On the NSFC website, they list goals for November to raise awareness for Stomach cancer. Education is always top in the list because it encourages us to tell people about the risks factors, detection, and prevention. As with any type of cancer, funding is needed to continue research and improve treatments. They have educational events and a worldwide annual walk to help improve early detection rates and save lives.
While we are focusing on our Thanksgiving menu, let's look at what can cause stomach cancer. While the exact cause is unknown, there are identified foods that correlate to stomach cancer such as foods that are prepared by salting, pickled, or smoked. There is a lot of information on the Moffitt website regarding stomach cancer. Some things that can be a precursor for stomach cancer are atrophic gastritis and intestinal metaplasia. Either of these conditions would be diagnosed with an EGD, and these procedures are not approved for screening. Therefore, at this point, symptoms must be present in order to get an EGD. Some symptoms to look for according to Moffitt are: pain in the stomach area, swallowing difficulties, heartburn, jaundice, decreased appetite, and feeling full with little food. Some advances symptoms may include: fatigue, vomiting up blood, blood in stool, and weight loss. Moffitt's cancer center phone number is 1-888-663-3488
If you have patients, friends or family with any of the above symptoms, encourage them to see their primary physician or Gastrointestinal doctor. Nurses are often in the teaching role, and there are risk factors that patients can be aware of. Some of the risk factors we can be on the lookout for are: pickled and smoked foods (as mentioned before), previous surgery, obesity, smoking, excess alcohol, exposure to fumes and dust, and a history of stomach polyps, or long term stomach inflammation. There are hereditary genetic disorders that need to be surveyed such as non-polyposis colorectal cancer, hereditary diffuse gastric cancer, and familial polyposis. We have heard of H pylori and its effect on the stomach, but it is also one of the largest risk factors for gastric cancer. Because of H pylori propensity to cause ulcers and inflammation, it increases a person's chance of stomach cancer by six according to Moffitt. For those with a history of H pylori, the above genetic factors, or previous gastrectomies, there are tests that can be done to screen for stomach cancer. The EGD is the most effective because the doctor is able to take a biopsy of the stomach lining, a serum pepsinogen measurement, and a barium-meal gastric photofluorography. Depending on the type of stomach cancer a patient has and the stage will dictate the type of treatment. Whether it is Lymphoma, carcinoid, squamous cell, small cell, GIST, or Leiomyosarcoma, the oncologist will know best how to treat the cancer. A patient can undergo chemo, radiation, surgery, and molecularly targeted therapy for their cancer. There are several types of surgeries as well. The surgeries performed for stomach cancer can be as minimally invasive as a an endoscopic mucosal resection, to a partial gastrectomy, or a total gastrectomy. If you have taken care of patients or have family members who have undergone a total or partial gastrectomy, you have seen the difficulty they have just being able to eat.
This subject is personal to me not only because I am a GI nurse, but because my precious Uncle had gastric/esophageal cancer. He is no longer with us, and the cancer isn't the only problem that he suffered with, but it changed his life. He had a partial gastrectomy and part of his esophagus removed. The recovery was horrible, but the part that bothered me the most was his inability to eat. He was never able to eat normally after his surgery and lost a tremendous amount of weight. To be able to sit with him and enjoy a meal, only to see him stop after a couple of bites and even be in pain was difficult to see. He had a long history of smoking and drinking which probably played a part in his cancer. Love and miss you Uncle Ed. Share your stories about gastric cancer and keep educating!