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Millions of people experience tummy troubles like bloating and abdominal pain, and oftentimes it’s nothing serious. But when symptoms continue on a regular basis, it shouldn’t be ignored. “It is very common for people to have stomach problems, but listen to your body and make note of bowel habits that have changed over time and are persistent,” Dr. Nicholas Trikalinos, Washington University medical oncologist at Siteman Cancer Center tells us. “If that happens, reach out to your doctor.”
While stomach cancer cases are declining, the disease still affects well over 20,000 people each year with an estimated 11,000 deaths. However, there are ways to lower the risk. Dr. Trikalinos explains, “While some times cancer happens randomly, there are also some steps you can take to decrease the risk of gastric cancer in the future. Avoiding smoking, keeping a healthy weight and limiting overly processed, salty or smoked foods can make a difference.”
According to Yale Medicine, “Experts attribute the steady decline in U.S. rates to better food refrigeration and fewer Helicobacter pylori (H pylori) infections. However, it’s important to note that gastric cancer remains prevalent in other areas of the world, particularly in East Asia.” As with every cancer, early detection is vital and increases the survival rate, so knowing the signs could be life saving. Eat This, Not That! Health spoke with experts who share what to know about stomach cancer and signs to look out for. As always, please consult your physician for medical advice.
Dr. Foster Lasley, Radiation Oncologist for GenesisCare says, “Stomach cancer cases have seen a steady decline over the past century, and now only account for around 1.5% of all cancer cases today, according to the American Cancer Society. It is estimated that around 27,000 Americans are diagnosed each year, ranking far lower than more commonly diagnosed forms of cancer like breast cancer. However, stomach cancer is still a danger to those diagnosed, making early detection and effective treatment just as important.
Thus, the challenge is to continue to make people aware of the symptoms of stomach cancer. Because it’s relatively uncommon, many fail to consider the early symptoms of gastric cancer, including unexplained indigestion, anemia, and resulting fatigue to name a few, as serious problems. This can lead to the cancer progressing if undiagnosed and untreated. That’s never an ideal scenario for patients, and is why it’s still important to know the risk factors and symptoms.”
Dr. Trikalinos states, “Stomach cancer (or gastric cancer) is not rare. It actually used to be the leading cancer problem before lung cancer took over. It is more common in Eastern Asia, Eastern Europe, and South America compared to North America. About 22,000 patients per year are diagnosed in the U.S. Some good news is that the number of patients being diagnosed are dropping over time and people are living longer with this disease.”
Dr. Lasley explains, “Stomach cancer can be difficult to identify, because early forms of the disease do not typically cause many unusual symptoms. Another factor making stomach cancer difficult to catch early is that routine screenings for stomach cancer are not common practice. Therefore, the cancer is not typically found until it has spread outside of the stomach.
Nonetheless, symptoms of stomach cancer may include:
Lack of appetite
Unexpected weight loss
Pain in the abdomen (or belly)
Feeling full after eating only a small amount of food
Regular heartburn or indigestion
Nausea and vomiting, sometimes with blood
Swelling or fluid build-up in the abdomen
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Blood in stool (Dark Tarry Stools as the blood will be partially digested – frank blood in the stool is usually a sign of either hemorrhoids or a lower GI bleed)
Anemia, which causes the individual to feel tired or weak
Jaundice, which is a yellowing of the skin and eyes, and shows when the cancer spreads to the liver
It is important to seek a proper medical diagnosis if you are displaying symptoms further down this list, as many of these can be indicative of other health problems.”
Dr. Trikalinos adds, “Since the stomach helps digest food and then pushes it through the bowels, any tumor that grows there can interfere with that process. For example, people can lose a lot of weight because they are feeling full easily, have nausea or even complain of trouble swallowing. Pain is not a common symptom of stomach cancer, at least not in the early stages of the disease. Sometimes even small stomach tumors can bleed for a while before they are discovered. That blood is not easy to see in the stool, as it is partially digested, but these patients can get diagnosed because they have low blood levels. A lot of people will have upset bowels from time to time. However, any persistent change in your digestive habits is a reason to consult your primary doctor.”
According to Dr. Lasley, “The most important modifiable risk factors that people can implement in their everyday life today is to: avoid or quit smoking entirely, consume a healthy diet, and work to stay fit and avoid obesity. Other non-modifiable risk factors include age, sex, and family history.”
Dr. Trikalinos says, “Sometimes stomach cancer problems appear randomly or in families with shared inherited genetic problems. There is no way to prevent this, but you should still let your doctor know if a family member has been diagnosed with stomach cancer. Thankfully, there are other, modifiable risk factors that can decrease the risk of getting stomach cancer. We know, for example, that chronic inflammation of the stomach from an infection (such as H. pylori) or an immune disorder (such as atrophic gastritis) can raise the risk for gastric cancer. Treating that inflammation might help decrease the chances of cancer arising in the future. Some things you can do to lower your risk is avoid smoking and high salt foods, eat more fruits and vegetables, and maintain a healthy weight.”
Dr. Lasley tells us, “H Pylori is a common bacteria present in 30-40% of people that can cause inflammation and ulcers in the stomach. It is thought that this long-term inflammation makes the cells in the stomach lining more likely to become cancerous, but not everyone who has this bacteria is diagnosed with cancer. Still, H Pylori is linked as one of the main causes of one of the two main classifications of stomach cancer: non-cardia gastric cancer. Modern medicine has made it possible to test and treat H Pylori through antibiotics, improving the likelihood of a positive outcome for patients. But if an H Pylori infection is found, then immediate treatment is recommended.”
According to Dr. Trikalinos, “H. pylori is a bacterium that can surprisingly live in a very acidic stomach environment; it took us many years to realize that. More commonly it can cause gastritis, inflammation and pain. Studies, however, have shown that the infection and resulting inflammation can increase the risk of early and more advanced cancer in some patients, so it is reasonable to treat the infection when you discover it.”
According to Dr. Lasley, “Researchers have found that a regular diet of high-salt foods can lead to an increase in developing stomach cancer. Physicians recommend avoiding eating in abundance, especially foods preserved through drying, smoking, salting, and pickling, or that are high in added salts. Much like with many other forms of cancer, smoking is a major risk factor for stomach cancer as well. Most tobacco products contain a host of carcinogens that not only spread to the lungs but throughout the esophagus and into the upper parts of the stomach. The latest research estimates that individuals who smoke are twice as likely to develop stomach cancer than those who don’t.”
Dr. Trikalinos shares, “We estimate that up to a half of all stomach cancers might be influenced by smoking and lifestyle factors. Tobacco products contain carcinogens that can increase the risk of many cancers. Studies have shown that people who smoke have a higher risk of stomach cancer as well, and the risk decreases after smoking cessation, although it might take years. Interestingly, smoked foods have also been associated with a higher risk of developing stomach cancer. Other foods blamed are those high in salt or preserved in salt. We believe that these foods can irritate and damage the stomach lining and thus make it more vulnerable to developing cancer problems.”
Dr. Trikalinos says, “We have noticed that gastric cancer cases are decreasing and people tend to live longer with this disease. Longer survival could also be due to early detection and better treatments. One of the prevailing theories is that nowadays food is more fresh, less preserved (for example salted or smoked) and less contaminated (because of good refrigeration). This minimizes the exposure of the stomach to toxins. Other theories believe that the decreasing rates are because of the changes in smoking habits and the better education and recognition of H. pylori as modifiable risk factors.”
Dr. Lasley says, “Historically, stomach cancer was the leading cause of cancer deaths in the United States. The cause of this high mortality rate was the popularity of diets consisting of mostly high-salt foods, due to the usage of preservation methods like those mentioned above. But with the adoption of the refrigerator, food preparation methods shifted and stomach cancer cases began to see a steady decrease as diets became more varied and salt consumption decreased. Currently, stomach cancer ranks low on the list of most diagnosed forms of cancer in the United States thanks to these advancements in food science.
Stomach cancer rates in Asian countries are much higher than the United States. For instance, the risk of gastric cancer in Korea is about 13 times that of non-Hispanic whites in the United States. Asian Americans living in America may be at a higher risk of stomach cancer than other populations in the United States, and this is thought to be mostly attributable to H. Pylori prevalence, which can be different based on ethnicity. For example, Japan and Korea have screening programs, but this is not typically done in the United States due to the much lower overall prevalence of the disease. Those with a family history of stomach cancer or from a high-risk background should know the symptoms and be sure to speak with their physician about it if they ever have any concerns.”
