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Friday, 17 March, 2000, 17:12 GMT
Stomach cancer

The muscles and juices of the stomach help digest food into a liquid from which nutrients can be absorbed lowel in the bowel.

Cancer: the facts
Unfortunately, some of its symptoms can be confused with many common stomach complaints, such as indigestion or heartburn.

However, being alert to changes in stomach and bowel symptoms, and consulting doctors about persistent problems could lead to far earlier detection.

Dr David Cunningham, an expert in stomach cancer from the Royal Marsden Hospital in London, said: "Cancers arising at the stomach are increasing at a fairly rapid rate in most of Western civilisation - we're not entirely sure why this is taking place.

"Anyone experiencing significant indigestion or heartburn for the first time, over the age of 50 should certainly be seen by their GP."

"We now know that treating this type of cancer involves fairly major surgery and other sorts of treatment such as chemotherapy or radiotherapy."

Click here to listen to Dr David Cunningham talking about stomach and oesophageal cancers.

There are number of symptoms which a stomach cancer might cause.

These include:
  • Nausea and vomiting (including vomit which contains blood)
  • Blood in the stool (faeces)
  • Indigestion or heartburn
  • Weakness or fatigue
  • Loss of appetite, or stomach bloating

Of course, these symptoms, including which produce blood, could be caused by a stomach ulcer, and a simple virus could produce many of the others.

There are tests available which can help detect or rule out stomach cancer.

The faecal occult blood test checks for the presence of blood in the stool. It can be carried out at home or at a GP surgery. A small amount of faeces is placed on a slide.

This does not confirm cancer, however, and if suspicions are strong, a gastroenterologist may decide to carry out further tests.

These include x-rays of the throat and stomach, normally involving a "barium meal" in which the patient swallows a solution containing a dye which shows up on x-rays.

This will highlight any abnormal bumps and lumps in the digestive tract which could be tumours.

Finally, the doctor may carry out endoscopy, in which a probe with a camera on the end is passed down the throat so the doctor can view the interior of the stomach.

The probe can also remove tissue samples for closer analysis.

Most patients find the idea of passing a tube down their throats while conscious worrying, due to the natural gagging reflex.

However, normally either anaesthetic is sprayed on the throat, or the patient is sedated to lessen the discomfort.

Stomach cancers is another which doctors think may be linked to an infection - but they do know it cannot be "caught" from another person.

The bacteria is called Helicobacter pylori or H. pylori, which is also thought to be the cause of some stomach ulcers.

However, simply having ulcers does not appear to increase the risk of getting cancer.

Stomach cancer may also be linked to poor diet, particularly those which contain a lot of salty foods.

High levels of stomach cancers in Japan have been linked to the consumption of salted meat.

The disease mainly affects people above their mid 50s, and is more common in men.

People who have had certain illnesses such as pernicious anaemia - a shortage of red blood cells, seem to be at higher risk of developing stomach cancer.

And smoking is also thought to increase the chances of cancer.

A relatively high intake of vitamin C may provide some protection against stomach cancer.

Treatment depends how far the cancer has spread.

Very often, surgery is the first option for patients with stomach cancer.

The operations are called gastrectomy, and involve either the partial or total removal of the organ.

Sometimes chemotherapy is given before the operation to shrink the tumour and make it easier to remove, although there is no clear evidence that giving it before surgery improves the final result.

A total gastrectomy means that the throat, or oesophagus is connected straight to the next part of the digestive tract, the duodenum.

This is a major operation which not only requires recovery time, but has pronounced effects on the lifestyle of the patient.

Patients may have short term or long term inability to deal with certain types of food, and could need vitamin injections to replace those which would normally be absorbed by the stomach.

Very often the patient will have to eat little and often, as opposed to big meals, to prevent too much food reaching the the duodenum too quickly, which can cause pain and nausea.

Dr Cunningham said: "The patient may feel they can't eat as large meals as in the past and the recommendation is to eat small meals regularly to maintain the nutritional content."

If the tumour has been completely removed, and there is no evidence of cancer remaining, the operation may be the only treatment.

But cancer can spread along with fluids which pass through the lymphatic system, and a surgeon will remove parts of that system near the stomach to check whether this has happened.

If this is the case. more chemotherapy or radiotherapy may well be recommended.

Recent progress in drug treatment has been made with a drug blocking a chemical produced by tumour cells which allows them to spread and invade neighbouring cells.

This slows the progress of the cancer.

To learn more about survival rates for stomach cancer compared to other cancers, click here .
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