Could It Be Stomach Cancer?

WebMD Live Events Transcript

John S. Macdonald, MD, from the St. Vincent's Comprehensive Cancer Center, joined us on April 13, 2005 to discuss stomach cancer: the risk factors, the symptoms, and the latest emerging treatments.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

This event is made possible by an educational grant from Aventis Pharmaceuticals, a member of the sanofi-aventis Group.

MODERATOR:
Welcome to WebMD Live, Dr. Macdonald. Thank you for joining us today. Who is the typical gastric
cancer patient? Who is most likely to be affected?

MACDONALD:
If you look in the United States, the average or median age for gastric cancer is about 65. People tend to be older. Of course, the demographics of the US population show we are getting older. The typical patient has not had previous disease in the stomach and there's no major association with the causation of gastric cancer and habits such as smoking, drinking alcohol; it does not seem to be typical with gastric cancer. However, people who have gastric cancer frequently have a history of a low grade infection in the stomach that can cause gastritis. This infection is caused by a particular bacterium called H. pylori.

MEMBER QUESTION:
Are there lifestyle choices that increase risk of stomach cancer?

MACDONALD:
In general, there are not. Stomach cancer appears to be more common in people in this country who are recent immigrants, who may have grown up in countries where they did not eat as much fresh food as in the United States. In the past, when gastric cancer was substantially more common in the U.S. before 1930, it was associated with the consumption of preserved foods like salted meats.

"One of the things that has always interested doctors studying stomach cancer is: why did the incidence of this disease decrease over the last 50, 60, 70 years? It appears the major reason has been related to less use of preserved foods and more use of frozen and fresh foods in the United States."

MEMBER QUESTION:
Doesn't the bacteria you mentioned, H. pylori, cause ulcers?

MACDONALD:
Now that's a good question. H. pylori is associated with ulcers also. There are some patients with ulcers who can be shown to have H. pylori as causation and when it is associated with the cause of gastric cancer the reason is the H. pylori contributes to a chronic gastritis or inflammation of the stomach.

MEMBER QUESTION:
So do people with ulcers have to be more concerned about developing stomach cancer?

MACDONALD:
Interestingly enough people with ulcers of the stomach don't seem to have a particular increase of stomach cancer. Sometimes there is confusion because cancers of the stomach can ulcerate but it's not that a stomach ulcer, a benign one, has transformed into a stomach cancer.

MEMBER QUESTION:
But what about gastritis? Is that a precursor to stomach cancer?

MACDONALD:
What is called chronic gastritis -- when there's inflammation in the stomach over many years and also with the presence of the H. pylori and the absence of acid in the stomach -- those kinds of patients have a higher incidence of stomach cancer.

MEMBER QUESTION:
How common is stomach cancer?

MACDONALD:
That's a very good question. If you look at 1900, stomach cancer was the most common cause of cancer death in the U.S. Now it is about the eighth most common, with about 25,000 new cases occur each year. In the world, about 800,000 cases occur each year. So it's very common around the world; less common in the U.S. One of the things that has always interested doctors studying stomach cancer is: why did the incidence of this disease decrease over the last 50, 60, 70 years? It appears the major reason has been related to less use of preserved foods and more use of frozen and fresh foods in the United States.

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