Stomach cancer has been one of the common malignant tumors in China, and the incidence rate is the highest among digestive system tumors. Compared with Europeans and Americans, Chinese people have a higher chance of stomach injury and are more likely to be targeted by stomach cancer. However, gastric cancer is preventable and curable, with early detection and early treatment, the cure rate can reach 90%. By answering the following 9 questions, you can recognize stomach cancer.
1.Is there any ethnic, geographical and age differences in stomach cancer?
The Global Cancer Report 2014 released by the World Health Organization shows that there are 405,000 new cases of stomach cancer in China, accounting for 42.5% of the new cases in the world. In fact, there are significant ethnic and geographic differences in gastric cancer. East Asia is a region with a high incidence of gastric cancer, with three countries – China, Japan and Korea – accounting for about 70% of the total number of gastric cancer cases worldwide. This is related to the genetic predisposition of the population in this region, the high consumption of barbecued and pickled foods in the diet, and the high rate of smoking.
Specifically in mainland China, stomach cancer also “favors” people in coastal areas, the middle and lower reaches of the Yangtze River or relatively poor areas such as Jiangsu, Shandong, Anhui, Henan, Gansu, Inner Mongolia and the northeastern provinces, who prefer high salt diets.
In terms of age, the average age of onset of stomach cancer is 58 or 59 years old, but patients range from a few years old to over 90 years old. The youngest patient I encountered was only 9 years old, and the exact cause of the disease is unknown. In the past 10 years, the incidence of gastric cancer in China is generally stable and slightly increasing. It should be noted that the incidence rate of young people is increasing faster than the national level, and most of them are diffuse gastric cancer, which is relatively more difficult to treat.
2.Does gastric cancer have precancerous lesions? What are the main symptoms?
Gastric polyps, chronic atrophic gastritis and remnant stomach are the high-risk factors for gastric cancer. The occurrence of gastric cancer is a multi-factor, multi-level and multi-stage development process. In the early stage of gastric cancer, patients often have no obvious symptoms or only have upper abdominal discomfort, atypical upper abdominal pain, loss of appetite, fullness, belching, and a few may have black stool or vomiting blood. Once the symptoms are more obvious, it often means that gastric cancer has entered the middle and late stage, mainly manifesting as unexplained gradual wasting, anemia, hypoproteinemia, swelling, persistent epigastric pain, vomiting blood and black stool, etc.
3.Who are the high-risk groups of gastric cancer? How to detect it early?
First, people with family history of tumor. Among two or three generations of relatives who have had digestive system tumor or other tumors, their chances of getting stomach cancer will be higher. The response is to do professional tumor screening about 10 years earlier than the youngest age of cancer members in the family, and gastroscopy should be done for gastric cancer, every 3 years, according to the doctor’s recommendation. For example, if the youngest age of cancer in the family is 55, the first gastroscopy should be done at the age of 40.
Secondly, people with bad habits such as long-term smoking, alcohol consumption, especially hot food, pickled and barbecued food, and high-salt food. These habits can cause more serious damage to the stomach and should be adjusted in time.
Third, patients with gastric ulcers, chronic gastritis and other gastric diseases. People with these diseases should be actively treated to prevent disease progression and go to the hospital for regular review.
4.If one has chronic gastritis, gastric ulcer and other diseases, will one get gastric cancer?
Some gastric diseases are high-risk factors for stomach cancer and need to be taken seriously, but having gastric diseases does not mean that you will definitely get stomach cancer. Gastric ulcer is clearly associated with gastric cancer, which will increase the risk of cancer. Long-term, severe chronic gastritis, such as those with atrophic changes, intestinal hyperplasia or atypical hyperplasia, must be closely monitored. It is important to say goodbye to bad habits, quit smoking and limit alcohol, and eat less fried and high-salt foods. In addition, it is necessary to see a gastroenterologist regularly every year, who will give specific advice on gastroscopy, medication, etc. depending on your specific situation.
5.How much is H. pylori related to stomach cancer?
H. pylori is the only type of stomach bacteria known to man, and it has been associated with certain types of stomach cancer. If H. pylori is found to be positive and combined with chronic gastric diseases, such as chronic gastritis and gastric ulcer, the risk of developing gastric cancer in the future is higher and should be cleared in time. Not only should I clear it, but also my family members should be examined and cleared at the same time.
6. Gastroscopy is painful, is there no other better examination method?
It is true that gastroscopy can be painful if painless measures are not taken. But at present, in order to detect early gastric cancer, you can only do gastroscopy; the gastric cancer that can be detected by other methods is not early, and the stage of gastric cancer directly affects the cure rate.
The great thing about gastroscopy is that it reaches into the stomach with a thin, soft tube, and through the mirror-like probe at the bottom, the doctor can look straight into the stomach and see the stomach clearly, without missing the slightest change. The early manifestation of gastric cancer is very secretive, it may be like a small plaque on our hand, only the color of the gastric mucosa has changed a little. The current CT and imaging technologies can scan a certain diameter of the stomach lesion, but they cannot capture such a small change. Therefore, people who should have gastroscopy should not hesitate.
7.Is there a “gold standard” for gastric cancer diagnosis? What are the treatment methods for gastric cancer?
Gastroscopy plus pathological biopsy is the “gold standard” for gastric cancer diagnosis, which is the qualitative diagnosis, followed by staging diagnosis. Surgery, radiotherapy, chemotherapy and supportive therapy are the main treatment methods for gastric cancer, among which surgery is the main method to cure early gastric cancer, while multidisciplinary comprehensive treatment is the most advanced treatment mode for gastric cancer at present. It is based on the comprehensive judgment of the patient’s physical condition and disease, and the relevant multidisciplinary experts will jointly formulate a set of treatment plan for the patient, which is very necessary for the patient with complex disease. If the patient’s stage and diagnosis are very clear, the patient can be treated according to the standard treatment of gastric cancer.
8.How to seek medical treatment scientifically if I have gastric cancer?
Every time I go out to the clinic, I will encounter some patients who have not received standardized treatment, accounting for about 1/4 of the clinic volume. Whenever I see this situation, it makes me very worried. It is important to know that irregular treatment may stimulate the growth of tumor cells and make the subsequent treatment more difficult.
The first treatment is the most critical for gastric cancer patients. If you have gastric cancer, you must make two points clear: firstly, you must seek medical consultation from a digestive tumor specialist; secondly, you must wait for the doctor to do a full examination and evaluation before making treatment decision. Many patients are so anxious that they want to be diagnosed today and have surgery to remove the cancer tomorrow. Queuing for examination? Can’t wait! Waiting in line for a bed? No! Therefore, many patients often go to non-digestive tumor specialists or irregular and unspecialized hospitals to receive irregular treatment as soon as possible.
When gastric cancer is detected, it has been a long time, and there is no hurry for these three to five days, unless there are serious complications such as perforation, bleeding and obstruction, which require immediate surgery. In fact, some waiting is for better treatment. It is necessary to give the doctor time to fully understand the patient’s physical condition and analyze the tumor, so that a scientific treatment plan can be tailored for you. It is worth noting that the treatment level of gastric cancer in China varies greatly. Patients can also judge whether the doctor is professional or not by whether he fully understands your physical condition, tolerance, stage of the disease, etc.
9. Is it right to say that 1/3 of cancer patients die of fright?
Obviously, this statement is too exaggerated. In my 30 years of medical experience, I have only met one patient who passed away due to excessive fear. She did not eat or drink every day, and lay in bed chanting: “I am going to die, I am going to die. ……” No communication with her was effective. 12 days later, she passed away. In fact, cancer is actually not as scary as we think, many people survive with cancer and still live a wonderful life. After suffering from cancer, you must adjust your mentality and communicate more with optimistic patients. For recovering gastric cancer patients, family members and colleagues do not need to protect them like “porcelain dolls” and do not let them do anything, which may make them feel that their life is worthless.
How high is the cure rate of gastric cancer?
In China, the average cure rate of stomach cancer is 30%, which is not particularly low among cancers. Specifically for individuals, the level of cure rate is directly related to the stage of gastric cancer.
For early stage gastric cancer patients, the cure rate can reach 85%-90% or even higher; stage II can reach 70%-80%; stage III is already intermediate and late, and the cure rate drops to 30%; stage IV is less than 10%.
In terms of types, distal gastric cancer has a higher cure rate than proximal gastric cancer, the former refers to cancers near the pylorus and other parts of the stomach, while the latter refers to cancers near the cardia and stomach body. Indolent cell carcinoma has a lower cure rate because it is more insidious and more likely to metastasize.
Compared with the overall cure rate of 60% in Japan, the cure rate of gastric cancer in China is low. This is mainly because Japan requires the first gastroscopy to be started after the age of 50, and its early stage patients account for more than 60%; while only about 10% of patients in China are found to be early stage.