Health sense: Stomach cancer: Symptoms and treatment

Stomach cancer is also known as gastric cancer. It is a disease that is caused by an abnormal growth of cells in the stomach. The cancer cells can develop throughout the stomach wall and can spread and affect other organs in the body.

Like other forms of cancer, gastric cancer more commonly affects older people from ages 50 and up. It is common in countries like Iceland, Japan and Chile.

In Singapore, it is the fifth most common cancer among women and the third among men. Over the past 60 years, there has been a decreasing trend in the number of people diagnosed with stomach cancer.

The most common type of stomach cancer is adhocaranoma of the stomach. This is when the case arises from the lining of the stomach. Other types of stomach cancer are: lymphoma that affects the functions of the immune system, carcinoid tumours that disrupt the hormone-producing cells in the stomach and gastrointestinal stomach tumors, referring to gastric sarcomas.

Symptoms of stomach cancer do not manifest in the early stage. More often than not they are associated with the symptoms of minor stomach and digestive diseases. It is therefore recommended to see a physician if any of the symptoms below persist longer than the usual: persistent abdominal discomfort (bloating, nausea, heartburn), unintentional weight loss, unexplained loss of blood, vomiting blood or passing out, difficult or painful swallowing, previous stomach surgery or persistent vomiting.

When the patient has any of the above mentioned symptoms, he or she should be evaluated by his or her physician. After evaluation, the doctor may refer him to an endoscopist for more detailed investigation of the symptoms.

An endoscopist may be a general surgeon or a gastroenterologist. These are doctors who have an interest in treating diseases of the stomach, intestines and colon.

When required a gastroscopy can be performed. In this procedure, a small tube with a camera at the end is passed from the mouth into the stomach to have a look at the lining of the stomach. If a cancer is found in the stomach, a biopsy can be performed at the same time to confirm the diagnosis. This procedure usually takes less than 20 minutes. Many patients are initially fearful about the procedure but their fears are usually unfounded. This procedure is done under sedation and the patient does not feel any discomfort when it is being performed. The risks with this procedure are
minimal.

The amount of stomach removed during surgery depends on the extent of and the position of the cancer. If the cancer is in the upper half of the stomach, the whole stomach is removed. If it is in the lower half than half to two-thirds of the surroundings of the stomach are also removed. At the time of surgery, the lymph nodes surrounding the stomach are also removed.

After surgery the patient may require further treatment in the form of chemotherapy or radiotherapy. This depends on what stage the cancer is.

After surgery, the patient is slowly able to return to a normal diet. Portions for each meal may be smaller and as such those in recovery will need to eat more frequently.

Dr. Chan Hsiang Sui is a consultant general surgeon practicing at Gleneagles Medical Center.