Gastric catastrophe: Eat right to avoid stomach cancer

Can you stomach it? I’ve learned, with my middle-aged wisdom, to learn to be more tolerant of things that don’t quite settle well in my stomach, such as news stations named after animals, bumper stickers that say “Bite Me,” and Charlie Sheen.

Asian people in general have strong stomachs, which is why we can eat spicy foods that would make The Towering Inferno seem like a mere bonfire. However, no one is completely immune to stomach woes.

Can we detect stomach cancer soon enough?

Gastric cancer is the number-two cause of death from cancer in the world. This stomach cancer is most prominent in Asia, parts of South America, and Eastern Europe. It affects men more than women. On our big blue marble in space, about 870,000 new gastric cancers are diagnosed each year, and about 650,000 people die annually from it.

Gastric cancer is nothing new. In fact, Egyptian hieroglyphics from 3000BC describe the disease.

Although the incidence of gastric cancer has been decreasing over the decades, the overall number is still increasing because babies continue to be born, and in general we are living longer.

Two main types of gastric cancer exist: “diffuse” and “intestinal.” Diffuse is not as common, but has a worse prognosis than intestinal, affects younger folks, and is found equally in both sexes. This discussion focuses on the intestinal type of stomach cancer.

Chronic gastritis– inflammation of the stomach lining– can lead to atrophy (shrinkage) of the stomach cells. This leaves the stomach unprotected in ways that allow cancerous cells to develop.

H. pylori is something you might have heard of. It’s the bacterium associated with ulcers and gastritis. Persons with H. pylori have a six times greater risk of developing gastric cancer, so treatment with a couple of antibiotics and antacids is usually recommended.

Eating citrus fruits such as oranges, fresh veggies, milk, and vitamin A lower the risk of gastric cancer. Exercise and winning the battle of the bulge both also lower the risk. See, mom was right when she told you to eat your vegetables and fruit– although I don’t think most parents (or school cafeterias) these days do much to insure kids get a balanced diet. (And speaking of extra weight, some bariatric surgeries may increase the risk of gastric cancer.)

Processed meats and fish, fried foods, smoking, and especially salt are main risk factors for gastric cancer. I think of men in Asia who are eating smoked fish, soy sauce (with a ton of sodium), smoking cigarettes, and drinking liquor (so Memoirs of a Geisha). Maybe that’s why Asian men are at high risk for gastric cancer. As far as alcohol, some studies show wine to reduce the risk.

The incidence of gastric cancer was so high in Japan that routine gastric cancer screenings were introduced in the 1960s. In the ‘70s, not only did disco become queen, but endoscopic mucosal resection (EMR) became king– king of gastric cancer prevention. By use of an endoscope through the mouth and into the stomach, dysplastic gastric cells (pre-cancer) can be removed before they turn to cancer. EMR is very successful because about 90 percent of patients with dysplastic cells will survive for at least five years. The treatment appears to be as effective as surgical removal of the stomach.

As with most cancers (such as melanoma, breast, and colon), catching the disease before it spreads can save lives as well as minimize suffering. A very close family member just had EMR, and I pray he will have many happy years ahead.
Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, Email him with your questions.