Gut Health: The Importance of Early Detection for Stomach and Oesophageal Cancer
Digestive health is often overlooked until discomfort arises, but stomach and oesophageal cancers highlight the need for proactive care. In Malaysia, cancer was the third leading cause of death in 2022, rising from fourth place in 2021. While not the most common, stomach cancer accounted for 3 in 100 new cases, and oesophageal cancer for 1 in 100 new cases in 2020.
Understanding Stomach and Oesophageal Cancer: Symptoms and Risks
According to Dr Hafizah Zaharah Ahmad, Consultant Clinical Oncologist at Sunway Medical Centre Velocity (SMCV), these cancers are often diagnosed late because their symptoms such as difficulty swallowing, unexplained weight loss, persistent heartburn, nausea, vomiting, and chest or upper abdominal pain are often ignored.
The five-year survival rate for early-stage stomach cancer is 65%-75%, but it drops to 5%-7% at Stage 4. Similarly, oesophageal cancer survival rates are 47%-55% in early stages but decrease to 5%-6% in advanced stages.
Key Risk Factors and the Need for Early Screening
Dr Tan Yu Peng, Consultant Gastroenterologist and Hepatologist at SMCV, emphasizes that individuals with high-risk lifestyles should be more proactive in screening. Key risk factors include:
Oesophageal Cancer
- Squamous oesophageal cancer is linked to smoking, betel nut chewing, excessive alcohol consumption, frequent intake of preserved foods, and very hot liquids.
- Oesophageal adenocarcinoma is more common in obese individuals, smokers, those with chronic gastroesophageal reflux disease (GERD), or Barrett’s oesophagus.
Stomach Cancer
- GERD, high-fat and low-fiber diets, frequent consumption of smoked foods, and Helicobacter pylori infections increase the risk.
- Family history of stomach cancer also raises susceptibility.
GERD and Its Link to Oesophageal Cancer
GERD is a condition where stomach acid frequently flows back into the oesophagus, potentially leading to Barrett’s oesophagus, a precancerous condition. Dr Tan notes that smoking, overeating, alcohol, and excessive coffee consumption can worsen GERD. While lifestyle modifications and medication can help, severe cases may require fundoplication surgery, which strengthens the oesophageal sphincter to prevent acid reflux.
The Role of Endoscopy in Early Detection
Endoscopic procedures like gastroscopy and colonoscopy play a crucial role in detecting stomach and oesophageal cancer at an early stage. Dr Tan recommends screening for:
- Individuals over 50 years old, or
- Those over 40 with a family history of gastric or colorectal cancer.
In Japan and South Korea, upper endoscopies are advised from age 40 and repeated every three years, whereas in Malaysia, screenings are mainly focused on high-risk individuals or those showing cancer warning signs.
Treatment Options and New Advances
Treatment for stomach and oesophageal cancers depends on the stage and location of the tumor and may involve surgery, chemotherapy, and radiation therapy. Dr Tan highlights key advancements:
- Immunotherapy offers hope for advanced oesophageal cancer, particularly in PD-L1-positive tumors.
- Targeted therapy for stomach cancer, such as anti-HER2 treatment, has been effective for HER2-positive cases, which make up 10%-20% of stomach cancers.
A Caregiver’s Perspective on Cancer
A caregiver of a cancer patient at SMCV shared how her family’s journey changed drastically after a cancer diagnosis. She emphasized the importance of support, emotional well-being, and adapting meals to liquid or pureed forms for patients who struggle with swallowing.
Conclusion
Early detection, lifestyle changes, and regular screenings are crucial in improving survival rates for stomach and oesophageal cancer. Greater awareness and proactive health measures can help individuals safeguard their digestive health and enhance their overall quality of life.
For more information about Sunway Medical Centre Velocity (SMCV), visit www.sunwaymedicalvelocity.com.my or follow Facebook: Sunway Medical Velocity.
