Stomach cancer can be puzzling as its symptoms can often be masked by other ailments. Early detection, however, is key to treatment. (For Spectrum Health Beat)
Stomach cancer can be puzzling as its symptoms may be masked by other ailments. Early detection, however, is key to treatment. (For Spectrum Health Beat)

As a women’s health care expert, I must admit that I hadn’t done much research on stomach cancer—until now.

Through my research, I have discovered many factors that contribute to developing this disease, including:

  • Being a woman of Asian descent
  • Eating a diet high in nitrates and/or salt, or a diet low in vitamin C
  • Smoking
  • Obesity
  • Having chronic ulcers
  • Having H. pylori bacteria present

Stomach cancer is the fourth most common cancer in women in developed countries, although men suffer from this disease more frequently than women. The women who do get this type of cancer tend to be 50 or older.

Globally, women in Japan, China and Venezuela are at highest risk, unless they move to low-risk areas at a young age. In these high-risk countries, women are screened for stomach cancer every two years after age 45.

So, how is stomach cancer diagnosed? The best way is with a camera that is used during an upper gastrointestinal test or scope of the esophagus and stomach. A barium swallow may be performed instead, but the scope is much more definitive and sensitive.

The question of who needs to be scoped can be a controversial one.

Here in the United States, for the general low-risk population, there has been much discussion as to when we should be first scoped. Unfortunately, there is no standard screening protocol. At Spectrum Health Medical Group, however, our specialists follow guidelines to test men and women who have other conditions that could lead to stomach cancer.

These conditions include pernicious anemia, familial polyposis, and Lynch syndrome. Our specialists also screen low-risk patients who have symptoms such as vomiting blood, persistent dyspepsia, discomfort in the upper abdomen, loss of appetite, unexplained weight loss, persistent sensation of feeling full after only a small amount of food, or reflux or heartburn that does not respond to medication. In addition, if a patient has H. pylori, which is a proven cancer-causing bacteria, he or she often gets frequent scope procedures.

The good news is that stomach cancer is very treatable if discovered early. However, it becomes more dangerous the longer it has time to develop and spread.

Stomach cancer can be aggressive, and it may require both surgery and chemotherapy to treat it. The bottom line is that prevention and early diagnosis are the best answers, and if this blog reaches even one person, it is worth the effort of getting the message out there.

A good example of early diagnosis comes from a patient I’ll call Jane.

At age 61, she was due for her second routine colonoscopy. Jane’s first one was a bit late at age 51 (one polyp was found but was negative for cancer), but she did make sure she was on time for her second one 10 years later.

Jane was actually relieved she had a colonoscopy scheduled because, as her appointment approached, she wondered if something was wrong. For several months, she had persistent belly pain, especially after she ate. And, she just wasn’t feel quite right—much more tired than normal.

Like many women, Jane had written off being tired as a result of extra stress in her life. She had a granddaughter who was dealing with some issues and Jane was worried about her.

Jane noticed, however, that she had lost her appetite for even her favorite foods and that her clothes were quite loose on her—without trying to lose weight. Fortunately, Jane was smart and aware of changes in her body.

She had recently read something about heartburn and ulcers as a result of stress, so she called her primary doctor at Spectrum Health to discuss her health in more detail.

Her physician looked at Jane’s chart and noticed she had an upcoming colonoscopy. She talked with Jane about her symptoms and recommended she also consider having an upper GI endoscopy (scope) at the same time to see if she had a small ulcer that could be causing her symptoms. In addition, her doctor asked Jane to get her blood drawn to check for anemia or a low blood count.

When Jane saw the GI doctor, they discussed her symptoms, and he asked about her health history and current lifestyle. Jane had many factors in her present and past that were red flags for her doctor.

Jane had:

  • Always struggled with her weight
  • Prediabetes
  • Mild high blood pressure
  • Reflux in the past and took medication on and off to keep it in check
  • Smoked many years ago—before she had kids
  • Raised her family on a basic diet of meat and potatoes, including meats like bacon, polish sausage and ham
  • Skipped eating vegetables on a regular basis, opting for corn and canned green beans when she did add vegetables to her diet
  • Tried to cut out salt when she was diagnosed with high blood pressure, but hadn’t stuck to a salt-free diet for long
  • A glass of milk with dinner each night, but only occasionally took a multivitamin and calcium pill
  • Aches and pains from early arthritis and regularly took ibuprofen to help with her joint pain

After talking about her lifestyle, Jane and her doctor reviewed her blood work. Her liver and kidney function were normal (good news), but her blood count was low—with a hemoglobin of nine. He assessed all the information and agreed that a stomach scope was definitely a good idea.

The results: Jane’s colon was mostly clean, again showing one small polyp, but her stomach had a small ulcer, plus areas of thinning lining. A biopsy was done after the procedure, and the results showed Jane had early gastric cancer.

Spectrum Health Cancer Center doctor was able to remove the entire cancer through the scope in an outpatient surgery. Fortunately, Jane did not need to have her stomach removed or have chemotherapy, and she went on to recover fully.

She used her recovery time to make a new health plan for herself from the tactics she’d learned along the way.

Here’s what Jane learned and what you need to know about stomach cancer prevention:

  • Get diagnosed early. Tell your doctor about recurring symptoms such as upper belly pain, food intolerance, loss of appetite, sudden loss of weight, nausea and fatigue that doesn’t make sense.
  • Reduce salt in your diet. Add other healthy seasonings to reduce the amount of salt you eat each day. Garlic, oregano, basil and low-salt seasoning mixes are good choices.
  • Limit nitrates to two servings per week. Processed meats such as bacon, hot dogs, cured lunch meats and salami are all high in nitrates. Instead, look for brands without nitrates.
  • Lose weight if needed. A healthy weight is key and a Body Mass Index (BMI) of 25 or less is optimal.
  • Eat five servings of fruits and veggies every day. This means fresh, not canned with added salt. Frozen vegetables are fine (my kids love frozen peas), and roasted veggies like broccoli and cauliflower are excellent choices.
  • Add vitamin C to your diet. Orange juice has lots of vitamin C, but other healthy options include kiwi, papaya, strawberries and tomatoes.
  • Talk to your doctor early if you are in a high-risk category. Don’t wait! If you immigrated to the U.S. later in life, and you are from high-risk areas such as Japan, Korea, Taiwan, China, Vietnam, Venezuela or Chile, discuss an early scope with your doctor.