What is Stomach Cancer (Gastric Cancer)?
The stomach is located in the upper portion of the abdomen. It connects the oesophagus and the first part of your intestine. It mixes the food and releases gastric juices that helps digest food. Stomach Cancer (also known as Gastric Cancer) occurs when healthy cells in the inner layer of the stomach become abnormal and grow out of control.
What are the types of Stomach Cancer?
A tumour can be cancerous or benign. A cancerous tumour is malignant, meaning it can grow and spread to other parts of the body. A benign tumour means the tumour can grow but will not spread. Cancer can begin in any part of the stomach. It can also spread to nearby lymph nodes and other parts of the body, such as the liver, bones, lungs, and a woman’s ovaries.
Most stomach cancers are a type called adenocarcinoma. This means that the cancer started in the glandular tissue that lines the inside of the stomach. Other types of cancerous tumours that form in the stomach include lymphoma, gastric sarcoma and neuroendocrine tumours, but these are rare.
Stomach Cancer is curable if diagnosed at an early stage.
Get your Gastroscopy done early with Dr Tan.
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Family history of Stomach Cancer (Gastric Cancer)
A history of Helicobacter Pylori infection
Previous history of stomach polyps or stomach lymphoma
Previous stomach surgery
Long term stomach inflammation (chronic gastritis)
A diet high in salty and smoked foods
A diet low in fruits and vegetables
Stomach cancer is more common in people from East Asia, Eastern Europe, South and Central America
*People who think they may be at risk should discuss this with their doctor
Who is at risk?
What are the symptoms of Stomach Cancer?
Stomach cancer often do not have any symptoms or signs. When symptoms occur, they may be vague and can include those listed below. Some of these symptoms can also be caused by many other illnesses, including stomach ulcers, or Helicobacter Pylori infection.
Symptoms may include:
Indigestion or heartburn
Pain or discomfort in the abdomen
Nausea and vomiting
Diarrhoea or constipation
Bloating of stomach after meals
Loss of appetite
Unexplained loss of weight
Weakness, fatigue and lethargy
Vomiting blood or having blood in stools
If you are concerned with any of the above symptoms, please get an appointment to speak to Dr Tan.
Reduce your risk factors:
If you have Helicobacter Pylori, please ensure it has been treated.
Limit alcohol intake
Exercise regularly and stay physically active
Eat fresh fruits, vegetables.
Reduce intake of salty, preserved and smoked foods.
Go for early screening. Early detection of gastric cancer can be curative with surgery. This will lead to a more successful outcome and better survival.
Can Stomach Cancer be prevented?
How to detect Stomach Cancer?
Gastroscopy is the most common way to detect any abnormalities within the stomach. During the gastroscopy, a thin flexible tube with a small light and video camera is inserted through the mouth, until it reaches the duodenum. Dr Tan will inspect the inner linings of the oesophagus, stomach and first part of your small intestine (duodenum) for any irregularities. It is connected to a screen that allows Dr Tan to evaluate any abnormalities seen along the way. During the procedure, you will be given sedation. If there are polyps or abnormalities detected, they will be removed. Dr Tan will also check for any presence of Helicobacter pylori bacteria.
Other options include a barium meal X-ray. This is a radiological procedure. During the examination, the patient swallows a liquid containing barium. X-ray pictures are then taken of the outline of the stomach wall.
A gastroscopy is usually more accurate in diagnosing stomach cancer than the barium meal X-ray. If there is a tumour, a biopsy is used to confirm the presence of cancer cells. Once cancer is confirmed on biopsy, other tests such as CT scan will be carried out to assess the extent of cancer spread.
Another way of detecting stomach cancer is by using GASTROClear™. This is the first approved miRNA-based biomarker for early detection of gastric cancer that can be used in conjunction with endoscopy. Dr Tan offers GASTROClear™ in his clinic.
Have you or your family members been diagnosed with Gastric Cancer? Get a second opinion with Dr Tan now.
He will discuss your options with you.
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How do you treat Stomach Cancer?
Surgery is considered the treatment of choice for stomach cancer. If the tumour growth has not spread to other organs, part or whole of the stomach and the surrounding lymph glands are removed via open or laparoscopic (key hole) surgery.
Standard Open Surgery
Standard open surgery requires a long incision on the abdomen. Surgery involves the removal of a part or total removal of the stomach together with its blood supply and lymph nodes. The small bowel is then used to join back to the remaining stomach or oesophagus to restore continuity of the digestive tract. The average hospital stay is about 1 to 2 weeks depending on the patient recovery.
Laparoscopic (Keyhole) Surgery
Laparoscopic (Keyhole) surgery uses small keyhole incisions on the abdominal wall and the operation is performed using specialised long instruments and a surgical camera. The exact same procedure as in standard open surgery is done internally with the use of keyhole instruments to remove part or total removal of the stomach together with its blood supply and lymph nodes. The small bowel is then used to join back to the remaining stomach or oesophagus to restore continuity of the digestive tract. The average hospital stay can be less than 1 week, depending on the patient recovery.
The operative steps are similar to open surgery with the advantage of having smaller wounds, shorter hospital stay and quicker recovery period.
Dr Tan sub-specialty clinical expertise is the use of laparoscopic surgery for the treatment of stomach cancer. After awarded the Health Manpower Development Plan (HMDP) by the Singapore Ministry of Health (MOH), he did his second fellowship training in Seoul National Bundang Hospital (SNUBH) to learn from Emeritus Professor Hyung-Ho Kim. In Seoul, Dr Tan performed and assisted in multiple laparoscopic gastric cancer surgeries and hone his surgical skills in the treatment of gastric cancer. He was also the previous Head of Department for Upper Gastrointestinal Surgery before joining private practice.
Partial Gastrectomy is where the lower portion of stomach is removed and the remaining stomach is connected to the small intestine.
Total Gastrectomy is where the whole stomach is removed and the oesophagus is connected to the small intestine.
Endoscopic therapy is only applicable to early stage of stomach cancer. It removes the tumour via gastroscopy without the need for surgery.
Chemotherapy and Radiotherapy.
Chemotherapy uses drugs to kill cancer cells and slow down the growth of tumours. The drugs can be administered through a vein or orally as a tablet. The side effects depend mainly on which drugs and the amount administered. Radiotherapy uses high-energy rays to kill cancer cells in the affected area of the body. It can be used to alleviate stomach obstructions and stop bleedings caused by the cancer. Chemotherapy and radiotherapy can also be used together, before or after a surgery