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He lost 13kg in a few months and found he had stomach cancer, but early treatment saved him.
Early detection is important
When civil servant Frankie Wong started to lose his appetite in mid-2008, he did not think anything was amiss at first. He did not even realise he had lost 13kg over a few months until friends commented that his stomach had “disappeared”. The 59-year-old, who went from a hefty 90kg to 77kg, used to have a big appetite and frequently had snacks such as instant noodles even after dinner. But from mid-2008, he could skip all his meals and not feel hungry.
When he couldn't stop belching, he went to a polyclinic to seek a doctor’s opinion. He was referred to a hospital for further checks. A stomach scope examination at the end of 2008 confirmed that he had early stage stomach cancer. Shocked, he kept his sickness from his three adult children and told only his wife.
“The doctor said I had to cut off half the stomach but the cancer could still grow again,” he said. Hesitant about such an operation, he asked for an alternative treatment and was recommended endoscopic submucosal dissection, a relatively new procedure here at that time. This involves inserting – through the mouth into the stomach – a long tube with a camera and various special mini-knives attached.
The knives are then manipulated to cut away the cancerous superficial layer within the stomach. Mr Wong preferred this procedure to having half his stomach removed in surgery. He would also not have to make major changes to his diet and lifestyle. In December 2008, he went though two rounds of the procedure to clear out the cancer cells. There was little pain and he could go home within days of the operation.
Often a silent killer
He is now in remission but he still needs to go for follow-ups. Because of the early treatment, his cure rate is almost 100 per cent. Looking back today, the grandfather of three said he was relieved that his condition was discovered early. Stomach cancer, also known as gastric cancer, is often a silent killer as most sufferers are diagnosed with it only at an advanced stage.
Mr Wong, who was a smoker and who had chronic gastritis for three decades, was actually at high risk for stomach cancer. He also paid little attention to his diet and to his weight. After his cancer scare, he quit smoking and has cut down on acidic and spicy food like lime juice and lontong which could aggravate the stomach lining.Otherwise, his diet remains largely unchanged and he is not on any medication.
The clerk is now back to his normal work routine and he tries to spend more time with his family. He urges those at risk to go for regular screening. “People should take note when there are changes in their appetite or if they lose weight. When there’s pain, it’s too late,” said Mr Wong.
Symptoms of stomach cancer
Stomach or gastric cancer has few or no symptoms in its earlier stages. Because of this, most patients are diagnosed in the later stages. Many patients are also reluctant to take the endoscopy diagnostic test for stomach cancer, said Associate Professor Jimmy So, a senior consultant in surgical oncology at the National University Cancer Institute. Symptoms that may signal stomach cancer include appetite loss, unexplained weight loss and chronic abdominal pain.
While the exact causes are not known, risk factors include a diet high in salt and preservatives, a lack of vitamin C and a family history of stomach cancer, said Prof So. Those infected with Helicobacter pylori, a bacterium associated with gastritis and gastric ulcers, are also at risk, he added. Upon diagnosis, the treatment varies, depending on the condition of the patient. Early stage cancer patients can undergo endoscopic procedures, where a tube is inserted into the stomach via the mouth. With the help of a camera and special endoscopic knives attached to the tube, the surgeon can cut out the affected layer, leaving the stomach wall intact.
The stomach is preserved and recovery is faster with no loss of normal stomach functions, said Dr Ang Tiing Leong, a consultant gastroenterologist at Changi General Hospital. Not everyone is a suitable candidate for this procedure, though, he added. Only those who have pre-cancerous lesions or early cancer that has not spread beyond the inner stomach lining are suitable candidates. Those in the later stages of the cancer have to rely on surgery to remove part or all of the stomach, as well as chemotherapy or radiation.
Doctors estimate there is more than an 80 per cent survival rate when the disease is treated in stage one but this is whittled down to about 10 per cent in stage four. So early detection is important. In Singapore, more than 600 people are diagnosed with stomach cancer every year, and about 400 die from it. Stomach cancer is the fifith most common cancer among men and the seventh most common cancer among women here. |