Cancer is the uncontrollable growth of cells in the body. This growth can occur in different bodily organs, but the stomach is a prevalent location. According to statistics by the WHO, around 1.1 million people were newly diagnosed with stomach cancer in 2020, leading to an estimated 770,000 deaths globally that year.1 Despite such high rates of mortality, there has been a significant decline in the number of people with stomach cancer, nevertheless, it remains a global health problem as the fifth leading cancer and the fourth most common cause of cancer-related deaths worldwide.2 Several factors can contribute to stomach cancer, smoking being a major and preventable one. Thus, this article will discuss the relationship between stomach cancer and smoking in detail, while highlighting the importance of preventing excessive alcohol consumption or abstaining entirely.
The stomach is an organ usually located in the upper left side of the tummy, which is primarily involved in food digestion. There are several types of stomach cancer depending on the type of cell the cancer originates from.3 Let's delve a bit further into the types of stomach cancer:
Several reasons contribute to stomach cancer such as:
Across the globe, tobacco use affects close to 1.25 billion adults—meaning about one in every five people uses cigarettes —making it one of the most widespread and preventable health risks today. Cigarette smoke consists of more than 5000 chemicals, of which most can have detrimental effects on health. 70 of these chemicals are carcinogenic and thus increase the chances of developing cancer.5,6 Upon entering our body, there are several ways that this can happen.
Our body cells consist of DNA that acts like a biological blueprint, providing the instructions our body follows to grow, function, and stay healthy. Some chemicals in cigarette smoke can damage this DNA. Long-term smoking can cause repeated damage to the DNA, thus disturbing its function and leading to cancer development. These chemicals can also prevent the repair of damaged DNA, thereby increasing the chances of cancer development.
The immune system is built as a protective mechanism of our body. Research suggests that tobacco smoke promotes a suppressive effect on the immune system, thereby increasing the risk of cancer development (tumour microenvironment). In addition, these chemicals in tobacco smoke can cause inflammation that results in DNA damage, thus contributing to cancer formation.
Passive smoking is when an individual is exposed to smoke despite not actively being involved in the act of smoking. When exposed to smoke, these individuals will be exposed to the same carcinogenic substances, thus heightening the risk of developing cancer.
There is no such thing as a safe amount of smoking to prevent stomach or any other type of cancer. Maybe you are a light, an occasional or a social smoker. However, none of this matters when it comes to its contribution to cancer, as any amount of smoking will increase one’s chances of cancer formation in comparison to those who do not smoke. It is always best to abstain from smoking if possible to prevent the development of stomach cancer due to smoking.
Symptoms of stomach cancer always overlap or sound similar to other conditions, especially a stomach bug (virus) or stomach ulcer. All cancers usually have some common symptoms, which include:
The following are some early presentation symptoms of stomach cancer:
Other symptoms that relate to stomach cancer:
Based only on initial clinical suspicion, basic tests such as blood tests and a physical examination will usually be carried out at primary care. Depending on the findings and the strength of the clinical suspicion, referral will be made to visit a specialist (gastroenterologist or upper GI surgeon), where further investigations such as gastroscopy/ endoscopy will be carried out. A gastroscopy/ endoscopy helps to look at the food pipe, stomach and intestine up close with the help of a long flexible tube with a camera and light attached to its end. During this process, doctors extract samples of tissue they suspect, known as a biopsy, and send them to the lab for confirmation. Additional tests such as CT scans, Endoscopic ultrasound (EUS) or laparoscopy can be suggested concerning the diagnosis of stomach cancer.7
Treatment involves a team of specialists or an MDT (multi-disciplinary team) that handles various aspects of stomach cancer.7,10 MDT team consist of:
Treatment decisions will also be based on the cancer's type, grade, and spread. Treatment will range from surgery, chemotherapy, targeted or immunotherapy cancer drugs, radiotherapy and lifestyle modifications ( eating healthy, exercising).
There are support groups available for individuals with stomach cancer, such as:
Let's build a healthy lifestyle by putting an end to smoking. Stopping smoking can help you and everyone around you (passive smoking).9 Nicotine in tobacco is primarily responsible for smoking becoming addictive. Here are some ways in which we can achieve this:
Stomach cancer globally affects over a million people, with smoking being one of the most significant contributors. Cigarette smoke is made up of many chemicals, approximately 5000 of which 70 are harmful carcinogens. These carcinogens damage DNA and suppress the body's immune system. The patient can be affected with indigestion, weight loss, loss of appetite, black stools, swallowing difficulties, nausea and vomiting that often mimic benign conditions, making early detection crucial. Initial diagnosis typically involves blood tests and physical examinations, with further advanced confirmatory tests based upon the results of the basic investigations and strength of the clinical suspicion, namely endoscopy with/without biopsy and scans. Treatment can either entail surgery, chemotherapy or radiotherapy, depending on the type and stage of the cancer, with the involvement of an MDT team. Quitting smoking is the most effective way to lower the cancer risk, which can be achieved with the help of support groups, certain prescribed stop smoking medications and the NHS Quit Smoking app. Protecting yourself and others from tobacco smoke is a vital step toward a healthier future.
