Stomach cancer claims many Vietnamese lives due to late detection

"If the disease is detected at an early stage, doctors can completely treat the lesion through endoscopy, without having to perform gastric surgery, and the chance of recovery is high," said Dr. Nguyen Duc Thong, Head of the Endoscopy Department, Nguyen Trai Hospital, at the international conference on endoscopic intervention for early gastrointestinal cancer treatment, on October 16.

According to statistics from the Global Cancer Organization - GLOBOCAN, stomach cancer ranks 5th in Vietnam in terms of new cases (more than 16,200 cases), and 3rd in terms of deaths (more than 13,200 cases). Most patients come to the hospital at a late stage, missing the opportunity for treatment during the golden period. There are patients who are diagnosed with the disease at a stage too late for surgery.

According to Dr. Thong, in the early stages, patients are treated with endoscopic submucosal dissection (ESD) technique, treating gastrointestinal lesions through endoscopy, preserving the entire stomach, avoiding the risk of surgical complications, with a high chance of recovery, early discharge from the hospital and less costly.

Dr. Kinoshita Koshi, Head of the Department of Gastroenterology and Endoscopy, Kyoto Miniren Central Hospital (Japan) said that ESD is widely applied in this country, thanks to the fact that most patients are detected early through screening. Previously, people from 40 years old had a contrast X-ray of the stomach followed by an annual endoscopy. Recently, the number of stomach cancer cases in Japan has gradually decreased due to the decrease in HP infection rate, and the screening program is performed in people over 50 years old every 2-3 years.

Dr. Nguyen Thi Thanh Nga, Deputy Director of Nguyen Trai Hospital, said that early detection of stomach cancer can increase the 5-year survival rate to 80-90%. At a later stage, when the lesion has spread, the survival rate is only 10-15%. Therefore, the hospital has equipped itself with new techniques and continuously trained human resources to help increase the chance of early detection and cure for patients.

However, the biggest obstacle at present is that Vietnam does not have a national screening program, most early stage patients are detected through opportunistic screening. That is, patients come to the clinic for other diseases, other symptoms, and the disease is discovered by chance.

This has led to the ESD technique for early-stage cancer patients being deployed at the hospital since 2020, but so far only a few cases have been performed. This is also the common situation at some hospitals in Ho Chi Minh City. Not to mention, if the endoscopist does not perform all the steps, he may miss the lesions and not recognize abnormalities in the early stages of the digestive tract.

Early stage stomach cancer has no obvious symptoms and is often confused with common digestive disorders. Some risk factors for stomach cancer are HP infection, salty diet, and consumption of foods containing high levels of nitrosamines such as pickles, fermented foods, salted fish, etc.

Doctors recommend that everyone should have a screening endoscopy from the age of 40, then depending on the risk group, there will be appropriate follow-up. High-risk groups such as those with a family history of gastrointestinal cancer should have a screening endoscopy before the age of 40.

In cases of HP infection that have been cured, close monitoring is required afterwards, because some people develop atrophic gastritis, with the risk of developing cancer. When there are unusual signs, it is necessary to go to the hospital for examination, do not arbitrarily treat with folk methods or drugs of unknown origin.