Materia Medica Malaysiana

Nationwide campaign on gastric cancer

IT is the fifth most common cancer in Malaysia but the mortality rate is as high as cervical cancer. Yet, stomach cancer or its clinical term, gastric cancer, is relatively unknown due to a lack of awareness of its symptoms and causes.

Recently, a nationwide campaign on gastric cancer was held in four cities — Kuala Lumpur, Ipoh, Johor Bahru and Malacca.

It was jointly organised by the National Cancer Council (Makna), the Academy of Family Physicians and the Malaysian Society of Gastroenterology and Hepatology. Also taking part was Abbot Laboratories (M) Sdn Bhd.

Ling Hea Sieng, Abbot’s division manager of pharmaceutical product division, says the campaign was aimed at increasing public awareness on the seriousness of the illness, which can be prevented with early detection.

"People do not realise that stomach cancer can be treated if they seek early treatment. Because of this, the mortality rate is as high as that of cervical cancer."

She says that based on research, chances of stomach cancer patients leaving the hospital alive are lower than these of any other diseases.

In 2000, the discharge rate of stomach cancer was at seven per cent compared to other forms of cancer. The rate was even lower in 2002, at 5.6 per cent. Many stomach cancer patients are diagnosed and treated when the cancer is already at stage three or four, she says.

"Often, the early symptoms of stomach cancer mirror that of heartburn, indigestion or ulcer. They would then take some form of medication to ease the pain.

"As a result, many of the cases had reached the advance stage, spreading to the other parts of the body before it is discovered," says Ling.

According to the National Cancer Registry, the risk of stomach cancer starts to increase after the age of 40. The rate in males was about 1.5 times higher than in females. Chinese had the highest rate, more than four times that of Malays, who had the lowest. Indians rated about three times that of Malays.

However, among Indians, the men had an incidence rate of only 10 per cent more than women.

Gastric cancer can develop in any part of the stomach and may spread throughout the stomach and also to the liver, pancreas and colon. It can also spread to the lungs, the lymph nodes above the collar bone and the ovaries.

Ling says a lack of awareness that stomach cancer can be prevented by simple treatment and diet has lead to the high mortality rate.

One of the major causes of stomach cancer is the infection of helicobacter pylori (H. pylori) bacteria.

"Sixty per cent of stomach cancer cases have been associated with H. pylori infection. The bacteria has been classified as a class one carcinogen."

Class One status is reserved for the most dangerous carcinogens, most likely to be connected with the development of cancer in humans.

H. pylori, which lives in the stomach lining, is found in 20 per cent of people aged 40 and younger, and 50 per cent of those who are 60 or older.

In his study, Professor K.L. Goh from the Gastroenterology & Hepatology Division in Universiti Malaya, says that H. pylori infection causes inflammation of the stomach lining which may result in gastric, ulcers and stomach cancer.

He adds that H. pylori infection is likely to spread from person to person through the mouth, saying that eating practices in some countries may be the reason, such as the use of chopsticks.

Communal eating, the sharing of food from the same bowls and eating with hands may also be factors for spreading H. pylori.

Other risk factors for stomach cancer include consumption of salted, smoked or pickled foods, smoking and family history.

Research shown that stomach cancer is more common in China, Japan, Korea, parts of Eastern Europe, and Latin America because people in these countries eat foods that are preserved by smoking, salting or pickling.

"We believe that Chinese are more prone to stomach cancer because of genetics and food. The Chinese like to eat pickled food. The H. pylori infection is very high in China until today," says Ling.

On the campaign, Ling says it has increased public awareness on stomach cancer, adding that many realised that a simple check could determine if they are infected with H. pylori.

"The best thing to do if you are suffering from stomach pain is to have doctors do a H. pylori test. It is a simple and inexpensive test. And if you are infected, a simple treatment would help get rid of the bacteria."

Research by the Universiti Malaya faculty of medicine has found that H. pylori infection can be successfully eradicated with triple therapy, based on antibiotics plus an acid blocker.

It said that a 90 per cent eradication rate was achieved with a one-week treatment of the triple therapy.

A total sum of RM23,516.30, which was raised during the campaign, was donated to Makna for its cancer education efforts.