Stomach Cancer

Overview

Stomach cancer is the 7th most frequent cancer in males and 9th most frequent cancer in females in Singapore (2014-2018) according to the Singapore Cancer Registry.

Stomach cancer is the cancer of the cells of the inner lining of the stomach. The medical term for stomach cancer is gastric adenocarcinoma.

Stomach Cancer

Symptoms

Oesophageal cancer may not present with any symptoms in the early stages. However, common symptoms include:

  • Difficulty swallowing
  • Pain during swallowing
  • Weight loss
  • Heartburn
  • Regurgitation
  • Vomiting blood
  • Black, tarry bowel movements
  • Hoarse voice
  • Persistent cough

When to Seek Treatment

People with the above symptoms will need further evaluation.

Those with a strong family history of stomach cancer may consider screening for it.

Diagnosis

By directly visualising the stomach through a gastroscopy, the doctor can accurately locate where the cancer is. A tissue biopsy is obtained to confirm the diagnosis.

Following the diagnosis of the cancer, a CT scan may be arranged to check if the cancer has spread.

Endoscopic ultrasound, PET scan and Laparoscopy may also be used to determine the stage of the disease.

Treatment

Treatment depends on the location and stage of the disease as well as the general condition of the person. Surgical treatment followed by chemotherapy and radiotherapy may be necessary as additional treatment.

A gastrectomy is an operation to remove part (partial gastrectomy) or all (total gastrectomy) of the stomach.
The operation performed depends on the location of the cancer and the size of the tumour.

Distal Partial Gastrectomy

The lower portion of the stomach is removed and the upper portion of the stomach is joined to the small intestine.

Total Gastrectomy

The entire stomach is removed and the oesophagus is attached to the small intestine. In cancer surgery, the surrounding lymph nodes are removed as well.

The surgical approach can be performed by the traditional open technique or the laparoscopic technique.

Open Gastrectomy

A vertical incision is made in the upper abdomen.

Laparoscopic Gastrectomy

In select cases, the operation can be performed with small ‘keyhole’ incisions in the abdomen.

The advantages of a laparoscopic approach are

  • Less postoperative pain
  • Early recovery of bowel function
  • Early hospital discharge
  • Early return to work
  • Better cosmetic results

Both open and laparoscopic approaches are performed under general anaesthesia. A thin tube will be inserted through the nose into the stomach during the operation and left in place for a few days after the operation.

When bowel sounds return, the diet will gradually advance from liquids to soft foods.

Causes

  • Not yet known.
  • Related to mutations in the DNA of the cells.

Risk Factors

  • Infection with bacteria called Helicobacter pylori (H. pylori)
  • Smoking
  • Family history of stomach cancer
  • Consumption of salty and smoked food
  • Lack of intake of fruits and vegetables
  • Lack of intake of Vitamin C
  • Pernicious Anaemia
    (an auto-immune disease where the body develops antibodies which attack parts of the stomach)

Consult Our Doctor

Dr Lim Khong Hee
General Surgeon

MBBS (Singapore), M.Med (Surgery), FRCS (Edin), FRCSEd (Gen), FAMS (Surgery)

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