Stomach cancer: what are the symptoms that should not be ignored?

It is the fourth leading cause of cancer in men and fifth in women. Each year, approximately 6,500 new stomach cancers are diagnosed in France.

In 2010, stomach cancer took 4420 French; while the 5-year survival rate remains around 25-30%, experts still believe that the rate of death from stomach cancer has halved over the last 30 years *.

What is stomach cancer?

First thing to know: there is not a cancer of the stomach ... but two.

The first (so-called "cardiac cancer" or "proximal cancer") develops at the junction between the esophagus and the stomach."It is linked to gastroesophageal refluxsays Dr. Cindy Neuzillet, a gastroenterologist. The wall of the esophagus is not made to receive acidity: the gastric acid reflux will gradually cause chronic inflammation of the lining of the esophagus (its "inner lining") and this may, in some cases case, turn into cancer."

The risk factors cardiac cancer are:

"It is a cancer that is increasing in France and in Western countries since it is closely related to the increase in frequency of overweight and obesity."

The second cancer of the stomach is the distal cancer - this one rather concerns the stomach in itself. It is associated with food and a bacterium, Helicobacter pylori: frequent in the mucous membrane lining the inside of the stomach, it can cause inflammation that can be complicated by ulcer and cancer.

Again, distal cancer is linked to some risk factors :

• a diet rich in salt and nitrites (note: distal cancer is more common in Asia),
• low consumption of fruits and vegetables,
• smoking,
• distal cancer is more common among Latin populations (South and Central America, Spain, Portugal ...) and in Eastern Europe,
• genetic predisposition (family history of stomach cancer).

"When a person is at risk of developing distal cancer and carrier of Helicobacter pylori, we can eradicate this bacterium by antibiotics in a preventive way, adds Dr. Neuzillet. This cancer is less common since the invention of the refrigerator, which has made obsolete the technique of preserving food in salt!"

Stomach cancer: 6 symptoms that must be taken seriously

"People who have risk factors (especially overweight) and / or have family predispositions (stomach cancer in the family) should remain alert to these symptomssays Dr. Neuzillet immediately. It should also be known that half of stomach cancers develop after age 75."

The main ones symptoms stomach cancer are:

• epigastric pain (at the level of the upper belly),
• acid reflux, especially if they appear after the age of 45,
• a gene for swallowing (especially solid foods: an impression that "it does not pass" or that "something blocks the way"),
• anemia (a decrease in hemoglobin levels) more or less marked ("the tumor may bleed"develops Dr. Neuzillet),
• black stools (like charcoal) and very fragrant,
• a significant weight loss associated with an alteration of the general state (fatigue, loss of appetite ...).

"The earlier the diagnosis of stomach cancer, the better the prognosis. If the cancer is not extensive (ie, if there is no metastases), the treatment is based on surgery: all or part of the stomach is removed, with (most often) chemotherapy before and after the surgery to eradicate the microscopic cells that could lead to recurrence.

If there is already a distant extension of cancer (liver, peritoneum), the surgery is not useful: it will rather treat the disease by chemotherapy, possibly associated with a targeted therapy according to the profile of the tumor."

Thanks to Dr. Cindy Neuzillet, gastroenterologist and digestive oncologist atInstitut Curie et al'Ambroise Paré Hospital.

* National Cancer Institute and High Authority of Health, September 2011.

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