2023-04-16 23:43:44
[헬스코리아뉴스 / 박원진] Gastric cancer is one of the most common cancers in Korea. According to the National Cancer Registry statistics released at the end of last year, gastric cancer ranked 4th (10.8%) in cancer incidence in Korea as of 2020. It is followed by thyroid cancer (11.8%), lung cancer (11.7%), and colorectal cancer (11.2%). Gastric cancer was the undisputed number one cancer in Korea until just a few years ago. About 30,000 new cases occur each year, and the incidence rate per 100,000 population is 10 times that of the United States.
The reason why there are so many gastric cancer patients in Korea is due to Koreans’ unique eating habits and the resulting Helicobacter pylori infection. Korea is the country with the highest number of gastric cancer patients in the world, to the extent that there is a saying that ‘the fact that you are Korean is a high risk group for stomach cancer’. Helicobacter pylori of East Asians, such as Korea, Mongolia, and Japan, has a gene with special toxicity, and the hypothesis that it is because they are exposed to this Helicobacter strain is gaining strength. Here, it is reported that salted foods such as kimchi and fermented soy sauce, which Koreans enjoy, increase the incidence of gastric cancer.
Professor Kim Byung-wook of the Department of Gastroenterology at Incheon St. Mary’s Hospital at the Catholic University of Korea said, “There is no need to be intimidated by the large number of gastric cancer patients in Korea.
Up to 10-fold increase in gastric cancer in case of Helicobacter pylori infection
People infected with Helicobacter pylori have a 2 to 10 times higher risk of developing gastric cancer than people who are not. Infection with Helicobacter pylori progresses to chronic gastritis, atrophic gastritis, intestinal metaplasia (a phenomenon in which gastric cells are replaced by cells of the small intestine or colon), gastric adenoma, and gastric cancer. It usually takes regarding 30 to 40 years to become infected in a teenager and develop gastric cancer, but in some cases, young people progress to gastric cancer quickly. On the other hand, with Helicobacter pylori eradication treatment, the chance of getting stomach cancer drops to less than half.
It is good to have a Helicobacter pylori test together with endoscopy in older people than in young people and in their 40s or older. Helicobacter pylori testing is also recommended for patients suffering from chronic gastritis. In particular, the urea breath test, which checks for Helicobacter pylori infection by blowing your breath, is known to be particularly useful when checking the results following eradication treatment due to its high accuracy.
If Helicobacter pylori infection is confirmed, eradication treatment is essential. For eradication treatment, two or three antibiotics and a gastric acid secretion inhibitor are taken for 1 to 2 weeks. The disinfection success rate is over 90%.
Professor Kim Byung-wook said, “It is estimated that regarding half of the adults in Korea are infected with Helicobacter pylori, but the fortunate thing is that the Helicobacter infection rate is gradually decreasing.” We need a personalized treatment tailored to the patient,” he stressed.
Treatment depends on the stage… Stage 1 removed by endoscopy
Gastric cancer treatment is different for each stage. Surgery is common, but stage 1 gastric cancer that remains only in the gastric mucosa or submucosa is removed with an endoscope. Laparoscopic surgery is performed in the second and third stages when cancer cells have invaded the muscle layer, subserosal layer, or serosal layer, or cancer cells have spread to the gastric lymph nodes, but have not metastasized to other organs. However, to reduce the risk of recurrence, chemotherapy must be combined.
On the other hand, if metastasis has progressed to stage 3b or 4, the efficacy of surgical treatment is very low. Professor Kim Byung-wook said, “The reason gastric cancer is scary is that the response rate to chemotherapy is less than 60% when it has progressed right away.” The risk of dying from stomach cancer increases over time in the stage of the disease,” he warned.
Professor Park Jae-yong of the Department of Gastroenterology at Chung-Ang University Hospital Cancer Center said, “Endoscopic resection has already been established as a standard treatment for early gastric cancer if appropriate indications are met.” I see,” he said. Above all, since the stomach can be preserved, it is explained that it has advantages over gastrectomy in terms of quick return to daily life and quality of life.
Professor Park said, “Because the treatment method may vary depending on the location, depth of invasion, and form of cancer, it is necessary to determine the best treatment method by comprehensively considering the recurrence rate, side effects, complications, and quality of life through sufficient consultation with a specialist. There is,” he said.
However, it is not all over just because the excision was performed through an endoscope. This is because there is a possibility of the occurrence of ‘metachronous gastric cancer (MGC)’, which is newly formed following time passes in other parts of the remaining stomach.
Studies on the occurrence of ‘metachronous gastric cancer’, in which cancer recurs following endoscopic resection in early gastric cancer, report an average recurrence rate of regarding 5 to 15%. For example, as a result of follow-up of 1,302 early gastric cancer patients who recently underwent endoscopic submucosal dissection (ESD) by a research team at a university hospital in Korea, regarding 9% (117 patients) were found to have metachronous gastric cancer (MGC) recurrence. .
For early prevention, a gastroscopy should be performed every 2 years over the age of 40.
In order to prevent stomach cancer, it is necessary to avoid the eating habit of sharing soup or stew with each other and avoid the culture of passing drinks as much as possible. Salted seafood containing a lot of salt, salted foods such as kimchi, and soups and stews increase the possibility of stomach cancer. Fix irregular eating habits and avoid foods that are difficult to digest. The cooking method is to boil rather than fry and boil rather than bake. Enjoy the natural taste and aroma of food without seasoning as much as possible. At night, metabolism slows down, so gastric acid secretion is reduced and food ingested cannot be properly digested. Avoid eating late at night.
Spicy, salty, or greasy irritating foods can chronically irritate the gastric mucosa and cause atrophic gastritis, in which the mucous membrane becomes thin. Burnt food contains carcinogens. When you are stressed, your immunity decreases. The stomach is particularly vulnerable to stress, and stomach cancer is closely related to stress. Stress hinders digestion by blocking the secretion of digestive enzymes and atrophying gastrointestinal motility. It is good to exercise lightly on a regular basis. Preferably every day, at least three times a week, 30 minutes to 1 hour of light walking, etc., is recommended.
Alcohol can cause damage to the gastric mucosa. In particular, drinking alcohol on an empty stomach is fatal to the stomach wall. Smoking is considered the highest risk factor for the development of digestive cancer. Smokers are two to three times more likely to develop gastric cancer than non-smokers.
Above all, early prevention of gastric cancer is important. If you are over the age of 40, it is important to have a gastroscopy every two years. Professor Kim Byung-wook said, “If you have had an adenoma removed or have had an endoscopic surgery for stomach cancer, you should have an endoscopy at least once a year.” After a certain period of time, you should actively inspect once a year.”
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