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Stomach/Gastric Cancer

Dr Ganesh Ramalingam

Specialist in General Surgery

Condition

Stomach Cancer In A Nutshell

  • Stomach cancer is one of the most common forms of cancer around the world.
  • It is caused by a mutation in the DNA and the cells of your stomach, leading to the formation of ulcers.
  • The process of ulcers developing into cancerous tumours may occur over many years.
  • Stomach cancer does not usually display symptoms in the early stages.
  • If you experience frequent heartburn or indigestion, loss of appetite, nausea, stomach pain or unintentional weight loss, you may have stomach cancer.
  • Stomach cancer is typically diagnosed through an endoscopy or gastroscopy.
  • While many stomach cancer cases may not be completely cured, it is possible to relieve the symptoms through chemotherapy and radiotherapy along with surgery.

Table of Contents

Stomach Cancer

What Is Stomach Cancer?

The stomach is an organ connected to the oesophagus at its top and the small intestine at its other end. Its primary function is to break down solid food. This makes it easier for the digestive system to absorb nutrients from the food.

“Stomach cancer, commonly known as gastric cancer, usually begins in the cells of the lining in the upper part of the stomach. The cells can grow to form a tumour, as in most other cancers.”

Dr Ganesh Ramalingam

Around 95 per cent of cancers of the stomach are adenocarcinomas; cancers that develop in glandular cells. Glandular cells are present in our body’s internal organs that produce and secrete substances such as digestive juices, or other fluids. Stomach cancers develop from the cells that make up the innermost lining of the stomach.

What Causes Stomach Cancer?

Stomach cancer is caused by a mutation in DNA and the cells of your stomach. When ordinarily healthy cells within the upper digestive tract system become cancerous, they can multiply and grow uncontrollably, leading to tumour formation. This process may take place slowly and result in the development of stomach cancer over many years.

As one of the top killers in Singapore, stomach cancer’s survival rates decrease with each developmental stage.

While sharing with AsiaOne about her recovery from Stage 4 Stomach Cancer, stage actress Emma Young of the Dim Sum Dollies recounts her experience.

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What Are The Risk Factors Leading To Stomach Cancer?

Certain factors may increase your risk of developing stomach cancer. This includes:

  • Genetic predisposition
  • Being male and above 55 years of age
  • Smoking
  • A diet high in salt and smoked meats
  • Having undergone stomach surgery

Other factors that might increase your risk of developing stomach cancer pertains to certain diseases and condition such as:

  • Lymphoma (cancer that affects the immune system)
  • H. pylori infections
  • Tumours in other parts of the digestive system
  • Presence of stomach polyps

What Are The Symptoms Or Warning Signs If I Have Stomach Cancer?

Unfortunately, there are few symptoms in the early stages of stomach cancer, making it hard to diagnose without doing procedures such as endoscopy. In later stages, symptoms include:

  • Persistent heartburn and indigestion
  • Feeling of bloatedness after a meal
  • Loss of appetite
  • Nausea
  • Stomach pain
  • Unintentional weight loss

While it could be challenging to detect if you have stomach cancer, one patient decided to follow his gut feeling, and that saved his life. At the age of 32, Jason Diaz was troubled by severe gastrointestinal issues, acid reflux, and pain; symptoms led his doctor to diagnose that he has GERD (Gastrointestinal Reflux Disease).

How Can Stomach Cancer Be Prevented?

While stomach cancer cannot be prevented. There are recommendations that you can take to lower your risk of developing all cancers by:

  • Maintaining a healthy weight range
  • Consuming a balanced diet
  • Quitting smoking
  • Exercising regularly

In some cases, your doctor may even prescribe medications that can lower the risk of stomach cancer. This approach is recommended for people who have relating diseases that may contribute to the cancer. An early screening test is another option that you may want to consider.

By conducting several tests, you can detect stomach cancer early, improving your treatment and success chances. Your doctor may suggest one of the following screening tests check for signs of stomach cancer:

  • Physical exam
  • Gastroscopy/endoscopy
  • Lab tests, such as blood and urine tests
  • Imaging procedures, such as X-rays and CT scans
  • Genetic tests

How Is Stomach Cancer Diagnosed?

Your doctor may schedule you for a gastroscopy, biopsy and/or diagnostic imaging tests such as an upper GI series test, CT scan, PET scan, or MRI after a physical examination.

Gastroscopy works by letting the doctor see the lining of your oesophagus, stomach, and the top part of the small intestine. During this procedure, biopsies which are tissue samples, are taken and sent to the lab to check if there is cancer.

Diagnostic imaging tests make use of X-rays to show the stomach fairly clearly. These can frequently confirm the location and extent of the cancer. Blood tests can show signs of stomach cancer.

For stomach cancer survivor, Ron Dunnahoo, his first detection that something was wrong when he began experiencing severe indigestion. While the initial diagnosis ruled that Dunnahoo was experiencing mild acid reflux, he felt sure that there was more to it.

His suspicions were confirmed after undergoing an endoscopy. His doctor detected a large tumour and further diagnostics showed that it was stage 4 stomach cancer.

How Is Stomach Cancer Treated?

While many stomach cancer cases may not be completely cured, it is still possible to relieve the symptoms while improving the quality of life using chemotherapy and in some patients radiotherapy and surgery.

Depending on the condition, your doctor may recommend one or more of the following treatment plans, including:

Depending on the origin and development stage of the cancer, the treatment plan may differ for individuals. Each treatment option can be discussed and recommended by your doctor based on your age and overall health condition.

In cases where surgery is an option, stomach cancer is a recommended option as long as all cancerous tissue can be removed. Surgery to remove parts or the entire stomach is known as a gastrectomy. While you may have your stomach or parts of it removed, it will still be possible to eat normally, although you may have to adjust the size of your food portions.

Chemotherapy may also be recommended before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer from returning.

Taking the time to learn about the difference between your treatment options and talking to your doctor to make informed decisions is key to your treatment progress. By understanding the benefits and challenges or each treatment course, you can then work out the treatment that fits your care’s goal.

Aside from treating cancer cells in the stomach, treatment aims to prevent the cells from spreading. Stomach cancer, when left untreated, may spread to the:

  • Lungs
  • Lymph nodes
  • Bones
  • Liver
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