Stomach cancer is also known as gastric cancer.  It is a disease that is caused by an abnormal growth of cells in the stomach.  The cancer cells can develop throughout the stomach wall and can spread and affect the other organs in the body.

Like other forms of cancer, gastric cancer affects more commonly older people from ages 50 and up. It is common in other countries like Iceland, Japan and Chile. In Singapore, it is the fifth common cancer among women and third among men. Over the past 60 years, there has been a decreasing trend in the number of people diagnosed with stomach cancer.

Types of Stomach Cancer

The most common type of stomach cancer is the adhocaranoma of the stomach.This is when the case arise from the innermat lining of the stomach. Other types of stomach cancer are:

  1. Lymphoma – this affects the functions of the immune system
  2. Carcinoid tumours – this disrupts the hormone-producing cells in the stomach
  3. Gastrointestinal stomach tumours – refers to gastric sarcomas

Symptoms of Stomach Cancer

The symptoms of stomach cancer do not manifest in the early stage. More often than not, they are associated with the symptoms of minor stomach and digestive diseases. It is therefore, recommended to see a physician if any of the symptoms below persists longer than the usual:

  1. Persistent abdominal discomfort (bloating,naesea,heartburn )
  2. Unintentional weight loss
  3. Unexplained loss of blood
  4. Vomiting or passing out blood
  5. Difficult or painful swallowing
  6. Previous stomach surgery
  7. Persistent vomitting

Diagnosis and Treatment

When the patient has any of the above mentioned symptoms, he should be evaluated by his primary care  physician.

Diagnosis

When the patient has any of the above the symptoms, he should seek medical advise from his primary care physician. After evaluation, his doctor may refer him to an endoscopist for more detailed investigations of the symptoms. An endoscopist may be a general surgeon or a gastroenterologist. These are doctors who have an interest in treating the disease of the stomach, intestine and colon.

When required a gastroscopy can be performed. In this procedure a small tube with a camera at the end is passed from the mouth into the stomach to have a good look at the lining of the stomach. If a cancer is found in the stomach, a biopsy can be performed at the same time to confirm the diagnosis. This procedure usually takes less than 20 minutes. Many patients are initially fearful about the procedure but their fears are usually unfounded. This procedure is done under sedation and the patient does not feel any discomfort when it is being performed. The risk of this procedure is minimal.

Treatment

Surgery is the main stay of treatment for gastric cancer.

The amount of stomach removed during surgery depends on the extent of and the position of the cancer. If the cancer is in the upper half of the stomach, the whole stomach is removed. If it is in the lower half than half to two thirds of the surrounding the stomach are also removed. At the time of surgery the lymph nodes surrounding the stomach are also removed.

After surgery the patient may require further treatment in the form of chemotherapy or radiotherapy. This depends on what stage the cancer is.

After surgery on the stomach, the patient is slowly able to go back to a normal diet. His portions for each meal may be smaller and as such will need to eat more frequently.

DR CHAN HSIANG SUI
MBBS (Singapore), MMed (Surgery), FRCSEd, FAMS
Consultant General Surgeon
(Gastrointestinal, Laparoscopic, Cancer and General Surgery)

Dr Chan is a Consultant General Surgeon practicing in Gleneagles Medical Centre. He graduated from the National University of Singapore in 1986. He was admitted as a Fellow to the Royal College of Surgeons (Edinburgh) in June 1991 and completed his Masters in Medicine (Surgery) in August 1991 and FAMS from Academy of Medicine (Singapore) in June 1997. Dr Chan pursued his further training at Massachusetts General Hospital,USA; as a Clinical Fellow in the Department of Surgery. He also had his Surgery training at Lahey Clinic in Burlington Massachusetts, USA; Department of General Surgery in 1996 where he functioned as a Chief Resident in the Department.

On return from his training in America he was practicing as a Consultant surgeon at the Department of Surgery, Singapore General Dr_Chan_Hsiang_Sui-cover_LargeHospital and the Department of Surgical Oncology at the National Cancer Centre.

Over and above the routine general surgical procedures, Dr Chan has a sub-specialty interest in minimally invasive surgery, oncology surgery (cancer surgery) of the gastro intestinal tract (aesophagus, stomach, colon an rectum and the pancreas), thyroid, and breast.

Dr Chan’s main interests are:

  • Laparoscopic Surgery
  • Cancer Surgery
  • General Surgery
  • Obesity Surgery

Dr Chan was the general surgeon that was involved in a medical relief mission to Sri Lanka following the aftermath of the tsunami in December 2004.

Websites: http://www.chansurgery.com.sg/

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