Tag Archive for: East Asia

What Key Ways Is Early Detection of Stomach Cancer Delayed?

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What Key Ways Is Early Detection of Stomach Cancer Delayed? from Patient Empowerment Network on Vimeo.

How is early detection of gastric cancer commonly delayed? Expert Dr. Joo Ha Hwang from Stanford Medicine discusses symptoms that patients may experience, whether some patients may be asymptomatic, risk factors, and proactive patient advice for early detection.

[ACT]IVATION Tip

“…each person should know what their risk for gastric cancer is, and we know the main risk factors are your ethnicity, especially your immigrant status. So if you’re a recent immigrant from a high incidence area, then you’re at risk. And then number two, have you had H. pylori infection? Again, if you’re a recent immigrant from an area that’s endemic with H. pylori, you should get tested for H. pylori. And number three, talk with your physician about your risk factors and determine whether or not you weren’t having endoscopic screening or surveillance, especially if you have any symptoms whatsoever.”

 

See More from [ACT]IVATED Gastric Cancer

Related Resources:

What Is the Role of Biomarker Testing in Stomach Cancer?

 What Are the GAPS Study Key Findings About Gastric Precancer?

 How Can Public Policy Measures Reduce Gastric Cancer in High-Risk Populations?

Transcript:

Lisa Hatfield:

Dr. Hwang, what are the key challenges in the early detection of gastric cancer, and how is your research addressing these challenges?

Dr. Joo Ha Hwang:

Well, the key challenge in detecting early gastric cancer is that there are no symptoms, or the symptoms are very generalized. You can have some vague abdominal pain, your appetite might change a little bit, but we don’t see symptoms until the later stages of gastric cancer when it’s no longer curable. So the real key challenge is to diagnose it at an early stage when it’s still curable and what we’re doing in terms of our research, and then the research community in general, is one, trying to identify patients who are at particularly high risk for developing gastric cancer.

And we have a pretty good idea on who that is. And it’s essentially recent immigrants from high-risk areas such as East Asia, Eastern Europe, Western, South America. There are populations where we know there’s a high incidence of gastric cancer. And in many of these locations, they do endoscopy for early gastric cancer. And so the key really is to identify who is at higher risk for developing gastric cancer and then having them undergo endoscopic screening to further determine what their risk factor is to develop gastric cancer. And then those who are at extremely high risk, they should be on what we call a surveillance program for that.

Lisa Hatfield:

Do you have an activation tip for people for that particular question?

Dr. Joo Ha Hwang:

Yeah. I would say a couple activation tips. I know we’re trying to stick to just a few key ones, but number one would be know your risk for gastric cancer. So each patient, each person should know what their risk for gastric cancer is, and we know the main risk factors are your ethnicity, especially your immigrant status. So if you’re a recent immigrant from a high incidence area, then you’re at risk. And then number two, have you had H. pylori infection?

Again, if you’re a recent immigrant from an area that’s endemic with H. pylori, you should get tested for H. pylori. And number three, talk with your physician about your risk factors and determine whether or not you weren’t having endoscopic screening or surveillance, especially if you have any symptoms whatsoever.

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Addressing Elevated Gastric Cancer Risks in Asian and Hispanic Communities

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Addressing Elevated Gastric Cancer Risks in Asian and Hispanic Communities from Patient Empowerment Network on Vimeo.

 How can higher gastric cancer risks for Asian and Hispanic populations be overcome? Expert Dr. Jun Gong from Cedar-Sinai Medical Center discusses H. pylori risk and screening and advice to patients to be proactive in their care.

[ACT]IVATION Tip

“…for the risk factors that are specific to the Asian and Hispanic populations is to understand the symptoms of H. pylori, which is one of the most common causes of stomach cancer, because they can be very effectively treated with antibiotics over a period of two weeks, oftentimes, and they’re very effective. This can be done at multiple provider levels from the primary care setting to the subspecialist setting. And also to know that symptoms, if they occur in family members that reside with the patient that is infected with h pylori or has stomach cancer, for them to be tested and the importance for their treatment as well.”

Download Resource Guide | Descargar guía de recursos

See More from [ACT]IVATED Gastric Cancer

Related Resources:

How Does Gastric Cancer Screening Differ for High-Risk Groups?

 What Gastric Cancer Challenges Do Asian and Hispanic Groups Face?

 How Can Gastric Cancer Patients in Rural Areas Access Specialists?

Transcript:

Lisa:

Dr. Gong, what can be done on an individual and systemic level to address the elevated risk for gastric cancer in the Asian and Hispanic populations?

Dr. Jun Gong:

To address the elevated risks for gastric cancer in Asian and Hispanic populations, I think it’s very important to understand what are probably some of the universal risks to both groups. And here, there’s been growing evidence that H. pylori infection affects both Asians and Hispanics and is one of the more pivotal risk factors to address on a systematic level. Here, there have been ongoing research where they’re just identifying H. pylori as a procedure and eradicating it with treatment.

This is usually with antibiotic containing treatment for about two weeks. And this imposes what we call a primary prevention method if we can actually eradicate one of the primary causes of stomach cancer. Is this the best way to address the greatest risk factor on a systematic level for Asians and Hispanics and other ethnic groups at high risk? On an individual level, I think again, this comes to tailoring what the diagnosis is with the respect of ethnicity of the patient and their cultural and their background as well as their familial background. Here, H. pylori, dietary lifestyle, hereditary causes are important to address, to minimize risk for stomach cancer.

And it’s also important to know that on the individual level, that family members that are living with patients with stomach cancer may also have what we call H. pylori incidence around the entire family. So it’s important to advise that sometimes your family members, because of the close living facilities and the shared utilities and restroom and how we dine together, that this shares a familial risk. And oftentimes it may need to be that your family needs to be treated if H. pylori is detected within the family as well.

Lisa:

So if a patient comes in and their family members are concerned, would it be advised that maybe their family members can go see their primary care provider and say, “Hey, my family member has gastric cancer. Will you test me for H. pylori? Is that…would that be a valuable question to ask?

Dr. Jun Gong:

So I think that raises the big question about should we systematically test all high-risk subgroups for H. pylori? And I think the jury is still out on that. There has to be formalized guidelines. What I recommend is family members who are with another family member that’s diagnosed with H. pylori and/or stomach cancer, if they are having any concerning symptoms of H. pylori infection, this is usually abdominal discomfort. It can actually be gastritis type symptoms of acid reflux. If you have any of those symptoms, then those are certainly indications for you to be tested either at the primary care level for H. pylori.

My activation tip for the risk factors that are specific to the Asian and Hispanic populations is to understand the symptoms of H. pylori, which is one of the most common causes of stomach cancer, because they can be very effectively treated with antibiotics over a period of two weeks, oftentimes, and they’re very effective. This can be done at multiple provider levels from the primary care setting to the subspecialist setting. And also to know that symptoms, if they occur in family members that reside with the patient that is infected with h pylori or has stomach cancer, for them to be tested and the importance for their treatment as well.

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How Does Gastric Cancer Screening Differ for High-Risk Groups?

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How Does Gastric Cancer Screening Differ for High-Risk Groups? from Patient Empowerment Network on Vimeo.

 Is gastric cancer screening different for some high-risk groups? Expert Dr. Jun Gong from Cedar-Sinai Medical Center shares how screening guidelines are evolving for some high-risk patient groups and advice to patients to ensure essential screening occurs.

[ACT]IVATION Tip

“…understanding whether you are in a specific high-risk subgroup it’s important to ask, whether diet and lifestyle can contribute to these risk factors are important to ask, and whether there is a risk of familial or hereditary causes of stomach cancer is important to ask as well. For us as oncologists to guide you to our supportive services and down the right path to address all of these concerns.”

Download Resource Guide | Descargar guía de recursos

See More from [ACT]IVATED Gastric Cancer

Related Resources:

Addressing Elevated Gastric Cancer Risks in Asian and Hispanic Communities

 What Gastric Cancer Challenges Do Asian and Hispanic Groups Face?

 How Can Gastric Cancer Patients in Rural Areas Access Specialists?

Transcript:

Lisa:

Are there any screening tests that are recommended for anyone who might be in a group that’s known to have a higher incidence of gastric cancer?

Dr. Jun Gong:

Screening for stomach cancer in the U.S. is very evolving. It’s somewhat controversial. Unlike in East Asia and parts of the world where they’ve actually implemented standard endoscopic screening protocols as young as 40 or age 50. Here in the U.S., there hasn’t been any formal screening guidelines implemented for stomach cancer.

However, a lot of consensus groups recognize the high-risk subgroups of stomach cancer and in these risk factor, high-risk factor groups, especially if you have a family member a first-degree family member with stomach cancer or you’re a part of one of these ethnic groups that are at high risk, they do encourage screening to be discussed with your provider. And this can entail endoscopy surveillance as well.

So my activation tip regarding risk factors is to always inquire whether from your provider or from ancillary staff.  It’s very common for us to refer our patients as well to cancer nutritionists, dieticians as well, in addition to going over what may be some possible familial or hereditary risk, if we sense that a strong family history is present.

And this is where referrals to genetic counselors are available. But understanding whether you are in a specific high-risk subgroup it’s important to ask, whether diet and lifestyle can contribute to these risk factors are important to ask, and whether there is a risk of familial or hereditary causes of stomach cancer is important to ask as well. For us as oncologists to guide you to our supportive services and down the right path to address all of these concerns.

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Do Gastric Cancer Risk Factors Differ Among Hispanic Communities?

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Do Gastric Cancer Risk Factors Differ Among Hispanic Communities? from Patient Empowerment Network on Vimeo.

Are there gastric cancer risk factors that differ for Hispanic communities? Expert Dr. Jun Gong from Cedar-Sinai Medical Center discusses risk factors for Hispanic and other higher risk stomach cancer groups.

Download Resource Guide | Descargar guía de recursos

See More from [ACT]IVATED Gastric Cancer

Related Resources:

What Early Phase Gastric Cancer Trials Are Showing Promise?

 Expert Guidance: Stomach Cancer Basics for Newly Diagnosed Patients

 How Is Gastric Cancer Screening and Care Impacted by Culture?

Transcript:

Lisa:

Are there any specific risk factors for gastric cancer that are more prevalent in Hispanic communities compared to other ethnic groups?

Dr. Jun Gong:

So this is an interesting question in terms of risk factors and certain ethnic groups. We’ve realized that actually gastric cancer is highly prevalent in East Asia. And there, the risk factors seem to be more diet-related. But then when you look on the Western side of the world, it’s different risk factors that exist for stomach cancer. You always have familial risk. These are genetic, ancestral, or hereditary causes of stomach cancer, which are fairly rare. And this is independent of geography.

But here on the West, we tend to see more of risk factors related to the Western lifestyle. Here, gastritis or chronic gastritis, heartburn, longstanding inflammation is a risk factor. Heavy smoking, heavy alcohol use, and obesity are emerging risk factors for stomach cancer as well. And also, we have a very unique risk factor in a bacteria called H. pylori that is known globally to be a risk factor for gastric cancer.

And we’ve done research on this in that although the demographics in the U.S. is very diverse, we do see that Asians and Hispanics and African Americans compose higher risk groups for stomach cancer when compared to non-Hispanic whites. And in certain ethnic groups such as the Koreans, it can be as much as five times the risk for non-Hispanic whites. And we think it is due to these unique variations in H. pylori risk across the different races. We’ve done research at Cedars-Sinai where we’re looking at the Hispanic population and we’ve seen over time that actually, in addition to Hispanic populations being at higher risk for stomach cancer, it seems to be affecting a younger group and in particular younger females.

So we’re looking into this kind of new epidemiologic evidence as to why stomach cancer in Hispanics is becoming younger in onset and tends to have a predilection for females. And these patients however, if they are afforded the correct treatment and the timely treatment, their outcomes are just as good as the non-Hispanic counterparts. So this is an emerging topic and a very important topic in my opinion.

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How Is Gastric Cancer Screening and Care Impacted by Culture?

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How Is Gastric Cancer Screening and Care Impacted by Culture? from Patient Empowerment Network on Vimeo. 

How can culture impact gastric cancer screening and care? Expert Dr. Jun Gong from Cedar-Sinai Medical Center discusses solutions for improving screening rates and patient advice for reducing barriers.

[ACT]IVATION Tip

“I think one of the most important things is always for providers to be culturally aware that certain ethnic groups may have certain preferences with how news is delivered, how news is handled, how treatment is decided upon.”

Download Resource Guide | Descargar guía de recursos

See More from [ACT]IVATED Gastric Cancer

Related Resources:

What Early Phase Gastric Cancer Trials Are Showing Promise?

 Expert Guidance: Stomach Cancer Basics for Newly Diagnosed Patients

 Do Gastric Cancer Risk Factors Differ Among Hispanic Communities?

Do Gastric Cancer Risk Factors Differ Among Hispanic Communities?

Transcript:

Lisa:

Dr. Gong, how do cultural beliefs and practices impact the prevention, diagnosis, and treatment seeking behavior of individuals with stomach cancer? And how can healthcare providers better address the cultural barriers to care?

Dr. Jun Gong:

Cultural beliefs have a huge impact on access to care in stomach cancer, and I think we can do better with addressing cultural barriers to care. I think one of the innovations here at our center is that we have a center of community outreach and a disparities core here where we recognize that certain cultures and this can expand beyond Asians and Hispanics into all racial groups, that there’s a heavily…there’s an important influence of church in this sector here.

And so what we do is we actively engage leaders in the churches, in the local churches for Asians, Hispanics, and a lot of different other subgroups. And we find this a great, great relationship and partnership to have for promoting awareness and educating patients about resources that we have within a culturally specific location where patients and family members find a great deal of trust in the church.

And we also have other innovations as well. So this is more from…more of a day-to-day lifestyle from a clinical trial, a research perspective here at Cedars, we also have a designated specialist from a diversity and inclusion research group where we actually move along the disease groups from stomach cancer to colon cancer to other cancer types.

And we have this specialist sit in, usually in our weekly meetings. And whenever there is a new study, a new clinical trial, this diversity inclusion specialist will raise the question, what racial groups, ethnic groups will be of interest to hear? And how can we expand outreach and participation in these clinical trials? So these are some of the innovations that I think we can do to address cultural barriers to care.

Lisa:

Dr. Gong, do you have an activation tip?

Dr. Jun Gong:

So, my activation tip is that yes, there are growing and emerging concepts to address cultural barriers. I think one of the most important things is always for providers to be culturally aware that certain ethnic groups may have certain preferences with how news is delivered, how news is handled, how treatment is decided upon.

And additionally, I think it’s important for patients and providers to promote awareness and education in a setting where patients and family members are very comfortable with. This can be the church setting as we recognize the importance of this in the day-to-day lives of many patients and family members across multiple cultures.

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