Who are at high risk?

People who:

• are aged 40 or above
• eat too much salty and processed food
• have high fat diet or little intake of fruit and fiber
• with family history
• are male (2 times higher risk than female)
• are infected with helicobacter pylori
• have vitamin B12 deficiency anemia
• performed stomach surgery
• are with rare stomach disease such as achlorhydria
• are smokers or heavy drinkers

What are the symptoms?

The common symptoms of stomach cancer include persistent abdominal pain and bloating, these symptoms worsen after eating, so it is often misunderstood as "indigestion". Patients usually control their diets in order to relieve the pain. This is obviously different from the regular pain of stomach ulcer or duodenal ulcer which will be relieved after eating or taking medicine. As the patients' condition develop, cancer in different parts of the stomach will result in different symptoms. If the following symptoms continue, consult your doctor immediately:

• Continuous indigestion or heartburn
• Loss of appetite
• Unknown weight loss
• Difficulty in swallowing
• Stomachache
• Hiccup
• A bloated feeling especially after eating
• Nausea, vomiting or hemoptysis
• Blood in the stools or black stool
• Unknown fatigue

What are the treatments?

1. Surgery – remove part of or the entire stomach, the most effective cure for early stomach cancer
2. Adjuvant therapy – enhance the treatment effect by using chemotherapy or radiotherapy after surgery
3. Palliative treatment – if metastasis of cancer occur, medicine will be used to relieve and control the patients' condition
4. Targeted therapy – only applicable to cancer cells with positive HER2 receptor

Surgery
Surgery is the major treatment method. For early stomach cancer patients, removing most or all of the stomach and surrounding lymphatic system is the most effective way of cure; small intestine is reconnected directly to the esophagus so that patients can eat after surgery. If the tumor is too large, the entire stomach or even some part of the esophagus and pancreas may have to be removed. If metastasis occurs and the cancer is no longer curable by surgeries, doctor may consider palliative treatments to ease the blockage at the stomach exit. Some patients may need to be treated additionally by radiotherapy or medicine to enhance the treatment effect.

Chemotherapy
Chemotherapy is a treatment to destroy cancer cells using chemotherapy drugs. There are many types of chemotherapy drugs to treat stomach cancer; they can be given as tablets or by injection intravenously. Doctor will usually use 2 to 3 types of chemotherapy drugs to treat stomach cancer patients according to their condition. The side effects of chemotherapy varies among different patients, the most common are nausea, hair loss, mouth ulcers, rash, etc.

Targeted therapy
Recent clinical research reveals that targeted therapy favors 20% of patients with cancer metastasis. Doctor needs to test HER2 receptor inside the cancer cells before the treatment as targeted therapy is only applicable when HER2 receptor is positive. Since the side effects of targeted therapy are relatively mild, additional impact on the patients is smaller.

How to prevent?

1. Consume more fruit and vegetables – consume at least 5 portions of different kinds of fruit and vegetables everyday;
2. Choose low salt food – reduce use of salt and replace with herbs or other seasonings;
3. Healthy cooking method – avoid burnt meat or fish;
4. Consume plant-based diet – consume plants rich in carbohydrate or protein, such as rice, beans, potatoes, etc.

Information source:
The Hong Kong Anti-Cancer Society