Benign and malignant stomach tumors (Part two)

Risk factors that lead to stomach cancer
  1. Having an HP infection exposes us 2-6 times more to cancer compared to those who do not have this infection. However, in many people with HP infection, stomach cancer has not been found, and research shows that genetic factors play a significant role. Having HP along with a gene form that causes low acidity in the stomach increases the risk for stomach cancer.
  2. The male sex is at 2 times higher risk than the female sex.
  3. The age at which stomach cancer is most often detected is from 50-60 years old. However, it can also be encountered under the age of 40 years.
  4. Diet plays a significant role. The consumption of preserved, smoked, salted foods, foods containing nitrates and nitrites, especially in processed meats, constitutes a risk factor that should not be neglected. On the other hand, the use of fruits, vegetables, especially those of red or yellow color like tomatoes, carrots, sweet potatoes, helps in protecting the body from stomach cancer.
  5. Alcohol and tobacco are implicated in stomach cancer. Drinking alcohol in moderation, which has been defined as no more than one drink per day for women, and two drinks for men can have a positive result on health. But drinking more can cause a number of problems that include irritation of the stomach and esophagus which can lead to cancer.
  6. The operated stomach poses a risk about 20 years after the surgery. Usually, it is about the removal of a part of the stomach, or the replacement of the pyloric valve, interventions that were made for the treatment of peptic ulcer. After the operation, biliary juices, sometimes even pancreatic ones can reflux back causing irritation and inflammation of the stomach. (gastritis) This condition can lead to stomach cancer in some people.
  7. Stomach polyps, which are small growths inside the stomach, are generally benign, but adenomatous polyps, especially when they are larger than 1cm in diameter, are often precancerous.
  8. Family cancer syndrome includes a hereditary disorder such as familial adenomatous polyposis, non-polyposis colorectal cancer, which easily increases the risk for stomach cancer. Hereditary diffuse gastric cancer is a rare form of stomach cancer that is associated with mutation of the CDH1 gene. A parent with the defective gene has a 50% chance of passing it to each of their children. For this reason, ¾ of the people who inherit this gene develop stomach cancer, therefore doctors recommend stomach surgery for all children of parents with this gene. However, DNA tests can now determine exactly who is at risk. If you have a family history of gastric cancer, your doctor or geneticist can answer your questions about DNA tests.
  9. Family history: if the parents have suffered from this diagnosis, there is a 2-4 times higher risk for stomach cancer.
  10. Pernicious anemia is a condition that often accompanies atrophic gastritis. It is related to the lack of vitamin B12 which affects the production of healthy red blood cells. This anemia is easily treated with vitamin B12 injections, but having this disease puts you at risk for stomach cancer.
  11. Blood group A: for reasons still unknown, people with this blood group have a higher risk for stomach cancer.
  12. Origin: the prevalence is higher in some countries like Japan, Korea, Eastern Europe, Latin America, compared to the USA. This difference is related to the diet and HP (Helicobacter pylori)
  13. Environmental exposure relates to some contaminated workplaces like with asbestos, nickel, etc.
  14. Obesity: men who weigh 15-20 kg more than the ideal weight, have a higher risk.
When should you seek a doctor's opinion?

Stomach cancer is treatable if it is caught early. Unfortunately, symptoms rarely start in the early stages. When symptoms do appear, they are often vague, and can easily be mistaken for a less serious problem like a virus, or acid reflux.

Should you see your doctor if you have a persistent feeling of discomfort in the upper or middle region of your abdomen, especially when it is related to weight loss or a general weakness?

YES

You should also get checked if you have vomiting after meals, or black stools. But not always such signs are the result of cancer.

To help in diagnosing stomach cancer and to exclude its possibilities, one or more of the following tests are recommended:

  1. Fecal occult blood test: is a non-invasive test to find the presence of hidden blood in feces. Although microscopic bleeding is one of the first signs of cancer, it can also be caused by other problems.
  2. Upper endoscopy or gastroscopy is a procedure that allows the doctor to see abnormalities of the upper gastrointestinal tract that cannot be distinguished by X-rays. This is the most accurate procedure when it is performed according to the protocol. Through this examination, the doctor can also take a biopsy where the stomach can be evaluated for precancerous conditions such as atrophy, metaplasia, and dysplasia. Upper endoscopy examines the esophagus, stomach, and the upper part of the small intestine. This procedure takes a few minutes. After this examination, you should not eat for 2 hours.
  3. Radiological examination of the upper gastrointestinal tract, which examines the esophagus, stomach, and the first part of the small intestine. Before the test, barium sulfate, a thick liquid, is drunk, which temporarily coats the stomach. After this test, you may eat normally or continue your usual activities, but it is necessary to drink more water to remove the barium from your digestive system. The simplest complication is temporary constipation.
  4. Endoscopic ultrasound or EUS helps to determine if cancer has spread to the walls of the stomach, or to nearby tissues and lymph nodes.
  5. Computed tomography or scanner is used to check for cancer spread outside the stomach especially to organs like the liver and lungs.
  6. Magnetic resonance imaging looks for cancer spread behind the stomach.
  7. Radiological examination of the chest sees if cancer has spread to the lungs.