“Many of these things are relatively harmless. But, of course, that’s how cancer kills you,” said Dr. Fabian Johnston, division chief of gastrointestinal oncology at Johns Hopkins.
Following Toby Keith’s death, doctors warn that stomach cancer warning signs are easy to miss. Doctors say symptoms don’t often appear immediately, but frequent signs include heartburn or acid reflux.
Toby Keith, 62, succumbed to stomach cancer on Monday night, two years after his diagnosis.
Keith revealed on X in June 2022 that he was diagnosed in the autumn of 2021 and had already undergone chemotherapy, radiation, and surgery.
Then, in June of last year, he informed The Oklahoman newspaper in Oklahoma City that his tumour had decreased by one-third and that he was still receiving chemotherapy. He also said he received immunotherapy, which is medicine that helps the immune system attack cancer cells.
His death has prompted doctors to issue renewed warnings about stomach cancer symptoms such as heartburn, acid reflux, anaemia, nausea, ulcers, pain after eating, abrupt weight loss, or feeling full after eating small amounts.
“Many of these things are relatively harmless. But, of course, that’s how cancer kills you,” said Dr. Fabian Johnston, division chief of gastrointestinal oncology at Johns Hopkins.
Doctors and patients may be tempted to write off symptoms like acid reflux as unimportant, according to Johnston, which can cause a delay in diagnosis. He stated that by the time symptoms occur, many people had a severe disease.
The typical age of diagnosis is 68, with men at a slightly higher risk.
Despite being relatively rare, stomach cancer is predicted to have approximately 27,000 new cases diagnosed this year, accounting for only 1.5% of all new malignancies diagnosed in the United States each year, according to the American Cancer Society.
Over the previous ten years, the overall rate of stomach cancer diagnoses has decreased modestly. However, rates among people under 50 are increasing for unknown reasons.
“There’s something going on—something we’re eating, something we’re ingesting—some combination of modern and contemporary factors that’s resulting in these increased cancers in young people,” said Dr. Ben Schlechter, a gastrointestinal medical oncologist at Dana-Farber Cancer Institute in Boston.
According to Schlechter, although tobacco and alcohol were historically major causes of stomach cancer, they are now linked to a small percentage of instances in the United States, maybe as a result of reduced smoking rates.
Instead, many new cases are discovered in people with chronic acid reflux or infections with the bacterium Helicobacter pylori, which can cause stomach inflammation. Scientists have yet to determine why some patients with those illnesses get stomach cancer while the majority do not.
For many patients right now, “it’s a disease of bad luck,” Schlechter explained. “Perhaps there is a link with H. pylori infection.” There may be a history of heartburn or reflux, but it is not always evident.”
Schlechter stated that stomach cancer is often more aggressive than other malignancies.
“This does not imply that people are about to die. It only means that the tools we have to treat them are restricted,” he explained. “People do pretty well compared to 15 years ago, but we are hardly at the level of, say, breast cancer, where the commanding majority of people are cured with surgery and chemotherapy and things like that.”
Adenocarcinomas, which begin in the stomach’s innermost lining, account for up to 95% of all stomach malignancies in the United States. From there, the cancer could migrate to the stomach wall, stomach body, or lymph nodes.
Dr. Rutika Mehta, a medical oncologist in the Gastrointestinal Oncology Programme at the Moffitt Disease Centre in Tampa, Florida, said that patients whose disease has not spread frequently undertake or receive chemotherapy, immunotherapy, or a combination of these treatments.
“In more advanced cases, we are not yet at a point where we can offer patients a ‘cure,'” Mehta noted in an email. She did, however, mention that chemotherapy or immunotherapy could help people live longer lives.
Doctors are also becoming better at matching patients to therapies that target specific proteins associated with stomach cancer. For example, some stomach tumours contain HER2, a gene similarly associated with breast cancer.
“Drugs that act in HER2 breast cancer can also work in HER2 gastric cancer. So we can now offer those medications to folks with stomach cancer and significantly increase the benefit of treatment,” Schlechter added.
Though the disease’s prognosis is “generally poor,” he says they’re “much better than they used to be.”
