Dr. Shria Kumar, Assistant Professor of Medicine at the University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center, explains how Helicobacter pylori (H. pylori) infection contributes to stomach cancer risk, particularly among Asian, Hispanic, Black, and Native American populations. Learn more about Dr. Shria Kumar here.
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Transcript
Lisa Hatfield:
Dr. Kumar, your research focuses on H. pylori, a stomach bacteria that can lead to stomach cancer. This infection can be prevented and cured with antibiotics, but infection rates vary by ethnic group. Which patients from high-risk backgrounds should ask their doctors about getting tested and treated for H. pylori?
Dr. Shria Kumar:
Absolutely. So, we know that H. pylori is the leading causative agent in the development of stomach cancer. And while the absolute risk of developing stomach cancer is low, the evidence that getting rid of H. pylori in someone who has it reduces stomach cancer is overwhelming.
We do know that certain groups of people are more likely to have H. pylori and develop stomach cancer. In the U.S., that includes Asian Americans, particularly people from East Asian countries; persons who are Hispanic or Latino; African Americans; immigrants from certain countries, such as East Asia, places like Korea, Japan, China; certain countries in Latin America or Eastern Europe; and native populations, such as Alaska Natives or Native Americans.
At present, there are actually no guidelines on stomach cancer prevention. So prevention and early detection are individualized. They’re based on a patient’s demographics, medical history, family history, and symptoms, if there are any. So making sure to communicate these factors is very helpful for your medical team. Make sure your doctor knows your social history, where you were born, where you lived, what your family history is. All of these things are crucial to make sure that preventative care is targeted for your personal risk.
Lisa Hatfield:
And for a patient getting tested, what does that test look like, and then what would treatment look like if they do test positive?
Dr. Shria Kumar:
Absolutely. So, testing can take one of three forms. Unfortunately, there’s not a blood-based test available that tests for active infection. Blood-based tests only check for any prior exposure. So what we really need to do is either a breath test, a stool test, or an endoscopy with biopsy.
A breath test is where someone takes a radiolabeled pill and they blow into a balloon, and that balloon—the breath contained in that balloon—is measured to detect any H. pylori. A stool test requires a stool sample drop-off. Or for certain people, an endoscopy with biopsies can detect those H. pylori organisms.
If someone has H. pylori, treatment is required. It contains multiple drugs and multiple antibiotics, and can be anywhere from 1 to 2 weeks of treatment. It can be difficult to take, but it’s very effective, and the way we know that the treatment works is that we test for eradication. So, 4 to 6 weeks after treatment is completed, we actually repeat one of those three tests again—stool test, breath test, or endoscopy, to make sure that the bacterium is gone.
Lisa Hatfield:
Dr. Kumar, since some stomach cancer risk factors can be changed, like treating H. pylori, improving diet, or reducing certain exposures, how can patients use this knowledge to take action and have more meaningful prevention conversations with their doctors? And how do you encourage your patients to be proactive about these changes?
Dr. Shria Kumar:
I think that’s really important. Having meaningful prevention conversations are important. It helps patients go from a passive role to being their own proactive advocate. I would really encourage patients to bring up risk factors, even if your doctor doesn’t. Tell them about your family history, about any GI symptoms, things like smoking, where you’re from, where you were born. And I would just encourage patients to ask the question directly: What is my risk of stomach cancer, and what can I do to reduce my risk?
Lisa Hatfield:
And if you had some suggestions, like under improving diet, can you give like two or three tips for people watching this?
Dr. Shria Kumar:
We know that there are certain modifiable risk factors, things like smoking and H. pylori are the two most common. So certainly minimizing any exposure to smoking is important. While there were some certain ways of cooking in the past that were associated with dietary risk factors, what we now know is just eating a balanced, healthy diet is the best thing that you can do for all GI cancers, but also including stomach cancer risk.