Stomach cancer is one of the common malignant tumors in China, and its incidence rate is the first among all kinds of tumors in China. Every year, about 170,000 people die from stomach cancer, which is almost a quarter of all malignant tumor deaths, and more than 20,000 new stomach cancer patients are produced every year. Stomach cancer can occur at any age, and 80% of stomach cancer patients do not have early symptoms, and stomach cancer is the second most common cancer death, so it is known as the “invisible killer”. Let’s ask the chief physician to talk about the prevention and treatment of gastric cancer and some issues that need attention.
Middle-aged men are the main incidence group of gastric cancer
Middle age is the period when men’s career is soaring, but it is also the period when they are under the most pressure from work and family. Under the influence of social competition, long-term smoking, alcohol consumption and changes in diet structure, the stomach of middle-aged men often becomes a “place of many things”.
Middle-aged men are the mainstream group of stomach disease. Big hunger, excessive smoking and drinking, life is not regular, which is the main reason for the decline of middle-aged men’s stomach function. Secondly, middle-aged men are working under stress and living under relatively high pressure, these repeated bad stimulation of the cerebral cortex, but also easy to contribute to the stomach lesions. Most middle-aged men suffer from gastric diseases to varying degrees, such as gastric ulcer, gastric polyp, chronic atrophic gastritis and other diseases, all of which have the potential to turn into gastric cancer.
The incidence of stomach cancer in men is much higher than that in women, 1.5-2.5 times higher than that in women. In addition to smoking, alcohol consumption and mental stress in men, scientists have found that estrogen has a protective effect on the stomach. One study showed that women who received hormone replacement therapy (which includes estrogen) had a 48% reduction in the incidence of gastric cancer, including a 66% reduction in the risk of non-cardia gastric cancer and a 32% reduction in cardia gastric cancer.
Preventing stomach cancer requires controlling your mouth
Although the incidence of stomach cancer is related to genetic factors, living environment and habits, most men’s stomach diseases are caused by eating. To prevent stomach cancer, we must first control our mouths.
1, the diet should not be too salty, less smoked food. High salt and smoked food will cause the epithelial cells of the gastric mucosa to produce carcinogens, such as increased sensitivity to nitroso compounds.
2. Quit smoking and drink less strong alcohol. Tobacco itself contains carcinogens, smokers have a 50% higher incidence of stomach cancer than non-smokers. And the lower the age of starting smoking, the higher the mortality rate. Alcohol can destroy the gastric mucosal barrier, and the incidence of gastric cancer in drinkers can be 9 times of that in non-drinkers.
3. Try to eat regularly, avoid eating too fast, hot and hard food and overeating.
4. Try to implement “chopsticks sharing system”. Half of normal people carry H. pylori, which can promote gastric cancer, in their bodies, and such behaviors as eating with chopsticks in a large pot or parents feeding mouth-to-mouth with children can transmit the bacteria.
Not eating breakfast is the biggest risk factor of stomach cancer
The cause of stomach cancer is not only genetic, but also has a lot to do with the environment and living habits. Evidence-based medical research shows that smoking, drinking alcohol, eating leftovers and other habits can increase the risk of developing stomach cancer, and not eating breakfast is the biggest risk factor. Zhou Xiaobin et al. did a META analysis on the relationship between lifestyle habits and gastric cancer incidence in domestic population, which showed that people who skip breakfast have 3.06 times more chances to develop gastric cancer than ordinary people.
To prevent the occurrence of gastric cancer, we must change the bad habits, besides the ones mentioned above, there are also bad habits like eating high-salt diet and pickled vegetables.
Early examination, early diagnosis and early treatment are the keys
80% of gastric cancer patients have no early symptoms. In the early stage of gastric cancer, only some of them have symptoms such as mild indigestion, such as hidden pain and discomfort in upper abdomen, slight fullness, pain, belching and nausea, which are easily confused with gastric ulcer and gastritis. Among the new gastric cancer patients in China every year, the surgery rate of early gastric cancer is less than 10%.
The use of gastroscopy has enabled more gastric cancers to be detected at an early stage, which has greatly reduced the mortality rate. If gastric cancer is limited to the mucosal layer of the stomach wall, the 5-year survival rate can reach 95%. Therefore, early examination, early diagnosis and early treatment are the most critical means to reduce the mortality rate of gastric cancer. Early detection of stomach cancer is a victory.
Why gastric cancer is difficult to be detected at early stage
Stomach cancer is one of the most common malignant tumors with high incidence and mortality rate. If detected early, the 5-year survival rate of patients can reach 95%. However, the reality is that most of the patients are already in the middle and late stage when gastric cancer is detected, and the 5-year survival rate is only 40%, so many patients have their lives taken away. Why is it difficult to detect gastric cancer at an early stage? There are two main reasons.
First, most gastric cancer patients have no early symptoms, and those with early symptoms are not typical. The symptoms of gastric cancer are not typical, and there are no specific symptoms to identify gastric cancer. Nearly half of early gastric cancer patients have no early symptoms. A clinical statistics shows that more than 80% of patients, appear pain in the upper abdomen; about 1/3 of patients appear stuffy stomach, epigastric discomfort, loss of appetite, indigestion, accompanied by acid reflux; 1/3 of patients, although they have no obvious digestive symptoms, may appear unexplained weight loss, emaciation and fatigue; some patients show acidity, heartburn, Some patients show symptoms such as acidity, heartburn, nausea, vomiting, belching or black stools. These symptoms are not unique to gastric cancer, but may also occur occasionally in patients with chronic gastritis, gastric ulcer, functional dyspepsia, and even in normal people.
Secondly, it is very difficult to detect gastric cancer by stomach ultrasound in regular physical examination. Among various examination methods, gastroscopy is the most accurate method, with a confirmation rate of over 90%. However, on the one hand, people have fear of gastroscopy, and on the other hand, gastroscopy is not a part of routine physical examination, which is also a difficulty brought by gastric cancer screening.
Dangerous symptoms need to be alerted
Although the symptoms of early gastric cancer are not typical and can be easily ignored and confused, people should still be vigilant and prefer to be on the alert in view of its serious danger. The following types of symptoms require vigilance.
1. Upper abdominal discomfort: it is a common symptom of early gastric cancer. At first, it is often diagnosed as gastritis or ulcer disease and treated, and the symptoms may be temporarily relieved, but recur after a period of time.
2. Indigestion symptoms such as loss of appetite, anorexia, nausea and vomiting, bloating after eating, belching and acid reflux are also a group of common but non-specific early signs of gastric cancer, but they are easily misdiagnosed as functional indigestion.
3.Gastrointestinal bleeding and black stool: it is a more serious symptom, which can appear in both early gastric cancer and progressive gastric cancer. If stool is tarry and fecal occult blood test is persistently positive, especially when it is not easy to stop even after general diet control or taking gastric medicine, it is one of the important early gastric cancer symptoms. Any elderly people without stomach diseases should be more alert to the possibility of stomach cancer once black stool appears.
4.Unexplained wasting, weakness and mental discomfort: it is progressively worsening, which is also a common but unspecific signal of stomach cancer.
In addition, most gastric cancers occur on the basis of chronic gastritis (especially atrophic gastritis), Helicobacter pylori infection, residual gastritis, gastric polyps, gastric ulcers and so on. Therefore, anyone who has these symptoms and is accompanied by high-risk factors such as genetics, age and history of gastric disease should pay high attention and go to hospital for examination as early as possible to further confirm the diagnosis.
Treatment methods of gastric cancer
I. Surgical treatment
The types of gastric cancer surgery include distal major gastrectomy, proximal major gastrectomy, total gastrectomy and total gastrectomy combined with spleen and tail of pancreas, Appleby’s surgery, combined gastrectomy of gastric cancer combined with affected organs and palliative surgery. In order to improve the cure rate of gastric cancer, a reasonable surgical method should be selected according to the specific condition.
Surgical treatment for gastric cancer can certainly remove the cancer and is one of the preferred treatment methods for gastric cancer, but there is a possibility of postoperative recurrence and metastasis.
Radiotherapy
Radiation therapy for gastric cancer can relieve the obstructive symptoms of cardia cancer and reduce the chronic bleeding of unresectable lesions. For some patients with undifferentiated carcinoma, low differentiated carcinoma, tubular carcinoma and papillary carcinoma, if the lesions are small and shallow and there is no ulcer, radiation is a better way to treat gastric cancer. It is not very helpful for patients who are not suitable to cooperate with resection. The overall effect of radiotherapy is less satisfactory and is less used clinically.
III. Chemotherapy
Chemotherapy, as an important part of comprehensive treatment, is one of the most important means to treat gastric cancer today. The commonly used drugs in gastric cancer chemotherapy include 5-fluorouracil, furanofurouracil, mitomycin C, adriamycin, cyclohexylnitrosourea, cis-chloroplatinum, fluorocyclic cytidine hydroxyurea, etc., mainly combined chemotherapy.
IV. Immunotherapy
Immunotherapy is mainly used for cases after radical resection of gastric cancer in early stage, cases that cannot be resected or palliative resection, and cases with ascites in late stage.
V. Traditional Chinese medicine treatment
As an adjuvant treatment, TCM treatment can be used throughout any of the gastric cancer treatment methods to improve the overall therapeutic effect.
Treatment methods for gastric cancer include surgery, radiotherapy, chemotherapy, immunotherapy and TCM treatment. A reasonable gastric cancer treatment plan usually integrates and integrates various gastric cancer treatment methods to complement each other. Surgery is the only possible way to cure gastric cancer. However, since most of the patients admitted at present are progressive gastric cancer (not early gastric cancer), the efficacy of surgery alone is not very satisfactory. Surgery is the best treatment for early gastric cancer but not for most advanced cases. Chemotherapy and Chinese medicine are the best treatments for advanced gastric cancer. Chemotherapy and Chinese medicine are the best methods to treat advanced gastric cancer. The best choice of various gastric cancer treatment methods may be different for different patients.
Life management for gastric cancer patients
During the recovery period after radical surgery and completion of adjuvant chemotherapy, gastric cancer patients should strengthen self-care and arrange a certain amount of time for exercise every day. After the disease, cancer patients have undergone great psychological and physiological changes, so they need to re-establish a good life routine, develop good habits, and change their original habits of smoking, drinking alcohol and working overnight. For patients who live in the city, they should take time to be in the natural environment as much as possible to breathe fresh air and reduce the impact of city exhaust and noise on their bodies. At the end of the treatment, when the physical strength has recovered to a certain extent, seek the doctor’s advice, you can properly resume work, which will help to re-establish the routine of life, and will have a positive impact on the psychological and character up, which is conducive to physical recovery. It is important to emphasize that having a good state of mind and confidence in overcoming the disease is vital to physical recovery.