Gastric (Stomach) Cancer

The stomach lies in the upper abdomen, just below the ribs. It is part of the gut (gastrointestinal tract). When we eat, food passes down the gullet (oesophagus) into the stomach. The stomach makes acid and some chemicals (enzymes) which help to digest food. Stomach cancer usually occurs when cells in the inner layer of the stomach wall grow and divide without stopping. Over time, these cells will form lumps called tumours and the cancer may invade deeper into the stomach wall. The cells may spread further to the rest of the body through the blood.

How common is it?

Gastric cancer is the 7th most common cancer in males in Singapore and the 9th most common cancer among females in Singapore. There is a decreasing trend in the incidence of this cancer. However, rates in Asia are among the highest in the world. Stomach cancer is commonly found in people aged between 50 and 70 years of age. It is more common in men.

What are the risk factors?

Lifestyle factors are linked to gastric cancers. These may increase your risk of developing it but it does not mean you will definitely develop stomach cancer.

    • Patients with stomach cancer have a higher rate of infection with a bacterium called Helicobacter pylori. However, the vast majority of people who have this bacterium in their stomachs do not develop stomach cancer.

    • An increased risk of stomach cancer is associated with diets containing large amounts of smoked foods, salted fish and meat, and pickled foods. On the other hand, eating fruits and vegetables high in Vitamin A and C appear to lower the risk of stomach cancer.

    • Family history of the disease can increase your risk of developing it, as well as smoking.

    • There is also some link between moderate to heavy alcohol consumption and risk of getting stomach cancer.

    • Chronic inflammation of stomach may also be a risk factor.

    • Smoking may increase the risk of gastric cancer.

What are the signs and symptoms?

Early stomach cancer may not show any noticeable signs or symptoms. Below are some symptoms of stomach cancer (although they may be caused by other conditions as well):

• Upper abdominal or ‘gastric’ pain

• Frequent indigestion

• Black coloured stool

• Nausea and vomiting

• Anaemia (low blood count)

• Loss of appetite and/or weight

You should consult a doctor if any of the symptoms above are present.

Very often no symptoms appear until the cancer is in the advanced stage. If the cancer is detected early, it is potentially curable.

However, more than two-thirds of stomach cancer patients are diagnosed at Stage III or IV.

What can you do to prevent Stomach Cancer ?

There are two ways that may prevent stomach cancer:

• Avoid diets that are high in salt, smoked or pickled foods

• Choose a diet high in fresh fruits, vegetables and whole grain foods

How is Stomach Cancer diagnosed?

Endoscopy: Your doctor uses an endoscope (a flexible tube with a miniature camera attached to the end) to look directly at the stomach. If necessary, the doctor can take a small sample of the tissue (a biopsy) for examination. This is inserted through the mouth into the stomach. The test will take about 15 minutes and it is not painful. Sedation can be given during the test if necessary.

If a cancer is found, the next step is to run other tests

What is the treatment?

There are different treatments available for stomach cancer depending on the stage, the position of the cancer and your overall health. The three main types of treatment include surgery, radiation and chemotherapy.