Understanding and treating stomach cancer

On ‘gastric cancer awareness month’, we learn about the disease from Dr Shekhar Patil, Senior Consulting Medical Oncologist at HCG Hospital, Bangalore.

Could you explain what gastric cancer is?

Cancer is a disease of uncontrolled cell growth, where abnormal or mutated cells divide and invade normal healthy tissue. When cells begin to uncontrollably multiply in the inner lining of the stomach, they eventually grow into a tumor, resulting in stomach cancer.

What are the symptoms that patients must look out for and get help if they persist?

Commonly reported signs and symptoms include poor appetite, weight loss, abdominal pain, buildup of fluid in the stomach, heartburn, indigestion, nausea and vomiting (with or without blood). Some patients also observe blood in the stool. These observations are however not specific to stomach cancer and could also be the result of a stomach ulcer or infection. So patients who experience symptoms as mentioned above must consult a qualified doctor at the earliest to diagnose the problem. The triad of anemia, anorexia and abdominal pain in the elderly (those older than 60 years) could also indicate a possible case of stomach cancer and should be investigated further.

Could you throw some light of the methods of diagnosing gastric cancer?

An upper GI endoscopy combined with a microscopic examination of stomach tissue is used to diagnose and confirm the presence of stomach cancer. The next step is to determine at what stage the cancer is, which is found from an endoscopic ultrasound, or imaging tests such as X-rays, CT, PET or MRI scan.

What are the various treatment options available for gastric cancer?

Depending on the stage of stomach cancer, your doctor and medical team will help you choose the most suitable treatment from a range of options such as surgery, chemotherapy, immunotherapy or targeted therapy. When detected in its earliest stage (stage 0 and I), the cancer is limited to the inner lining of the stomach and can be fully treated by surgery alone. Advanced stages of stomach cancer usually require a combination of different modalities of treatments.

It is important to understand that both the stomach cancer and its treatment, particularly stomach surgery, affect a person’s eating habits and dietary preferences. This must also be managed as a part of treatment strategies.

How can patients manage the symptoms of gastric cancer to meet their daily nutritional needs?

To ensure that you meet your nutritional requirements, master the art of portion control. Your oncologist and nutritionist will also recommend changes in diet, such as eating 6-8 smaller meals that are easier to digest. Some patients are also recommended nutritional supplements (vitamin B12, iron, folate or calcium) if the stomach is unable to absorb these from food.

Can gastric cancer be cured?

Patients diagnosed in the early stages have a much higher survival rate as compared to the late-stage stomach cancer. In addition, the availability of many new chemotherapeutic drugs and targeted treatments for this disease has enabled most patients, even with advanced disease, to lead a good quality of life.

How is stomach cancer caused and can it be prevented?

Stomach cancer, and in fact most cancers, are the result of a combination of environmental factors and genetic predisposition. These environmental factors include smoking, tobacco chewing and heavy drinking. Avoiding these factors can reduce the risk of stomach cancer.