[Local medical care]Unusual epigastric pain and heartburn should be vigilant for early screening and early treatment to repel gastric cancer

[Local medical care]Unusual epigastric pain and heartburn should be vigilant for early screening and early treatment to repel gastric cancer


Text: He Jianxing Organizer: Liang Yingxiu

Although gastric cancer is not the most common cancer in my country, it has reached the data of 7 people per 100,000 people.

It is necessary for the public to pay attention to the early symptoms of gastric cancer, including unusual upper abdominal pain, heartburn, nausea and even loss of appetite.

It is recommended to check in detail to find out the real cause, so as not to miss the golden period of treatment.

Senior Consultant of Hepatology and Gastroenterology
Doctor Huang Zhiqin
(Dr Wong Zhi Qin)

(Kuala Lumpur News) The stomach (stomach) is a part of the digestive system of humans or other vertebrates. It is connected to the esophagus and the duodenum. It is located in the left upper abdomen below the ribs of the human body. Its function is to store and digest food. By grinding large pieces of food After being formed into small pieces, the large molecules in the food are degraded into smaller molecules, which can be further absorbed.

Cases expected to rise to 1.8 million by 2040

Gastric cancer (stomach cancer/gastric cancer) refers to cancer that occurs in the gastric mucosa; in the early stages of gastric cancer, symptoms such as heartburn, upper abdominal pain, nausea, and loss of appetite will appear, and in the later stages, symptoms include weight loss. ), yellowing of the skin and whites of the eyes, vomiting (vomiting), difficulty swallowing (difficulty swallowing) and blood in the stool and other symptoms, and cancer cells will metastasize from the stomach to other parts, especially the liver, lungs, bones, peritoneum and lymph nodes.

Dr. Wong Zhi Qin, Senior Consultant of the Department of Hepatology and Gastroenterology, pointed out that according to statistics, in 2020, there will be 1.1 million new gastric cancer cases worldwide, and as many as 770,000 gastric cancer deaths, of which the highest incidence rate is in Japan ( 48.1%), followed by men from Mongolia (47.2%) and South Korea (39.7%), while Africa has the lowest incidence rate of 5 per 100,000 people.

As for gastric cancer cases in Malaysia, there are nearly 7 (6.9) per 100,000 people.

She said that according to the evolution of the current data, it is estimated that by 2040, the annual number of new gastric cancer cases worldwide will increase to 1.8 million, and the number of deaths will reach 1.3 million. It can be described as another cancer killer lurking around you and me.

What are the risk factors for gastric cancer? In fact, it covers different factors such as genetics, living environment, gender, aging, and the food you eat.

1. Heredity: Gastric cancer is related to family medical history. If a blood relative in the family suffers from gastric cancer, the probability of gastric cancer among relatives will be 2 to 3 times higher than that of normal people, but this needs to be further clarified, because what is the There are more similar living habits between each other, or whether it is a genetic defect that causes cancer, more research is needed to determine.

Of note, if a person has adenomatous polyps (gastric adenomas), pernicious anemia (gastric intestinal metaplasia), familial adenomatous polyposis (FAP), Lynch syndrome, Peutz-Jeghers syndrome and juvenile polyposis syndrome will aggravate the possibility of gastric cancer and should be treated with caution.

2. Living environment: similar to the above factors, is it because of the similar living environment or even eating habits that people get cancer? Still to be confirmed.

3. Gender: According to statistics, the risk of stomach cancer in men is twice that of women. This may be related to gender, but it may also be related to more men smoking and drinking.

4. Aging: The incidence of gastric cancer will increase suddenly after the age of 50, so increasing age plays an important role. Studies have found that it may be related to the higher incidence of atrophic gastritis in the elderly.

5. Food choice: According to epidemiological research, eating habits and content are directly related to the occurrence of gastric cancer, especially those who like to eat salted foods such as smoked and roasted food, barbecued meat, pickled vegetables and salted fish, the incidence of gastric cancer will increase. Very high.

Bad habits increase the risk of cancer

“The remaining factors include Chronic Atrophic Gastritis (CAG) and mucosal intestinal metaplasia (intestinal metaplasia), because atrophic gastritis has lower gastric acid secretion and gastric mucosa is more prone to intestinal metaplasia , increasing the risk of stomach cancer.”

“If the occurrence of gastric polyps is not treated in time, malignant lesions may also become gastric cancer;

Polyps refer to small tumors, or mushroom-like growths on the mucous membrane,

Under normal circumstances, most gastric polyps will not have malignant lesions.

But if gastric polyps (or gastric glandular polyps) are larger than 2 cm or more,

Then there will be 30% to 40% malignant lesions. “

“In addition, Helicobacter pylori is also one of the possible factors. If a person’s stomach is infected by Helicobacter pylori for a long time, it will cause chronic atrophic gastritis, or form some immune inflammatory reactions, and Helicobacter pylori Bacterial infection is closely related to the occurrence of lymphoma in the stomach.”

Finally, there are smoking and alcohol abuse. Undoubtedly, these bad habits will increase a person’s chances of developing cancer, including gastric cancer. Obesity is also one of the common health hazards of modern men and women. When a person is overweight, it will also increase the risk of gastric cancer risks of.

Fasting 6 hours before the test

Accurate gastroscopy with low risk

What are the types of gastric cancer? Gastric cancer has a variety of gross forms, and there are different classification methods.

However, if it is classified according to the location of the cancer, the types of gastric cancer can be divided into 3 types, namely cardia cancer, gastric body cancer and pyloric duct cancer.

Huang Zhiqin pointed out that cardia cancer refers to the adenocarcinoma that occurs in the gastric cardia, that is, within about 2 cm below the esophagogastric junction. Or called the anterior area of ​​the pylorus, the thinner duct formed between the pyloric entrance and the duodenal bulb is the pyloric tube.

60% accuracy of blood test screening

If you want to subdivide the differences between the three positions, it is that the cancer of the cardia belongs to the “upper side”, while the cancer of the stomach body is in the middle, and the pyloric duct is connected to the duodenum. The cancer of the stomach body and the pyloric duct are the most common, accounting for as much as 90%. , while cardia cancer is only about 10%.

“If it is analyzed from pathology, gastric adenocarcinoma (adenocarcinomas) accounts for 90% to 95%, which can be divided into intestinal type (intestinal) and diffuse type (diffuse), and then the other is gastrointestinal stromal tumor (gastrointestinal stromal tumor) tumors), neuroendocrine tumors, and lymphomas.”

How to make a diagnosis? Checking tumor markers through blood tests is a common screening test, but the accuracy is 60%, so the more accurate way is to take a gastroscopy, and then perform a biopsy and a computerized tomography scan (CT Scan) And positron emission tomography (PET Scan) to confirm cancer staging.

Is gastroscopy dangerous? She said that the risk of it is actually very low. Generally, you only need to fast for 6 hours before the test, and then enter light sedation (that is, fall asleep) to perform the test. The whole process takes about 15 minutes, and the patient does not need to be hospitalized.

What are the treatments for stomach cancer? Does it have to be surgically removed?

“At present, the treatment for gastric cancer is still based on surgery (surgery), chemotherapy (chemotherapy) and radiotherapy (radiotherapy); the purpose of surgery is to achieve a radical effect, so during surgical resection, the surrounding His organs and tissues were also removed.”

As for chemotherapy, it is to select appropriate anti-cancer drugs, through intravenous drip or oral administration, let patients absorb and distribute them throughout the body, so as to achieve the purpose of killing or controlling the growth of cancer cells. However, according to medical research results so far, chemotherapy is not very effective for gastric cancer, and it is generally only used as adjuvant therapy (adjuvant therapy). For example, in some patients undergoing surgery, chemical anticancer drugs are used to prevent the recurrence of cancer cells , in order to improve the survival rate after surgery.

Chemotherapy prolongs survival

She added that in certain cases of gastric cancer patients, chemotherapy may still be used as the main treatment for gastric cancer. Chemotherapy is given to prolong survival.

Radiation therapy (referred to as radiotherapy) is the use of high-energy radiation or various microparticles to kill cancer cells. In general, radiotherapy is the same as chemotherapy, and the main non-treatment is only adjuvant therapy, unless it is for patients with complications. Before and after surgery, radiation is used to irradiate the tumor growth area to kill invisible or unresectable, or even residual unclean cancer cells, so as to achieve the purpose of local control.

It is worth noting that preoperative chemotherapy is also a commonly used treatment today, that is, to reduce the size of the tumor first, and then perform surgical resection.

avoid complications

Most doctors recommend excision

At present, gastric cancer cases in Asia are still mainly in the lower half of the stomach, which has a lot to do with intestinal health.

Huang Zhiqin said that although there are three main treatment methods for gastric cancer, namely surgery, radiotherapy and chemotherapy, until 2017, in the treatment cases announced by the Cancer Foundation, most doctors still recommend patients to be resected first, mainly because Cancers of the digestive tract have a particularly large impact on nutrient absorption, and the lymphatic system of the stomach will cause rapid metastasis, and complications can also be avoided after resection.

Consider multiple factors to determine the treatment plan

She said that before deciding which treatment method to use, doctors must take many factors into consideration before making professional recommendations, including the location of the most important tumor lesion, is it at the upper or lower end of the stomach? Is it in the greater or lesser curvature of the stomach? Then consider the patient’s age, health status (whether there are other diseases), the extent of the tumor’s spread, the stage of the cancer at the time of diagnosis, the patient’s personal wishes, and even the opinions of family members.

It must be emphasized that the advice given by the doctor is only a principle, and it is also the “possible best choice” that can be provided to the patient according to the current medical environment. It is the result of research statistics, which is a probability rather than an inevitable result. Only after deciding to accept a certain treatment can we really see its effect.

Early detection and treatment if symptoms

“Of course, early detection and early treatment will inevitably lead to better therapeutic effects, and the same is true for gastric cancer. Early detection of its existence will bring better therapeutic effects, and may even achieve a curative effect.”

Therefore, the advice to the public is that if they notice any similar symptoms in the body, they should be checked early or even treated early, such as eradicating Helicobacter pylori and gastric polyps, etc. In the primary prevention of gastric cancer, eradicating Helicobacter pylori, Behaviors such as reducing salt intake, smoking cessation, alcohol cessation, and weight loss are all crucial, and they are also keywords for controlling the occurrence of gastric cancer.


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