Stomach cancer remains a serious public health challenge, especially in regions like Colombia where it ranks among the leading causes of cancer-related deaths. Marking International gastric cancer Day on November 28th, experts are highlighting the disease’s often-silent progression and the critical importance of early detection. This report details the latest understanding of risk factors, symptoms, treatment options, and preventative dietary measures, as shared by oncologists and nutritionists at the Clínica Bonnadona. Despite advances in treatment, a concerning 72% mortality rate in Colombia underscores the need for increased awareness and proactive health measures.
Stomach cancer, also known as gastric cancer, remains a significant and often silent threat to public health, ranking as the fourth leading cause of cancer-related deaths in Colombia. Even when detected early, the disease presents a substantial challenge to treatment and survival.
Despite advancements in diagnostic techniques, the lack of noticeable symptoms in its initial stages underscores the urgent need for increased prevention efforts and public education regarding risk factors. This is particularly crucial as early detection is key to improving outcomes.
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According to the Colombian League Against Cancer, stomach cancer is characterized by “uncontrolled growth of cells present in the gastric mucosa, forming tumors that can spread to other parts of the body.” The organization notes that symptoms often don’t appear until the cancer has progressed, making timely detection and treatment difficult.
Alarmingly, the League reports that 67% of people diagnosed with stomach cancer worldwide do not survive the disease. In Colombia, the mortality rate is even higher, with 72% of patients succumbing to the illness. The potential for metastasis, or spread to other organs, is a major factor in its lethality.
Marking International Gastric Cancer Day on November 28th, oncologist Carlos Castro explained that the disease “originates in the epithelium of the gastric tissue and can progress to what we call metastatic extension to other areas.”
Risk Factors
Castro, a graduate of the Institute of Classical Diseases in Lima, Peru, highlighted infection with Helicobacter pylori as the most significant risk factor, particularly when accompanied by atrophic gastritis or intestinal metaplasia. This bacterium can reside in the stomach, causing chronic inflammation (gastritis) or ulcers, and is classified as a Group 1 carcinogen by the World Health Organization.
Other contributing factors include “diet, genetic predisposition, a history of gastrointestinal discomfort, and prior stomach surgery.”
The surgeon explained that a diet high in salt or carcinogenic substances can exacerbate the effects of Helicobacter pylori. “This is where the carcinogenesis—the process by which normal cells transform into cancer cells—begins, leading to mucosal changes, gastritis, chronic gastritis, and ultimately, stomach cancer.”
Castro emphasized that even poorly managed gastritis can eventually develop into gastric cancer. “This isn’t an overnight process, but it illustrates the progression of these conditions.”
Symptoms
In its early stages, stomach cancer often produces mild and nonspecific symptoms that closely resemble those of gastritis or an ulcer, including:
Chronic indigestion or heartburn, unexplained weight loss, loss of appetite, persistent abdominal discomfort or pain, and a feeling of fullness even after eating only a small amount of food.
Treatment
Treatment options depend on the stage of the cancer and may include endoscopic surgery, particularly in T1 stages. “For T2 stages, gastric surgery with a D1 resection—removal of surrounding lymph nodes—is typically performed. For advanced disease, medical treatment, including chemotherapy, is often used before surgery.”
Diagnostic laparoscopy plays a crucial role in determining which patients are suitable for immediate surgery and which may benefit from chemotherapy beforehand.
“With the technology we have today, we can better classify patients, identifying those who can undergo curative surgery and those who require neoadjuvant therapy,” Castro stated. He emphasized that treating this disease requires a multidisciplinary team, including a surgeon, a clinical oncologist, a radiation therapist, and a nutritionist.
“There are essentially two types of surgery: a subtotal gastrectomy, where not the entire stomach is removed, and a total gastrectomy, followed by intestinal reconstruction. Patients will experience nutritional consequences, but our nutritionist provides appropriate nutritional support to minimize long-term effects.”
Dietary Recommendations for Gastric Cancer Patients
Clinical nutritionist Sandra Rambal believes that cancer patients “should eat from all food groups in general.”
“No food groups are typically prohibited, only individualized based on intolerances. Some gastric cancer patients, for example, cannot tolerate dairy. In these cases, consumption is reduced, switched to lactose-free options, or the food is eliminated.”
She added that many patients “can tolerate all food groups and can continue to eat normally. It’s not necessary to prohibit or remove any foods, as it has been shown that restricting diets or failing to provide adequate education can lead to malnutrition.”
Rambal explained that patients with comorbidities like diabetes or kidney problems require a different approach.
“In the case of diabetes, patients should consume fewer simple carbohydrates. For patients with kidney disease, the specialist provides individualized nutritional intervention based on the stage of their illness and their specific nutritional needs.”
The nutritionist emphasized that a healthy diet is the best recommendation not only for those diagnosed with the disease but also for prevention.
“A healthy diet means eating as naturally as possible, consuming foods readily available in our region—rice, potatoes, yuca, chicken, pork, and fish—and avoiding ultra-processed foods. Combined with regular physical activity, such as walking for 30 minutes three times a week, or strength training, the risk of cancer is significantly reduced.”
Countries with the Highest Incidence
The highest rates of stomach cancer incidence are found in Northeast Asia, South and Central America, and Eastern Europe. Japan and Korea have the highest rates of diagnosis in men.
In China, this disease is a leading cause of cancer-related mortality.
