Former CCTV presenter Ms. Fang Jing died in Taiwan at the age of 44 at 10:26 a.m. on November 18 due to the failure of medical treatment for cancer, according to informants, Fang Jing’s body did have problems some time ago, from stomach cancer to liver cancer. It is not long ago that during the National Day, a doctor in Shanghai’s medical circle also thought to be 38 years old left his friends and relatives due to liver metastasis from stomach cancer. Also in 2015, Japanese NHK-BS1 channel program “International Report” anchor Nana Kuroki was accidentally found to have stomach cancer in July 2014 and died at the age of 32 due to a sharp turn in her condition, just after her career had started.
The first question: Is there no cure for stomach cancer?
The answer is of course no, so why do we repeatedly see and hear that they all died of stomach cancer and are so young? First of all, we need to understand how stomach cancer is a disease.
Morbidity.
Gastric cancer is one of the most common malignant tumors, ranking 4th in global incidence and 2nd in death rate among malignant tumors. China is a region with high incidence of gastric cancer, with more than 400,000 new cases of gastric cancer each year, occupying 50% of the annual new cases worldwide. It is divided into early gastric cancer and progressive gastric cancer. Early-stage gastric cancer has very good effect after systematic and regular treatment, while progressive gastric cancer is very different.
The average diagnosis rate of early stage gastric cancer in China is only 10%, and the data from Fudan University Cancer Hospital shows that it is currently around 20%. After radical surgery, about 60% of patients with progressive gastric cancer will have recurrence and metastasis after surgery, 70% of them will appear 2 years after surgery and 90% will appear within 5 years after surgery, 30% of them will have metastasis through blood, mostly in liver, lung or bone marrow, and 50% of them will have peritoneal metastasis.
This shows that Ms. Jing Fang, the young doctor and Nana Kuroki were all in the progressive stage of gastric cancer when they were detected, and therefore had poor treatment outcomes.
Liver metastases from gastric cancer.
The incidence is 26%-38%, mainly through hematologic metastasis, and previous data show that the 5-year survival rate of liver metastasis from gastric cancer is almost 0. However, liver metastasis from gastric cancer is not an untreatable disease.
Firstly, in the case of single liver metastasis, if peritoneal implantation metastasis is excluded, radical resection of gastric cancer and liver metastases can be performed through multidisciplinary treatment, while multidisciplinary treatment for multiple liver metastases is also being actively explored, including chemotherapy, interventional chemotherapy and surgery, which can prolong the survival time of patients with liver metastases from gastric cancer.
The second question: Who will be more likely to get gastric cancer? Young people?
The high incidence age of gastric cancer is between 50-60 years old. Of course, statistics show that young people younger than 40 years old are often in the progressive stage after gastric cancer is detected, which leads to a poorer outcome of gastric cancer in young people.
At present, there are many causes of stomach cancer, which are summarized as follows.
1.Geography and diet.
There are obvious geographical differences in the incidence of gastric cancer, and the incidence rate of gastric cancer in northwest and eastern coastal areas of China is significantly higher than that in southern areas.
High incidence of distal gastric cancer in people who consume fumigated and salted foods for a long time.
The risk of gastric cancer in smokers is 50% higher than that in non-smokers.
2. Helicobacter pylori infection.
Helicobacter pylori has been as early as 1982, the Australian scholars Barry Marshall and Robin Warren found and proved that the bacteria infection of the stomach can lead to gastritis, gastric ulcer, duodenal ulcer and gastric lymphoma and even gastric cancer, the two scholars and thus won the Nobel Prize. 1994, the World Health Organization is the first category of H. pylori as a high-risk malignant factor. The rate of Hp infection among adults in China’s high incidence of gastric cancer is over 60%.
3.Pre-cancerous lesions
Gastric diseases include gastric polyps, chronic atrophic stomach and residual stomach after partial gastrectomy. These lesions may be accompanied by different degrees of chronic inflammatory process, intestinal epithelial metaplasia or atypical hyperplasia of gastric mucosa, which may be transformed into cancer.
4.Heredity and genes
There is an obvious family aggregation of gastric cancer patients. It is found that the first degree relatives of gastric cancer patients (i.e. parents and siblings) have an average risk of getting gastric cancer three times higher than the general population. For example, Napoleon’s grandfather, father and three sisters all died of gastric cancer, and the whole family, including himself, had 7 people suffering from gastric cancer.
The third question: How to detect early? How to treat after detection?
Early gastric cancer is very effective, so how can we detect it in early stage? The answer is symptoms combined with necessary examinations, among which the most appropriate screening means is gastroscopy.
Our 2014 endoscopic consensus states that.
According to serum PG (serum pepsinogen) test and H.pylori antibody test
Grade A, PG (-) H.pylori (-) patients can not be endoscopically examined
Grade B, PG (-) H.pylori (+) patients at least 1 endoscopy every 3 years
Grade C, PG (+) H.pylori (+) patients should undergo endoscopy at least every 2 years
Grade D, PG (+) H.pylori (-) patients should undergo endoscopy once a year
In terms of treatment, the treatment of gastric cancer advocates a multidisciplinary treatment integrating surgery, radiotherapy and chemotherapy, especially in progressive gastric cancer.
(1) The standardization and radicalization of the first surgery are emphasized. In a study from the Netherlands, 380 patients with D1 and 331 patients with D2 were followed up for up to 15 years, and the local recurrence rate of intraperitoneal and surgical field was 19% and 22% for D1 and 12% and 13% for D2; the 5-year survival rate after surgery was D1: 21% and D2: 29%. Therefore, D2 surgery is recommended for the surgical treatment of gastric cancer: no distant metastasis of tumor.
(2) Ensuring no residual tumor at the incision margin.
(3) Adequate range of lymph node dissection.
(4) en bloc resection.
Of course, with the improvement of endoscopic technology and understanding of the disease, we can now use endoscopic treatment in early gastric cancer to achieve radical cure and preservation of gastric function.
The fourth question: How to prevent it? Keep your mouth shut!
(1) Do not eat moldy food and pickles. Some of the molds are toxin-producing fungi, which are strong carcinogens, while food will produce a large amount of nitrites and secondary amines under the action of toxin-producing fungi, and pickles contain a large amount of such substances, which can be synthesized in the body to cause cancer by nitrosamines.
(2) Eat more fresh vegetables and fruits.
(3) To develop a regular and quantitative eating habit. Irregular diet, overeating, eating too fast or too hot will produce damaging stimulation to the stomach.
(4) Do not eat or eat less smoked and fried food. Smoked fish and bacon contain large amounts of carcinogenic substances such as 3-4 benzopyrene and cyclic aromatic hydrocarbons. Fried, baked, burnt food and reused high temperature cooking oil also contain such carcinogenic substances, so they should be consumed sparingly.
(5) Do not smoke and drink less alcohol. Smoking is related to stomach cancer because smoke contains many carcinogenic and carcinogenic substances such as benzo(a)pyrene, polycyclic aromatic hydrocarbons and dibenzocarbazole, which can lead to the occurrence of esophageal and stomach cancer. Although alcohol itself is not a carcinogen, strong alcohol can stimulate the gastric mucosa, damage the mucosal tissue, and promote the absorption of carcinogenic substances. If you drink alcohol and smoke at the same time, it is even more harmful because alcohol can enhance the permeability of cell membrane and thus strengthen the absorption of carcinogenic substances in smoke.
In conclusion, stomach cancer is not scary, what is scary is that we find it too late and do not get thorough and fundamental treatment after finding it, which is why the above cases of premature death happened. Let’s start from now, start from ourselves, and protect our stomachs.