A study by UKZN academics has indicated a significant prevalence of gastric cancer (GC) among Indians - mainly men - in Durban.
The study – published in the South African Medical Journal - was titled: “The Spectrum of Gastric Cancer as Seen in a Large Quaternary Hospital in KwaZulu-Natal, South Africa”.
The authors said a lack of good-quality data made it difficult to understand the burden of oncological disease in South Africa.
GC is the fifth most common visceral malignancy in the world, and the third highest cause of cancer-related death. However, there are major deficiencies in the registry and cancer data is reported poorly nationwide.
The retrospective study was conducted using a patient database at the Inkosi Albert Luthuli Central Hospital (IALCH) in Durban between 2009 and 2014, during which time 131 patients were referred for treatment. Of these, 63 were Indian, 59 African, seven White and two mixed race. Fifty-five percent were male while the average age of all the patients was 60.
The authors found that the most common locations of gastric cancer were the body and distal parts of the stomach (antrum and pylorus). Thirteen percent of the patients had a family history of GC.
According to the World Health Organization, GC is more common in males than females, and relatively common in Asian countries such as Japan and Korea, while it is rare in southern African countries. More than half of the total cases of GC are diagnosed in East Asia each year.
Studies suggest that people who eat a diet high in smoked, salted, or pickled foods may be at an increased risk for stomach cancer. Nitrates and nitrites are nitrogen-based chemicals added to certain foods, especially cured meats such as ham, bacon, hot dogs, and deli meats. Both nitrates and nitrites combine with other nitrogen-containing substances in the stomach to form cancer-causing agents known to develop into stomach cancer.
Symptoms, which usually indicate the disease being advanced, include abdominal discomfort or pain, blood in stools, bloating (especially after eating), diarrhoea or constipation, fatigue, gastrointestinal bleeding, indigestion or heartburn, loss of appetite, nausea and vomiting, and weight loss.
In general, treatment for stomach cancer depends on the size and location of the tumour as well as the stage of the disease and the individual’s age and overall health. High risk patients are those who consume alcohol and who smoke cigarettes. Treatment for early-stage cancer is aimed at curing the disease whilst with advanced stage cancer, a cure is unlikely and the goal is to reduce pain and restore some quality of life. Surgical removal is the only curative treatment whilst chemotherapy and radiation therapy may be used in addition to surgery or as palliative treatment.
UKZN’s Dr Emil Loots, a renowned Gastroenterologist in Durban and a co-author of the study, said the following about the findings: ‘Gastric cancer is often present in advanced stages because of non-specific symptoms and few clinical signs. It is imperative, especially among high risk groups, such as Indian male patients, to seek healthcare for abdominal symptoms. A timeous assessment with gastroscopy may detect gastric cancer in the early stages and may be lifesaving. The study also indicates the need to establish cancer registries and centralised management in order to promote innovative research to fight the disease.’ MaryAnn Francis