Gastric cancer: Early detection makes a big difference

MANILA, Philippines - Stomach or gastric cancer is the fourth most common cause of cancer worldwide, but because it is frequently fatal, it is the second most common cause of cancer death. With such grim statistics, Dr Tan Chi Chiu, a gastroenterologist from Gleneagles Hospital, sheds light on this disease in a case study. 

Chan, a 60-year-old Chinese smoker, came to see Dr Tan Chi Chiu for gastric pains associated with food intake that had been happening on and off for the past 20 years, and also for his recent loss of weight over the past one year. Chan had never seen a doctor previously for these symptoms. When he saw Dr Tan, he was found to be relatively well, but thin. Examination of his abdomen revealed a firm lump where his stomach was. “I recommended for him to undergo urgent gastroscopy which subsequently revealed a 5cm malignant gastric ulcer in the lower part of his stomach and the presence of a Helicobacter pylori infection,” shares Dr Tan. 

Unfortunately, early gastric cancer has no symptoms — this is the reason why it is often diagnosed late and at an incurable stage. However, if there are symptoms such as upper abdominal discomfort or pain which persists, then investigations should be done. It is more urgent to be tested when there are alarm symptoms such as loss of appetite and weight, vomiting, difficulty swallowing, vomiting of blood or passage of blood as black tarry stools — all symptoms of a disease already advanced. 

There is no absolute proof that food and drink are directly related to gastric cancer. However, some studies suggest that a healthy diet with a lot of fresh fruits and vegetables, while avoiding excessive salt and preserved food, might be helpful. Smokers should certainly consider stopping smoking altogether. Antioxidants such as vitamin C and E have potential but unproven protective benefit. For patients with acid reflux, obesity should be avoided. Alcohol also makes reflux worse and therefore avoiding excessive alcohol could help prevent proximal cancers.