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Stomach cancer, or gastric cancer, is cancer that starts in the stomach. Worldwide, stomach cancer is the second leading cause of cancer death in both men and women. It is particularly common in East Asia. In Singapore, it is the sixth most common cancer in men, who have a 1 in 50 lifetime risk of developing stomach cancer. In Singaporean women, it is the eighth most common cancer. Stomach cancer claims approximately 300 lives every year in Singapore.
While the exact causes of stomach cancer remain unknown, factors that may increase the risk of stomach cancer include:
This cancer has few or no symptoms in the early stages, which makes early detection difficult.
A patient may experience a loss of appetite, unexplained weight loss and chronic abdominal pain. However, gastric pain or dyspepsia (any pain or discomfort in the upper abdomen) is a very common symptom and mostly due to common ailments such as acid reflux or gastritis. As such, many people, even doctors, may not immediately suspect stomach cancer.
This is the main reason why the cancer is often discovered late. Less common symptoms of stomach cancer, and which tend to present in the more advanced stages, include vomiting and the passing of black stools, which is a sign of bleeding.
Tests for the diagnosis of stomach cancer include:
Doctors will also check for Helicobacter pylori infection. This can be done in different ways, including breath tests, blood tests, and other laboratory tests.
Stomach cancer is usually treated with one or more of the following:
This is the only effective method for curing stomach cancer. During surgery, the doctor might remove part or all of the stomach. Even in certain patients with advanced incurable stomach cancer, surgery is performed to reduce complications of the cancer such as blockage of the stomach or bleeding from the cancer.
After surgery, radiotherapy may be administered together with chemotherapy to kill very small remnants of the cancer that cannot be seen and removed during surgery. In patients with advanced stomach cancer, radiotherapy may be useful for relieving stomach obstruction. Radiotherapy may also be used to stop bleeding from cancers that cannot be operated on.
Chemotherapy is the use of drugs to help kill cancer cells and shrink the size of the tumor. It can be given alone or combined with radiotherapy after surgery. Chemotherapy may also be used to reduce symptoms or prolong life in patients with advanced stomach cancer that cannot be operated upon.
About 1 in 5 stomach cancers has too much of a growth-promoting protein called HER2 on the surface of the cancer cells. Tumors with increased levels of HER2 are called HER2-positive. Trastuzumab (Herceptin®) is a man-made antibody which targets the HER2 protein. Giving trastuzumab with chemotherapy can help some patients with advanced, HER2-positive stomach cancer live longer than giving chemotherapy alone.
Although the exact causes of stomach cancer are unknown, there are steps we can take to reduce the risk of developing stomach cancer.
In fact, in many developed countries, where refrigeration has allowed a greater intake of fresh rather than salt-preserved foods, rates of stomach cancer have fallen over the years.
Here’s what you can do:
CanHOPE is a non-profit cancer counselling and support service provided by Parkway Cancer Centre, Singapore. CanHOPE consists of an experienced, knowledgeable and caring support team with access to comprehensive information on a wide range of topics in education and guidelines in cancer treatment.
The CanHOPE team will journey with patients to provide support and personalised care, as they strive to share a little hope with every person encountered.