Stomach cancer: Curable when caught early

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 often play a role.

“H. pylori is a type of bacteria that infects your stomach and is associated with gastric cancer,” says Dr. Arthur Yan, a gastroenterologist with Sharp Community Medical Group. “The World Health Organization considers this infectious bacteria a Class 1 carcinogen, which means it is known to cause cancer.”

Lifestyle choices, such as diet, lack of weight management and smoking, can also contribute to the development of stomach cancer. Additionally, advanced age and genetics may increase a person’s risk.

“Patients with a family history of gastric cancers, breast cancers and polyposis syndromes, which cause the development of polyps, should share this history with their doctors,” Dr. Yan says. “Some may warrant further genetic counseling and testing.”

Dr. Yan also advises people who have severe indigestion or who are in close contact with someone who has an H. pylori infection to get tested for infection and treated, if needed. H. pylori is typically treated with a combination of antibiotics along with a proton pump inhibitor, a drug that helps reduce stomach acids.

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

“I commonly see patients with a positive colon cancer screening, who are referred to me for a colonoscopy,” Dr. Yan says. “If they have upper GI symptoms, such as heartburn or gastroesophageal reflux disease, commonly known as GERD; abnormal weight loss; or a family history of stomach cancer, a diagnostic endoscopic procedure can be performed to learn more.”

A CT scan can detect large tumors, Dr. Yan says. But they are not as effective as endoscopy, which is a nonsurgical procedure that uses a flexible, lighted scope to examine the interior of the body.

How stomach cancer is treated

According to Dr. Yan, if caught early, gastric cancer is curable. In fact, if the cancer is confined to the first layer of the stomach, it can be removed endoscopically.

An endoscopic submucosal dissection, 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, instead, a tumor has invaded the deeper layers, surgery is performed to remove the affected portion of the stomach and the adjacent lymph nodes.

Surgery can also 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,” Dr. Yan says. “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%. And 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.

Steps you can take to prevent stomach cancer

Because your diet can affect the risk of developing cancer, Dr. Yan recommends a high-fiber diet rich in fruits and uncooked vegetables. The antioxidants found in fruits and vegetables have a positive impact on overall good health, he says. 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, and 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, Dr. Yan says. 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.

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