40 years old and have a family history of stomach cancer, it is advised to have upper endoscopy yearly
Early symptoms of stomach cancer are very non-specific and may overlap with many other common illnesses such as gastritis, acid reflux or gastric ulcers. Common symptoms of stomach cancer include persistent indigestion, loss of appetite, chronic abdominal pain or discomfort, unintentional weight loss and fatigue.
This article was reviewed by Dr. Patricia Poon. Dr. Patricia Poon is a specialist in Clinical Oncology who practices in Hong Kong. She graduated from the University of Adelaide, South Australia in 1995. Dr. Poon subsequently received her Oncology training at the Queen Elizabeth Hospital in Hong Kong and became a fellow of the Royal College of Radiologists in 2002. Dr. Poon earned the Fellowship of Hong Kong College Radiologists and Fellowship of the Hong Kong Academy of Medicine (Radiology) in 2005. She also obtained a Master's degree in Palliative Medicine at the Cardiff University, U.K. in 2010. Besides training at the Queen Elizabeth Hospital in Hong Kong, she was a Consultant Oncologist at the Hong Kong Baptist Hospital until 2014. She is currently working as a private Clinical Oncologist in Virtus Medical Group Ltd. in Hong Kong.
This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.