Abdominal pain, heartburn could be subtle signs of stomach cancer; essential for patients to master food portion control


By Dr Ashok Kumar Vaid

In a fast-evolving world of medical advancements and wondrous innovations, some things never change: a cancer diagnosis. It is as frightening as it was decades ago. A stomach cancer diagnosis can be even more fearful as people know very little about it. Here are a few pointers your need to know that will help dispel the fear and give you a better understanding of the condition.

Stomach cancer: In numbers

According to World Cancer Research Fund International‘s Stomach Cancer Statistics, globally, an estimated 9,52,000 new cases of gastric cancer are diagnosed each year, with about 7,23,000 lives being lost to the disease (i.e. a 72% mortality rate). In India, about 62,000 cases of stomach cancer are newly diagnosed annually (with an estimated 80% mortality). Additionally, the incidence of stomach cancer is higher in the North-Eastern and Southern states, with the highest number of reported cases from Mizoram.

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What to expect & symptoms

Stomach cancer develops slowly over many years so there are no obvious symptoms at the start. Common symptoms include poor appetite, weight loss, abdominal pain, heartburn, indigestion, nausea, vomiting (with or without blood), swelling or fluid build-up in the abdomen, and blood in the stool. Some of these symptoms are treated as they appear and disappear, others continue despite treatment. If this happens, talk to your doctor to understand how best to deal with them. Your doctor may suggest something as simple as a change in diet or may advise more investigation if symptoms persist.

Diagnosing and treating stomach cancer

A stomach cancer diagnosis begins by taking into account the patient’s symptoms, medical history, and what the physical examination reveals. To confirm the presence of stomach cancer and determine at what stage it is, the doctor may recommend one or more of these tests: an upper GI endoscopy, endoscopic ultrasound, a biopsy, or imaging tests such as X-rays, CT, PET or MRI scan.

Depending on the stage of cancer, the doctor decides on the most suitable treatment for the patient choosing from a range of options such as surgery, chemotherapy, immunotherapy or targeted therapy. Surgery followed by chemotherapy/radiotherapy in the early stages of stomach cancer offers the possibility of curing one’s cancer. However, for patients with advanced metastatic or recurrent stomach cancer, chemotherapy can be supplemented with targeted drugs like trastuzumab, immunotherapy drugs, and ramucirumab, depending on the biology of the cancer. These treatments offer long-term survival with improved quality of life in several cases.

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Some treatments try to cure the cancer while others keep the cancer under control. The doctor will explain the side-effects of the chosen treatment and how to manage it. Remember that these side-effects are common and not cause for a great concern. You must however ensure that you keep your doctor and healthcare team informed of these side-effects and their frequency.

Lifestyle changes and how to cope with them

Living with stomach cancer can be a physical challenge because it alters a very fundamental aspect of life: eating. Patients are required to make diet and lifestyle changes, often at a pace to which they are not accustomed. This may get overwhelming, but asking for support from doctors and caregivers can help make this easier.

When it comes to meals, the most important thing to remember is to choose food that is easy to digest and less of a burden to your stomach at every meal. This includes foods that are soft in consistency, quick to digest and high in protein. Smaller food portions at each meal are also easier to digest. So master the art of portion control. Make sure you eat smaller portions more frequently (about 6 to 8 times a day) that give your body the nutrients it needs without putting a strain on your stomach to digest it. You may also need to take nutritional supplements (vitamin B12, iron, foliate or calcium) if the stomach is unable to absorb these from the food.

Master - Abdominal pain, heartburn could be subtle signs of stomach cancer; essential for patients to master food portion control

Some patients experience nausea, diarrhoea, sweating and flushing after eating. This is called the ‘dumping syndrome’, and occurs when part or all of the stomach is removed, causing the swallowed food to pass directly into the intestine. These symptoms often get better with time.

Stomach cancer requires adequate follow-up and post-treatment care, so it is important to meet with the healthcare team for regular check-ups. The doctor conducts a physical exam and reviews symptoms. For the first few years, check-ups are recommended every 3 to 6 months, and after that, annually. Coping with life after a stomach cancer diagnosis is stressful and filled with fear at first, but with the right treatment, lifestyle changes and support from doctors and well-wishers, patients can lead fulfilling lives.

Master - Abdominal pain, heartburn could be subtle signs of stomach cancer; essential for patients to master food portion control
Dr. Ashok Kumar Vaid

(The author is Chairman, Medical and Haemato Oncology, Medanta Cancer Institute & Padma Shri Awardee)

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