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Gastric Cancer

Clinical OncologyGeneral SurgeryGastroenterology Hepatology

Symptoms

Persistent indigestion
Loss of appetite
Unexplained weight loss
Abdominal bloating
Stomach bloating after eating
Vomiting, possibly with blood
Rectal bleeding or black stools
Fatigue

Early symptoms of stomach cancer are generally similar to those of gastritis, gastric ulcers, or duodenal ulcers. Moreover, these symptoms may appear intermittently, making it easy for individuals to dismiss them and delay seeking treatment. If there is any suspicion, it is advisable to consult a doctor as early as possible.

Factors

The causes of stomach cancer are still not clearly understood, but the following risk factors may increase the likelihood of developing stomach cancer:

Male gender
Increasing age (the risk of stomach cancer tends to be higher after the age of fifty)
Infection with Helicobacter pylori
Smoking
Alcohol consumption
Dietary habits: Regular consumption of pickled foods and processed meat products
Personal medical history (presence of stomach polyps, previous stomach surgery, or malignant anaemia)
Family history (genetic predisposition)

High Risk

In addition to the above risk factors, unhealthy dietary habits such as low intake of fruits and vegetables and lack of fibre, as well as being overweight or obese, should also be paid close attention.

Diagnosis

Gastroscopy	Gastroscopy examines the oesophagus, stomach, and duodenum. It is a standard diagnostic method for stomach cancer. Gastroscopy allows the observation of the gastric wall and surrounding organs for any abnormalities. The doctor may also take some tissue samples from the stomach for further examination if necessary.
Ultrasonography	Endoscopic ultrasonography: Endoscopy can penetrate deep into the body, approaching the source of the disease for ultrasonography. It allows for accurate diagnosis staging of cancer, and the doctor can perform fine needle aspiration to extract cell tissue for further examination and confirmation of the cause.
Computed Tomography (CT) Scan	Examining the tumour's location

Treatments

Stomach Resection Surgery	The stomach resection surgery aims to remove the tumour, surrounding tissues, and lymph nodes. Whether the entire stomach needs to be removed depends on the patient's condition.
Radiotherapy	Using high-energy radiation to eliminate cancer cells.
Chemotherapy	Killing cancer cells through drugs, but because the drugs have lower selectivity for cells in the body, they not only destroy cancer cells but also damage normal cells, leading to side effects.
Targeted therapy	Medications are designed for specific characteristics of certain cancerous tumour cells, with fewer side effects than traditional chemotherapy.
Immunotherapy	It targets specific characteristics of certain cancerous tumour cells. Cancer cells hinder the immune system's ability to recognize cells, allowing cancer cells to proliferate uncontrollably. Immunotherapy helps immune cells re-identify and eliminate cancer cells.

Side Effects

Complications for stomach cancer patients may include:

Gastrointestinal bleeding
Gastric outlet obstruction
Biliary obstruction, leading to jaundice
Abdominal distension

Complications after gastric resection surgery may bring about:

Leakage at the interface
Symptoms such as vomiting, diarrheal, and dizziness after eating

Chemotherapy side effects:

Reduced immune function
Diarrheal
Nausea
Vomiting
Fatigue

Prevention

If close family members have been diagnosed with stomach cancer or other cancers, or if someone is diagnosed with stomach cancer at a young age (e.g., below 40), the risk of developing stomach cancer may increase. Additionally, middle-aged individuals are also considered a high-risk group for stomach cancer, and doctors may recommend early gastric endoscopy for screening.

Patients who have undergone stomach removal should consider the following adjustments to their dietary habits: 1. Eat smaller, more frequent meals, such as six meals daily. 2. Avoid overeating at each meal. 3. Refrain from immediately consuming any beverages during and after meals to avoid affecting food absorption. 4. Choose easily digestible foods. 5. Chew food slowly during meals. 6. Take a short rest after meals to aid digestion. 7. Pay attention to supplementing vitamin B12, for example, through consuming foods like liver, meat, fish, and dairy. Some patients may need regular vitamin B12 injections.

Adopting healthy lifestyle habits, such as regular physical activity, maintaining healthy body weight and waist circumference, practising a balanced diet, avoiding smoking and excessive alcohol consumption, and preventing Helicobacter pylori infection, can help reduce the risk of developing stomach cancer.

^1.Cancer Online Resource Hub - Cancers in Hong Kong - Common Cancers in Hong Kong - Stomach Cancer

Rferences

Hong Kong Health Vault - Public Health Information and Statistics in Hong Kong - Stomach Cancer from https://www.healthyhk.gov.hk/phisweb/zh/chart_detail/58/
Cancer Resource Center - Local Cancers - Common Cancers in Hong Kong - Stomach Cancer from https://www.cancer.gov.hk/tc/hong_kong_cancer/common_cancers_in_hong_kong/stomach_cancer.html
Cancer Fund - Understanding Cancer - Stomach Cancer from https://www.cancer-fund.org/wp-content/uploads/2020/07/Stomach-Cancer-July-20C-Reprint-Web_s.pdf
Stomach Cancer | Gastric Cancer Facts and Information | American Cancer Society from https://www.cancer.org/cancer/stomach-cancer.html

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