Digestive Problems

Gastric Cancer Screening

22 Jan
Much like colorectal cancer, gastric cancer is eminently curable – but only when detected early via endoscopic screening, says gastroenterologist DR ANDREA RAJNAKOVA. It begins when cancer cells start growing in the inner lining of the stomach, and usually develops slowly over many years.

 How common is gastric cancer?

Though the incidence is decreasing worldwide, it remains the fourth leading cause of cancer death globally, according to World Health Organization (WHO), and the fifth most common malignancy worldwide, according to GLOBOCAN (International Agency for Research on Cancer) 2012. Traditionally, gastric cancer has a poor prognosis because of its late presentation. Early detection means better outcome, and endoscopy is the current standard diagnostic tool for gastric cancer.

What are the symptoms?

In the early stages, stomach cancer may cause indigestion, bloating after a meal, heartburn, slight nausea and loss of appetite. As stomach tumours grow, the symptoms worsen to include stomach pain, indigestion, loss of appetite, vomiting, weight loss, vomiting, fatigue, anaemia, blood in the stool and more.

5 Lifestyle Factors

  • The dramatic decline of stomach cancer in the past several decades is thought to be a result of improved standards of living, hygiene and methods of food preparation.
  • The rise in food preservation techniques such as freezing and refrigeration have largely replacedunhealthy salting, pickling and smoking.
  • A diet high in naturally occurring antioxidants, vitamins and fibre, found in fresh fruit and vegetables for instance, also lowers your risk of stomach cancer.
  • Being overweight or obese may add to the risk of stomach cancer. On the other hand, being physically active may help lower your risk.
  • Smoking increases the risk of stomach cancer, as with many other types of cancer, and is responsible for about a third of all cancer deaths.

How do you screen for gastric cancer?

Early gastric cancer can be very difficult to detect. In recent years, however, several new endoscopic imaging modalities have been developed. Once detected, anyone with signs of early gastric cancer needs to receive more targeted screening and be carefully monitored.

Who should go for it?

Singapore’s Gastric Cancer Epidemiology and Molecular Genetics Program (GCEP) identified five risk factors for the development of gastric cancer:

  • Chinese males over 50
  • A family history of gastric cancer
  • Helicobacter pylori infection
  • Smoking
  • The presence of atrophy gastritis and intestinal metaplasia

How is gastric cancer treated?

That depends on the stage, the site, and whether it has spread. Early gastric cancer can be removed through an endoscope and does not require surgery – much like colonoscopy. This technique was developed in Japan, where stomach cancer is often detected at early stages during screening. A deeper tumour will require surgery, often combined with chemotherapy or radiotherapy, or both. Once the cancer has spread to other organs, a cure is no longer possible.

Dr. Andrea

Dr. Andrea Rajnakova is our Consultant Gastroenterologist and Physician.


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