Abdominal Cancer

Stomach cancer is the second most frequent cancer in Macedonia, but not even in the top ten most widely occurring cancers in the USA - a striking difference when the incidence rates are compared between those of developed and developing countries. The main reason for this  difference is the bacteria called H.Pylori (Helicobacter Pylori).

What is Stomach Cancer?

In Macedonia in 1999, stomach cancer was the second most frequently occurring cancer, only after breast cancer in women and after lung cancer in men. According to the US National Health Institute`s 2005 figures, stomach cancer is not even among the top ten most frequently occurring cancer types in the US - a difference which is striking when the incidence rates of Helicobacter pylori are compared between developed and developing countries. H. Pilory is bacteria that lives adjacent to the stomach mucosa and is transmitted orally. H.Pylori is the number one cancer causing factor on the list published by the World Health Organization (WHO). However, it is doubtful whether the eradication of H.pylori (its removal with antibiotics) totally prevents stomach cancer. H.pylori leads to the lymphoma, the malignant stomach disease.

What are the Symptoms?

Stomach Cancer is generally an insidious disease that can be diagnosed at an advanced stage. On the other hand, even if symptoms manifest, the complaints may be overlooked by patients and medical doctors because many of them are common to other diseases.

Frequent complaints and symptoms include weigh loss (60%), stomach ache (50%), vomiting (35%), loss of appetite (30%), aglutition (25%), bleeding (20%), early saturation (15%), an ache similar to ulcers aches (15%). Five per cent of patients with advanced stage stomach cancers have never had any complaints.

How does stomach cancer appear? Is Family History important?

Besides genetic features, peripheral factors and cancer promoter diseases are also important factors in the development of stomach cancer. It is generally accepted that stomach cancer occurred incidentally and only 10 percent of occurrences are hereditary. People with immediate relatives who have contracted stomach cancer at some point in their lives (mother-father siblings) are two to three times more likely to contract stomach cancer than other people. A well known example indicating how some families have a higher probability of catching stomach cancer is the Bonaparte Family. Napoleon Bonaparte, the French general and statesman, died of stomach cancer, as did his father and grand-father. However, three conditions must be met accepting that stomach cancer is definitely generically transited within the family (hereditary):

1. There must be at least three stomach cancer incidents within the same family, two of which has to be an immediate relative.

2. It must have occurred over two consecutive generations.

3. At least one of the patient’s with the cancer must be under the age of 50.

What are the diagnosis methods?

Stomach cancer is usually diagnosed by the symptoms described as indigestion. Therefore, it may be neglected by the patient for a long time. Even when patient`s report some cases, early phase treatment is postponed, as patients are given medicine for gastritis and ulcer. However, treatment of cancer in its early phase usually produces successful results. Therefore, if there are symptoms and indications already apparent, it is best to search for the probability of stomach cancer by utilizing gastroscopy. Gastroscopy and biopsy are the most efficient methods in the diagnosis of stomach cancer.

How is it treated?

The most efficient and permanent treatment for stomach cancer is surgery. Surgery performed at the early phase of the cancer increases the probability of the patient’s survival. Contrary to that, when surgery is performed at a later stage, the probability of the patient’s long term survival decreases. In the Far Eastern countries (Japan, China, Taiwan and South Korea) where stomach cancer is widespread, there have been notable important successes in early diagnosis and treatment. In Japan where endoscopy examination is applied as a screening test, the ratio of determination of early phase stomach cancer is over 70 per cent. However, in Western societies, this ratio is below 20 percent. The ratio of early phase stomach cancer surgery  as part of all surgeries performed in Turkey is approximately 4 per cent. This prominent difference affects the probability of patients surviving after treatment.

The role of radiotherapy and chemotherapy in the treatment of stomach cancer is very limited. Generally, they are applied before or after surgery. Patients who cannot get any benefit from surgery receive radiotherapy and/or chemotherapy as palliative care.

Other factors in the formation of stomach cancer:

Besides factors such as H.pylori, genetics and nutrition, there are other factor’s playing protective or promoting role in the formation of stomach cancer.
• In some professions, the probability of contracting stomach cancer may be higher. People working in coal mines, in the rubber and petrochemical production, in fisheries, those working with rubber and asbestos are at a slightly larger risk of acquiring cancer than the general public.
• Benign stomach disease patients who had been and patients whose stomach had been exposed to increased gall and pancreas secretum have a higher probability of contracting stomach cancer.
• There is a three times higher risk of acquiring stomach cancer at people who had their first operation 25 years ago.
• The risk of stomach cancer to heavy smokers (and those who smoke from an early age) is twice as high as to non-smokers. There is no direct correlation between stomach cancer and alcohol use. On the other hand, the regular use of aspirin plays a protective role against stomach cancer.

Protective factors:

• Fresh vegetables and fruits
• Antioxidants (Vitamin C, beta-carotene alpha tocopherol, selenium)
• Green-black tea (polyphenols)
• Non-fermented soya
• Fresh fish

Risk factors:

• Salt
• Nitrates (food protective additives, drinking water)
• Nitrites, nitrosamines
• Fermented soya
• Meat cooked at high temperature
• Moldy cereals, seeds, sore seeds (aftatoxin)
• Excessive consumption of fried food and red meat