Stomach (gastric) cancer
Incidence
The incidence in the western world, Asia and Africa is in the region of 10 per 100,000 of the population whereas the numbers are much higher in countries such as Japan and Korea in the Far East, Eastern European countries, Albania and Portugal in Europe and Chile and Costa Rica in South America.
Risk factors
There are a number of factors that make you more prone to develop stomach cancer including infection with the bacteria H.pylori that causes stomach ulcers. Others include pernicious anaemia, the blood group A and chronic inflammation of the junction between the stomach and the oesophagus known as Barretts oesophagus. It is also slightly more common in men compared to women with a 3;2 ratio.
The role of social class has also been implicated with poorer populations being more at risk. However, this relationship is not straightforward as the poorer people of southern Italy have a lower incidence than the richer north. Smoking and alcohol consumption are also associated with increased risk
Diet
The fact that the incidence of stomach cancer decreases in Japanese who migrate to the USA suggests that diet plays a major role in promoting the onset of this disease and is not purely genetic. High calorie intake is associated with an increased risk while the ingestion of fresh vegetables, vitamin B6 (pyridoxine) and vitamin C appear to be protective.
Heredity
Over 90% of stomach cancers have no evidence that they are due to an inherited gene. If there is a strong family history of stomach cancer which is commonly associated with polyps in the stomach, then referral to a cancer geneticist is indicated.
Symptoms and signs
Unexplained weight loss,tiredness (due to anaemia from chronic bleeding), indigestion that does not respond to simple measures, vomiting or a feeling of fullness after eating small amounts. These may or may not be associated with stomach pain.
Treatment
Surgery is the best therapy to try and remove all the tumour and any surrounding glands that the tumour may have spread to. Unfortunately, stomach cancer is often diagnosed late and the tumour is too large or has spread too far to be removed by surgery.
If this is the case, then chemotherapy is given in order to shrink the tumour and in some cases the surgeon may then be able to operate. If not, then treatment is continued with chemotherapy.