Let's talk about cancer

Dear friends,

After going through the gallbladder ordeal, I told myself I would live my life differently from now on. Apart from exercising and being selective about the food I eat, I am arming myself with knowledge.

Recently, I saw that the Cancer Society was hosting a free talk on Gastric/Stomach and Colorectal cancer and I immediately signed up. In the past, I would never attend such talks. I'm glad I went for the talk because it was informative.

Firstly, are you aware that you can lower your risks and possibly prevent yourself from getting stomach and colorectal cancer? I did not. I somehow just lived my life not really thinking about lowering my risks of getting cancer. I kinda thought you're born with the tendencies to get cancer. There is a small percentage of the population who have inherited cancer syndromes and these increase their chances of developing stomach. But the most important thing to know about stomach cancer is the risk factors.

The Risk Factors for stomach cancer:
• Infection with Helicobacter Pylori Bacteria
• Diet which is high in salty, smoked and preserved food
• Diet which is low in fruits and vegetables
• Family history of stomach cancer
• Smoking

There are other risk factors but the ones above are the major ones. The important thing to do is to know if you fall into high-risk or average-risk. If you have first-degree relative such as parents, siblings, children who have stomach cancer, you are considered high-risk. If you smoke, yes you're high-risk. If you eat salty, smoked and preserved food most of the time, you are high-risk. If you have Helicobacter Pylori bacteria infection, you are high-risk.

The tool against stomach cancer is screening. Stomach cancer affects people 50 and above so you gotta catch it early. The problem with stomach cancer is it's usually caught at a late stage. Stomach cancer is actually curable if detected early.

Some symptoms of stomach cancer:
• Pain/discomfort in abdomen
• Persistent indigestion/heartburn
• Bloating after meals/feeling full after eating small amounts of food
• Feeling that food gets stuck in your throat while eating
• Unexplained weight loss
• Loss of appetite
• Blood in stool

Unfortunately, early stomach cancer stage doesn't always present itself in specific symptoms.

The tests to detect stomach cancer are:
• Gastroscopy (more accurate)
• Barium meal x-ray

Remember I had a gastroscopy done last year? The results were negative for Helicobacter Pylori bacteria infection and there weren't anything suspicious in the linings. So I feel very happy and secure. By the way, having Helicobacter Pylori bacteria in your stomach doesn't necessarily mean you will develop stomach cancer.

At the talk, someone asked the doctor presenting the talk if eating kimchi INCREASES risks of stomach cancer since kimchi falls under salted, preserved food. The answer is YES. And it's not just kimchi. It is salted preserved food that some people eat EVERY DAY as a side dish like pickled fruits. It's also the salty, fermented stuff you put in your stews. Some Chinese love to eat salted fish, salted vegetables and these are high-risk food. If you use salted fermented products to cook your food, that's high-risk food too.

Interestingly, guess which country came up top in stomach cancer WORLDWIDE? This is based on a 2012 study. Go here to see where your country stands. For both sexes, Korea had the highest rate of stomach cancer. Mongolia was second and Japan third. For women, Korea also had the highest rate of stomach cancer. Second was Guatemala, third Mongolia and fourth Japan.

In Singapore, stomach cancer (2010 to 2014) was the no. 7 cancer for men and 9th for women.

Why did Korea come up top in stomach cancer? I don't know this for a fact but it's possible diet plays a part.

If the food is bad for you, shouldn't you stop eating it or eat less? That's asking for the impossible. I can imagine the outcry if Koreans are asked to eat less salted, preserved, fermented food for their own health. Like what happened in Singapore in May. The Health Promotion Board chief executive wanted locals to eat less white rice to reduce the risk of diabetes. He suggested increasing whole grains and brown rice. The way the locals reacted it was as if he was asking the people to stop eating white rice completely.

So this is what I'm doing to prevent stomach cancer for myself. I will eat as little salted, smoked and preserved food as possible. Yes, I'm looking at you sausages, bacon, ham, luncheon meat, kimchi, salted egg yolk and pickled food. Freshly cooked food is the key. I will also regularly eat food which are whole grain and fruits and vegetables which contain Vitamin A and C. The key to food consumption is moderation. By the way, I told my kids they should stop eating bacon and they said I was being ridiculous. I haven't even mentioned ham.

The talk also covered Colorectal Cancer. Guess which country came up top in stomach cancer WORLDWIDE based on a 2012 study. Yes, once again Korea is top for both sexes. Slovakia was second and Hungary was third. Singapore came in 16th! For women, Norway was first, Denmark was second, The Netherlands was third. Korea came in fifth and Singapore came in 13th.

In Singapore Colorectal cancer is the NUMBER ONE cancer for men and for women, it's the number TWO cancer. (Breast cancer is number one for women)

What does this mean for me? Colorectal cancer is far scarier than stomach cancer.  This cancer usually strikes those 45 and above. A small minority get it aged 20 and younger and it is usually a inherited form of colorectal cancer.

Colorectal cancer may not have any symptoms at an early stage but these are some symptoms to look out for:

• change in bowel habits like persistent diarrhea/constipation
• feeling full/bloated
• blood in stool
• persistent abdominal pain/discomfort
• lump in abdomen

The risk factors for colorectal cancer are:
• age - 50 and above
• personal history of colorectal polyps
• personal history of IBS
• family history of this cancer in first degree relatives (siblings, parents, children) or polyps in the colon
• low fibre and high fat diet
- Red meat, processed meat, meat cooked at a high temperature, animal fat, tobacco and alcohol consumption increases the risk of getting colorectal cancer.
• obesity
• sedentary lifestyle

The tests to detect colorectal cancer:
• Faecal Immunochemical Test (FIT)
• Colonoscopy
• Sigmoidoscopy

Screening is a very important way to prevent/catch colorectal cancer. If you detect this cancer early, there's a good chance of cure. If you remove the polyps at colonoscopy, you can prevent the cancer.  But first, you need to know if you fall into the high-risk category because the frequency of the tests you do differs. People with polyps, previous colorectal cancer, family history of colorectal cancer, inherited polyps, IBS condition are considered high-risk.

FIT needs to be done once a year. This is a disgusting but necessary test. You collect your poop, use the kit to jab at the poop, seal it and send to the lab for detection of blood. Two samples (different days) within one week are required.  Blood in your poop doesn't always mean cancer but it means you need to do other tests to find out what's wrong. If you are someone who simply refuses to do any follow-up tests, doing a FIT is a waste of time.

For average risk, a colonoscopy is done once every 10 years. This test lets the doctor look at your large intestine using a long flexible lighted tube. During this test, tissue samples can be taken and abnormal growths removed. For high risk cases, it can be done once every 5 years or more frequently. For high risk cases, their doctors are the best persons to advise on frequencies of tests.

A sigmoidoscopy is done when the sigmoid colon needs closer inspection.

Looking at my lifestyle, I can't say confidently I won't develop colorectal cancer. I love eating meat cooked at high temperature!

But I will do the following to reduce my risks:
• No more overeating
• Exercise regularly
• Eat less processed and red meat
• Eat more vegetables and fruits
• Maintain a healthy weight
• Increase fibre in my diet

And I have done my FIT for this year. Hubs has done his as well. (his came back negative) Hopefully mine will come back negative as well. Fingers and toes crossed. As for colonoscopy, I have not been advised to do one yet. Hopefully hubs does one first so he can tell me about it.

p.s. Obviously I'm not a doctor and you should see your own doctor if you have any questions regarding your health.