Stomach cancer is a common type of cancer in Hong Kong. In 2019, there were 1 303 new cases of stomach cancer, accounting for 3.7% of new cancer cases. Its crude annual incidence rate per 100 000 Hong Kong population was 17. In 2019, a total of 696 people died from this cancer, accounting for 4.7% of all cancer deaths. The incidence rate of stomach cancer rises with age. The median age at diagnosis was 70 and 69 in male and female respectively.
The early symptoms of stomach cancer are not specific. Many patients regard these symptoms as stomach upset and take them lightly so that diagnosis of stomach cancer is often delayed. Therefore, more than half of the patients present with advanced stage in which the cancer has already spread to other tissues.
Stomach is one part of the digestive system. It secretes gastric acid to help digest and grinds large pieces of food into small ones. The food then enters the intestine by peristalsis for further digestion process.
Mutations in stomach cells lead to development into malignant tumour called stomach cancer. The etiology of stomach cancer is so far uncertain.
Many factors increase the risk of developing stomach cancer. Research shows that helicobacter pylori (a kind of bacterium which survives in the stomach and duodenum) infection may increase the chance of stomach cancer. Other risk factors include：
Patients with stomach cancer can have the following symptoms. However, these symptoms can be caused by other more common illnesses, such as gastritis, stomach or duodenal ulcer. If in doubt, consult a doctor as soon as possible.
The causes of stomach cancer are still not fully understood, but there are some risk factors for stomach cancer, including:
In general, adopting a healthy lifestyle through regular physical activities, maintaining a healthy body weight and waist circumference, having well balanced diet (including eat more fruits and vegetables, eat less food preserved by salting and processed meat) and avoiding smoking and alcohol consumption may prevent or lower the risk of stomach cancer.
People with aforementioned symptoms should consult a doctor as soon as possible and undergo tests. Detection of stomach cancer in early stages can increase the chance of cure. Tests for stomach cancer include:
The common complications of stomach cancer and its treatments are as follows:
Dizziness, palpitations, black tar-looking stool, coffee ground-looking vomitus.
It will cause pressure to common bile duct. The patient has symptoms of yellow eye white and skin and grey stool.
Pylorus is a spincter structure at the end of stomach. When it is blocked by tumour, food cannot pass to duodenum through pylorus smoothly, causing upper abdominal pain and vomiting.
Tumor can cause stomach perforation which can complicated by peritonitis. This is a life-treatening emergency in which the patient can present with acute abdominal pain.
There may be leakage in the anastomosis after stomach removal surgery. On the other hand, patients may have symptoms such as vomiting after meal, diarrhea, dizziness and low blood pressure. These symptoms are caused by the reaction to the food passing too quickly to small intestine after the removal of part of or the entire stomach.
Common side effects include weakened immunity, diarrhea, nausea, vomiting, and fatigue. Doctors will arrange regular blood tests to monitor the function of bone marrow. Doctors will also prescribe drugs to reduce the side effects of chemotherapy.
Targeted therapy for stomach cancer may cause diarrhea, nausea, vomiting and affect cardiac function. Doctors will prescribe drugs to reduce the side effects of targeted therapy and arrange regular cardiac assessment.
After removal of stomach, patient needs to make some adjustments in diet:
OGD is currently the best method in examining the lumen of the upper digestive tract; by using a flexible endoscope, oesophagus, stomach and duodenum can be examined. Compared with conventional X-ray examination, OGD is more accurate in making the diagnoses. With the use of different types of accessory equipment, endoscopist can perform biopsy and deliver surgical therapies for upper gastrointestinal tract diseases. Patients suffering from peptic ulcer disease or bleeding, suspected oesophageal and gastric cancer, symptoms of indigestion, acid reflux or difficulty in swallowing should receive OGD examination.
For further information please contact your doctor.
Surgical resection of the stomach is most commonly performed as treatment for malignancy. It is also sometimes indicated for benign pathology in the stomach. An adequate surgical resection remains the only effective treatment which offers a chance of cure or long term survival in cancer of the stomach. Furthermore, a palliative resection whenever feasible is effective in relieving symptoms such as obstruction, bleeding and perforation.
It is suitable for most operable gastric cancers and generally involves a midline incision in the upper abdomen. It follows the general surgical principles for stomach cancer.
Laparoscopic approach is regarded to be suitable for some early stage gastric cancer. It generally involves about five 1 to 4 cm incisions in the upper abdomen and the procedure is carried out laparoscopically.
For further information please contact your doctor.