According to the World Health Organization, cancer is the leading cause of death worldwide, killing about 9.6 million people. Gastric cancer or stomach cancer is one of the most common cancers; In 2018, there were 1.03 million cases and 783,000 deaths in the same year. It is a disease that we should be concerned about, especially since it is more prevalent in Asia. In Singapore, stomach cancer is the 6th most common cancer among Singaporean men and the 8th most common among women. This means that 1 in 50 men will develop stomach cancer in their lifetime.

In addition, stomach cancer usually does not show any symptoms in the early stages. Even if these symptoms are present, especially doctors do not immediately suspect stomach cancer, because these symptoms do not notice common diseases that affect the stomach, such as acid reflux and gastritis. By the time the diagnosis is confirmed, the cancer will have already moved to an advanced stage. Therefore, stomach cancer is often called the “silent killer.”

Who is at risk of this cancer and what can be done to prevent it? This article will explain everything you need to know.

How does stomach cancer develop?
The stomach is part of the digestive system and acts as a food storage. It connects the esophagus to the small intestine and aids digestion. Stomach cancer occurs when cells in the stomach wall grow and divide nonstop. Eventually, these cells form clumps and become tumors, and the cancer penetrates deep into the stomach wall.

What are the signs and symptoms of stomach cancer?
As mentioned earlier, stomach cancer does not show any noticeable signs or symptoms in its early stages. When they come into force, they will include:

Pain in the upper abdomen
Loss of appetite
Unexplained weight loss
Frequent indigestion and heartburn
Feeling very full after eating
Caught in the wind, always humming
Constant stomach pain
Black or bloody stools
As you can see, these symptoms are very similar to other conditions and are not very special. Therefore, it is important to see a doctor if any of the above symptoms appear, especially if they recur.

Who is at risk for stomach cancer?
You are at risk of stomach cancer if:

Family history of gastric cancer
Most gastric cancers are sporadic, but about 10% of cases are familial. Studies have shown that people with stomach cancer are three times more likely to have a family history of cancer, which is the highest among adults except for ovarian cancer.
History of Helicobacter pylori infection
I wrote a more detailed article about Helicobacter Pylori, but basically, people with Helicobacter pylori infection have a higher risk of stomach ulcers and cancer. This risk is higher if you are male and older than 55.
Past history of gastric lymphoma and gastric polyps
Although most types of polyps do not increase the risk of stomach cancer, adenomatosis can sometimes turn into cancer.
Long-term chronic gastritis
A diet high in salty and processed foods
Low fiber diet
In addition, men aged 55 and older and smokers are most at risk.

How is stomach cancer diagnosed in Singapore?
There are several ways to screen for stomach cancer. I usually perform diagnostic tests such as gastroscopy, biopsy and/or CT scan, upper GI series tests, PET scan or MRI. A gastroscopy allows a patient to view the esophagus, stomach, and upper small intestine. I will also take a biopsy (tissue sample) and send it to a lab to check for cancer.

If cancer is found, diagnostic imaging tests, such as X-rays, are performed to confirm the location and extent of the tumor.

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