Music lovers around the world mourned the passing of Grammy award-nominee Toby Keith due to complications of stomach cancer. Not often in the news, stomach cancer — also known as gastric cancer — is the fifth most diagnosed cancer in the world.
While precise causes of cancer cells developing in the stomach are not clear, there are known risk factors. Bacteria known as H. pylori, a Class 1 carcinogen, often plays a role. Additionally, lifestyle choices, such as poor diet, lack of weight management, and smoking, can contribute to the development of stomach cancer. Advanced age and genetics may also increase a person’s risk.
Patients with a family history of gastric cancers, breast cancers, and polyposis syndromes, which cause the development of colon polyps, should share this history with their doctors. What’s more, people who have severe indigestion or who are in close contact with someone who has an H. pylori infection should ask their doctors about H. pylori testing and treatment, if needed.
Recognizing and Treating Stomach Cancer
The American Cancer Society reports stomach cancers often develop slowly. In early stages, there are rarely symptoms, making detection difficult. When symptoms do arise, they may include:
- Involuntary weight loss
- Abdominal pain and nausea
- Inability to eat full meals
- Difficulty swallowing
- Gastrointestinal (GI) bleeding
- Iron deficiency, which can present as fatigue, weakness, light-headedness, dizziness or shortness of breath
- Presence of blood in stool
In my practice, I commonly see patients referred for consultation for a screening colonoscopy. If they also have upper GI symptoms, such as heartburn, gastroesophageal reflux disease (GERD), abdominal pain, abnormal weight loss, or a family history of stomach cancer, a diagnostic upper endoscopy with the use of a flexible endoscope can often be performed at the same time as the colonoscopy to further assess the upper digestive tract.
How Stomach Cancer Is Treated
If caught early, gastric cancer can be curable. In fact, if the cancer is confined to the first layer of the stomach, it can be removed endoscopically. Endoscopic mucosal resection, which is a minimally invasive procedure to remove larger polyps or early cancer lesions, can be used to treat tumors that are superficial and have not invaded the deeper layers of the stomach.
If a tumor has invaded the deeper layers, surgery can be performed to remove the affected portion of the stomach and the adjacent lymph nodes. Surgery can also sometimes be helpful for patients whose cancer has spread to distant organs, but may not completely cure the cancer. Chemotherapy may be used before or after surgery — sometimes in combination with radiation — or be the primary treatment, depending on the amount of cancer spread.
A treating physician will know the best path forward after the cancer has been staged. For those undergoing treatment, if the tumor is confined to the first layer of stomach, it is nearly 100% curable, as this can be resected with endoscopy or surgery. Once cancer invades into the deeper layers of the stomach wall, the 5-year survival rate drops to 75%. If the cancer spreads further to the lymph nodes or distant organs, the overall prognosis depends on the degree of the cancer’s spread and the response to treatment.
Preventing Stomach Cancer
Because your diet can affect the risk of developing cancer, a high-fiber diet rich in fruits and uncooked vegetables is recommended. The antioxidants found in fruits and vegetables have a positive impact on overall good health. Red meats, sugary drinks, and highly processed foods should be avoided. What’s more, regularly exercising, maintaining a healthy weight, getting quality sleep, reducing stress, avoiding smoking and the overuse of alcohol can reduce your risk of stomach cancer and other diseases.
Talk with your doctor if you have any concerns or notice changes in your digestive symptoms. Regular care and communication with your primary care provider and choosing a lifestyle of activity and good nutrition can help you not only feel good but also avoid costly and serious health concerns.
Dr. Arthur Yan is a board-certified Sharp Community Medical Group gastroenterologist affiliated with Sharp Memorial Hospital.