Source: Stomach Cancer, a booklet published by the National Cancer Centre Singapore, a member of the SingHealth group. It has information on the risk factors, symptoms, diagnosis and treatment of stomach cancer, and is in English and Chinese on the NCCS website.

Stomach cancer (or gastric cancer) is among the top 10 cancers in men and women in Singapore. Each year, about 200 are diagnosed with the disease here.

Stomach cancer (or gastric cancer) hits men above 40 more frequently, and is more common among the Chinese compared to Malays and Indians.

In stomach cancer, cells lining the stomach grow out of control, forming tumours which can spread throughout the stomach, and to nearby lymphnodes and organs such as the liver, pancreas or colon. It can also spread to the lungs, bones and brain.

The exact cause is unknown, but some factors worsen its development. The single most important risk factor is chronic infection by the helicobacter pylori bacteria. Family history of stomach cancer or hereditary stomach polyps can also be a factor.

Smoking raises the risk by 2.5 times. Other risks include diets with large amounts of smoked foods, salted fish and meat, and pickled foods. Eating more fruits and vegetables and taking vitamins A and C appear to lower the risk.

Stomach cancer symptoms

It takes many years for the cancer to develop and before symptoms are felt. Stomach cancer is hard to detect because symptoms are often non-specific, and in the early stages absent or very mild. They could also be similar to those of peptic ulcer diseases or gastritis.

Stomach cancer symptoms include:

  • Persistent indigestion and a burning sensation after meals (heartburn)
  • Bloated feeling after meals 
  • Upper abdominal discomfort or pain 
  • Early feeling of fullness despite a small meal 
  • Loss of appetite
  • Weight loss
  • Nausea, vomiting 
  • Blood in stools or black tarry stools

Stomach cancer diagnosis

The doctor will take a full medical history and per form a physical examination. A test may be done to detect blood in the stool because stomach cancer sometimes causes bleeding that may not be visible.

A gastroscopy may be called for, in which a fibre-optic scope with a light at the end of it is passed through the mouth and into the stomach. This is to examine the organ and take tissue samples from suspicious areas for examination.

Another test may be ordered where the patient swallows a thick, chalky liquid called barium which shows up on x-rays, so that abnormalities in the oesophagus and stomach can be detected.

When stomach cancer is diagnosed, further tests, such as a computerised tomography (CT) scan or a positron emission tomography (PET) scan, may be needed to determine if the cancer has spread.

Read on to learn about stomach cancer treatments and how to better cope with treatment.

Ref: O17