After Toby Keith’s death, doctors warn that stomach cancer signs are easy to miss
Originally published on 07.02.2024 & reproduced on 11.04.2024
In the wake of Toby Keith’s passing, medical professionals caution about the ease of overlooking signs of stomach cancer. Symptoms often lurk beneath the surface, with common indicators including heartburn and acid reflux.
Renowned country singer Toby Keith breathed his last on Monday night, aged 62, more than two years after being diagnosed with stomach cancer.
In June 2022, Keith revealed on the X platform that he had received the diagnosis in the fall of 2021 and had already undergone rounds of chemotherapy, radiation, and surgery.
Then, in June of the following year, he disclosed to The Oklahoman newspaper in Oklahoma City that his tumor had decreased in size by a third, and he was persisting with chemotherapy. Additionally, he underwent immunotherapy, a treatment aimed at empowering the immune system to combat cancer cells.
Keith’s demise has reignited the urgency among medical experts to be vigilant about signs of stomach cancer, which encompass heartburn, acid reflux, anemia, nausea, ulcers, postprandial pain, sudden weight loss, or early satiety after meals.
“Many of these symptoms may seem benign. However, with cancer, that’s how it ensnares you,” remarked Dr. Fabian Johnston, the chief of gastrointestinal oncology at Johns Hopkins Medicine.
Johnston emphasized that both physicians and patients might be inclined to disregard symptoms such as acid reflux as inconsequential, leading to delays in diagnosis. By the time symptoms manifest, many individuals will already have advanced stages of the disease.
The typical age of diagnosis stands at 68, with men facing a marginally higher susceptibility.
The American Cancer Society projects nearly 27,000 new cases of stomach cancer this year. Despite its rarity—constituting approximately 1.5% of new cancer diagnoses annually in the U.S.—incidences of stomach cancer have shown a slight decline over the past decade. However, there is a concerning uptick in diagnoses among individuals under 50, for reasons yet unclear.
“There’s a trend occurring—something in our diets, our consumption patterns, or a confluence of factors in our modern lives—resulting in these escalating cancer rates among the younger population,” noted Dr. Ben Schlechter, a gastrointestinal medical oncologist at Dana-Farber Cancer Institute in Boston.
Schlechter highlighted that while alcohol and tobacco were once prevalent risk factors for stomach cancer, they now account for a minority of cases in the U.S., possibly due to decreased smoking rates.
Instead, many new cases are observed in individuals with chronic acid reflux or infections caused by Helicobacter pylori, a bacterium implicated in stomach inflammation. However, the exact reasons why only certain individuals with these conditions develop stomach cancer remain elusive.
“For many patients, it boils down to sheer misfortune,” Schlechter remarked. “Perhaps there’s a link to H. pylori infection or a history of heartburn or reflux, but oftentimes, it’s not straightforward.”
Compared to other cancers, stomach cancer tends to be aggressive.
“It doesn’t imply imminent death. Rather, it reflects the limited efficacy of our current treatment arsenal,” Schlechter elucidated. “While outcomes have improved compared to 15 years ago, we’re far from achieving the success rates seen in, say, breast cancer, where the majority of patients are cured through surgical and chemotherapeutic interventions.”
Up to 95% of stomach cancers in the U.S. are adenocarcinomas, originating from the innermost lining of the stomach. From there, the cancer may progress to affect the stomach wall, body, or lymph nodes.
Patients with localized cancer often undergo chemotherapy, immunotherapy, or a combination of both. However, in advanced cases, achieving a complete cure remains elusive.
“We haven’t reached a stage where we can promise patients a ‘cure’ in more advanced scenarios,” wrote Dr. Rutika Mehta, a medical oncologist at the Gastrointestinal Oncology Program at Moffitt Cancer Center in Tampa, Florida. Nevertheless, she noted that chemotherapy or immunotherapy may prolong patients’ lives.
Medical practitioners are increasingly adept at tailoring treatments to target specific proteins associated with stomach cancer. For instance, certain stomach cancers express the HER2 gene, also implicated in breast cancer.
“The medications effective in HER2-positive breast cancer exhibit some efficacy in HER2-positive gastric cancer. Consequently, we can administer these drugs to stomach cancer patients, substantially enhancing their treatment outcomes,” Schlechter affirmed.
Though the prognosis for stomach cancer remains generally bleak, Schlechter underscored that advancements have led to significantly improved outcomes compared to the past.
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