Can Stomach Cancer Risk Be Reduced by Treatment and Lifestyle Changes?

Lisa Hatfield:

So you mentioned there is a treatment for H. pylori, does that significantly reduce the risk of gastric cancer then, if that’s treated?

Dr. Joo Ha Hwang:

Yes. It really depends on when you catch it. So if you catch H. pylori before it’s done, its damage to the stomach, it essentially brings your risk of gastric cancer back down to the baseline population, which is very, very low. If you catch H. pylori infection after it’s caused problems, you still decrease the risk, you kind of flatten the curve but you’re still at increased risk, if the damage to the stomach has already been done and you’ve already progressed onto intestinal metaplasia.

Lisa Hatfield:

Dr. Hwang, how do diet and lifestyle contribute to the incidence of gastric cancer in Asian and Latinx populations?

Dr. Joo Ha Hwang:

The main reason the diet affects, the risk of gastric cancer, is the salt content, to the best, that we know, and so we know that high salt content, for some reason increases your risk of gastric cancer, we think that maybe salts, somehow interacts with the mucosal barrier in the stomach and allows for H. pylori to become more invasive, we don’t know the specific mechanism for that but there was a recent study that came out of England that showed that if you added salt to your diet on a regular basis, that you increased your risk of developing gastric cancer by about 40 percent. Now, to put that into context, compared to the baseline population, if you have H. pylori infection, you increase your risk of developing gastric cancer by 2 to 300 percent.

And if you come from Korea or Japan, your risk of developing gastric cancer is probably somewhere between 8 to 1200 percent higher than the baseline population. So a 40 percent increase because of diet alone is a modest increase, compared to H. pylori infection and to some degree, your ethnicity. So that’s really both diet and lifestyle. There’s some data also that suggests, processed meats also increase your risk of gastric cancer, it’s always hard to study diet and its role in developing any type of cancer, because getting that data, specific enough is very difficult, but it makes a lot of sense since your stomach is basically the first thing that that food sees and we know that food can be somewhat toxic. On the flip side, things that we know to be healthy are the common sense stuff like fresh fruits, fresh vegetables.

We know that that is somewhat protective. And so how I counsel my patients and my activation code for this would be that for anybody, not just, if you’re Asian or Latinx, talk to your physician about a healthy diet, because what I basically talk to my patients about is I counsel them on minimizing salt intake increasing fiber, higher intake of fresh fruits and vegetables, a well-balanced diet. I don’t think you need to go to an extreme, there are no supplements that you need to take that will protect you from developing gastric cancer, probiotics really aren’t of benefit either. So in terms of diet and lifestyle, I think that those are just the main take-home points.