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Stomach cancer notorious disease

Many people are dying from cancers unnoticed in this world. The rural populace is one that is at a disadvantage in making early diagnosis because of lack of medical investigations like scans. Those who seek remedy from traditional healers will be told all sorts of stories yet the cancer will be spreading. Last week, we lost one of our greatest actors, Lazarus Boora, aka Gringo, to the notorious cancer of the stomach. Rest in peace, the Mayor of Rukweza.

health talk:with Dr Johannes Marisa

Stomach or gastric cancer is an abnormal growth of cells that begins in the stomach. Your stomach receives and holds the food you eat and then helps to break it down and digest it. According to World Health Organisation, every year about one million people are diagnosed with gastric cancer of whom about 738 000 die.

This cancer is the fifth most common cancer in the world, coming after lung, breast, colorectal and prostate cancer if 2018 statistics are to be believed.
Symptoms

Signs and symptoms of stomach cancer may include the following:

lHeartburn

lIndigestion

lStomach pain

lFeeling bloated after eating

lDifficulty swallowing

lVomiting

lUnintentional weight loss

lFeeling full after eating small amounts of food

Risk factors

It is not clear what causes stomach cancer, but there are many factors which have been shown to increase the risk of this cancer:

lGastro-esophageal reflex disease

lA high salty diet

lA diet low in fruits and vegetables

lFamily history of stomach cancer

lInfection with Helicobacter Pylori

lLongstanding gastritis

lSmoking

lObesity

lPernicious anaemia (low number of red blood cells from intestines not properly absorbing vitamin B12)

Diagnosis

It is unfortunate that so many gastric cancers I have witnessed so far have been diagnosed late. This is because many people just think they have “ulcers” in the stomach and they tend to take over-the-counter drugs like magnesium trisilicate on top of other remedies. The diagnosis comes from a combination of physical examination, blood tests, imaging and biopsy.

Physical examination: You may find severe tenderness on the epigastrium with a mass on the area.

Blood investigations: Full blood count may show microcytic anaemia if the cancer is bleeding. Tumour markers like Carcino-Embryonic Antigen (CEA) and CA19-9 can be checked in the blood.

Endoscopy: This is a very important investigation on suspicion of non-remitting “ulcers” of the stomach. A thin tube containing a tiny camera is passed down your throat and into your stomach. Book to have an endoscopy with chronic epigastric pains

Biopsy: If there are suspicious areas found during upper endoscopy, special tools can be used to remove a sample for testing. The sample is sent to the laboratory for testing.

Imaging tests: Computed Tomography (CT) can be done as well. Barium swallow can also be done and see how the tumour grew in the gastrointestinal system.
Where does gastric cancer metastasise to?

The most common sites of metastasis are the liver, peritoneum, lung and the bone. Metastasis to the lung, nervous system and bone is more frequent in cardia cancer and men whereas non-cardia cancer usually metastasises within the peritoneum.

Prognosis
The general five-year survival rate for people with stomach is 32%. Despite the success of modern chemotherapy in the treatment of large bowel cancers, the five-year survival of patients with advanced gastric cancer is about 3,1%

Treatment
Those with stage 1 cancer can be treated by total or subtotal gastrectomy. The nearby lymph nodes are removed as well.

Chemotherapy: This is the use of drugs to kill cancer cells that have spread beyond the stomach. Chemotherapy can also be used to shrink the cancer before surgery so that it can be more easily removed.

Radiotherapy: High-powered beams are used to kill cancer cells. Can also be used before surgery to shrink the cancer so that it is more easily removed.

Get screened for gastric cancer if you have incessant gastric symptoms. Do not wait until it is too late!

lDr Johannes Marisa is a medical practitioner and public health practitioner who can be accessed on: doctormarisa@gmail.com

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