Napoleon Bonaparte, John Wayne, and Peter O’Toole all succumbed to stomach cancer.
Yet, when we talk about cancer, all the attention usually goes to lung, breast, prostate or colon cancer. This is why stomach cancer is often called the Orphan Malignancy. But stomach cancer strikes over 32,000 North Americans every year. It also demands a dramatic change in lifestyle when this vital organ is lost. So, it’s well worth the effort to decrease the risk.
Early stomach cancer usually has no symptoms. In fact, when indigestion, bloating, and weight loss occur, it can be due to several benign reasons. So, it’s often only when fatigue, nausea, vomiting, and abdominal pain begin that patients realize there’s a problem and seek medical advice.
The diagnosis is made by endoscopy. A lighted instrument is passed down the esophagus (food tube) to explore the inside of the stomach. The doctor may find a definite malignancy, or suspect one, and then take a biopsy.
The usual treatment is surgical removal of part or all of the stomach. This may be followed by either radiation, chemotherapy or a combination of both.
One survivor explained that, when diagnosed with stomach cancer, she did not realize anyone could live without a stomach. A surgical removal of the entire stomach is made possible when doctors connect the esophagus directly to the small bowel in a way that allows the essential functions of the digestive system to continue. But it does require a major change of lifestyle.
Following stomach removal, patients have to learn to eat all over again. So, one of the biggest challenges is getting enough food and good nutrition. As this survivor remarked, “Imagine what it’s like going from eating full meals, to barely being able to finish two ounces of chicken and one-half a cup of mashed potatoes. I lost 95 pounds and only gained back 12 pounds in eight years.”
Following stomach removal, many patients also suffer from anemia and vitamin B12 insufficiency. It’s because the stomach’s acidity is required for the absorption of B12, essential for the normal functioning of the brain.
Since early diagnosis is often elusive the best protection is prevention. And three lifestyle factors can make a difference.
Alcohol consumption increases the risk of several malignancies, particularly when you have more than three drinks a day. Alcohol breaks down into acetaldehyde, which is carcinogenic, comprising substances capable of causing cancer to penetrate cells and damage DNA. Carcinogens also interfere with nutrients that protect the body from cancer.
For years, strong evidence has shown that eating salt-preserved foods is a probable cause of stomach cancer. These include meat that has been prepared by salting, fermentation, smoking or the addition of preservatives to enhance colour, flavour or shelf-life. Also included are foods such as bacon, ham, cold cuts and deli meats such as salami, bologna, turkey, and frozen meat products. It’s believed that nitrites in these products form compounds that are carcinogenic.
Nietzsche, the German philosopher, wrote, “The belly is the main reason man does not mistake himself for a god.” Today, we abuse the stomach with too much food causing obesity, another risk factor for stomach cancer. Obesity triggers inflammation linked to cancer in several organs.
Pogo, the cartoon character, was right when he said, “We have met the enemy and the enemy is us.” If we all consumed more fruits, vegetables and fish and less meat, fewer packaged foods, exercised more, used alcohol in moderation and stepped on a scale daily to monitor weight, there would be less stomach cancer and other malignancies in the future.
Nov. 30 is Stomach Cancer Awareness Day. For more information, see mygutfeeling.ca.
Dr. W. Gifford-Jones is a syndicated columnist whose medical column appears in The Guardian every Tuesday. Check out his website, docgiff.com, which provides easy access to past columns and medical tips. For comments, readers are invited to email him at [email protected]. He can also be found on Twitter @GiffordJonesMD.
