Early Diagnosis - the Key to Enhancing the Effectiveness of Stomach Cancer Treatment
“Early detection, proper treatment, patients can live healthily for over 10 years, even be completely cured,” Associate Professor, PhD, Dr. Võ Duy Long, Deputy Head of the Gastroenterology Department, University Medical Center, Ho Chi Minh City, emphasized when speaking about the importance of screening and early diagnosis of stomach cancer.
Associate Professor, PhD, Dr. Võ Duy Long, Deputy Head of the Gastroenterology Department, University Medical Center, Ho Chi Minh City performed an endoscopic stomach surgery.
Technical Advances Helping Early Detection
Stomach cancer is one of the most common cancers in Vietnam as well as in the Asian region. The prerequisite for successful treatment of this disease is detection at an early stage.
“The 5-year survival rate for patients diagnosed at an early stage can exceed 95% if treated with the correct protocol,” Dr. Long affirmed.
The difficulty in diagnosing stomach cancer lies in the fact that the disease often progresses silently, with few clear symptoms in the early stage.
Many patients are only detected during regular health check-ups or when undergoing endoscopy as a screening indication. Quite a few cases arrive at the hospital when the tumor has already progressed, while previously it was thought to be just ordinary stomach pain.
Dr. Long warns: “If abdominal pain lasts more than two weeks, especially at night, and medication does not cure it, a gastroscopy and biopsy are needed to determine the exact cause.”
Notably, about 20% of current stomach cancer cases occur in people under 40, including patients as young as 20, but are only detected at a late stage.
Therefore, he recommends regular gastroscopy after age 40, even without symptoms, especially for individuals with risk factors such as chronic gastritis, H. pylori infection, a family history of stomach cancer, frequent consumption of fermented or smoked foods, smoking...
With the rapid advancement of modern medicine, detecting lesions at an early stage is becoming more feasible.
“Previously, only lesions larger than 1 cm could be detected. Now, thanks to magnifying endoscopy, chromoendoscopy, and especially the application of artificial intelligence, lesions smaller than 1 cm can also be identified,” Dr. Long said.
If endoscopy detects a suspicious lesion, the doctor will perform a tissue biopsy to identify cancer cells and develop an appropriate treatment plan.
For small lesions, they can be removed via endoscopy; larger lesions will require surgical gastrectomy. In early-detected cases, endoscopic surgery helps preserve most of the stomach and maintain the patient’s quality of life.
A typical case is patient L.T.H. (22 years old), who was diagnosed with early-stage gastric cancer during a routine health check.
After undergoing endoscopic surgery to resect part of the stomach and perform thorough lymph node dissection, the patient did not require chemotherapy after the operation. More than five years post-surgery, the patient remains healthy, has married and had children, with no signs of recurrence or metastasis.
Infection with Helicobacter pylori (HP) is an important risk factor, but not everyone infected with HP will develop cancer.
The rate of progression to cancer in HP-infected individuals is only about 1–2 per 1,000 people. Detecting and eradicating HP at the right time can significantly reduce the risk.
Endoscopic surgery, a major advance in gastric cancer treatment
Laparoscopic surgery for treating stomach cancer is a notable advancement over the past 10-15 years. Master’s degree, Dr. Tran Quang Dat (Department of Gastroenterology Surgery, University Medical and Pharmacy Hospital of Ho Chi Minh City) said: “Previously, open surgery with large incisions caused a lot of pain and slow recovery. Now, laparoscopic surgery only requires a skin incision of about 5mm to 1cm, less pain, less blood loss, and patients can recover quickly”.
Laparoscopic surgery is especially effective in early stages or with small tumors. In cases where cancer has widely metastasized or patients have serious underlying conditions such as cardiovascular or respiratory diseases, careful evaluation is needed before intervention.
Typically, patients can mobilize after 12 hours, resume eating after 1-2 days, and be discharged after 5-6 days. A hospital study showed the complication rate was almost 0%.
Dr. Dat cited the case of an 81-year-old man with stomach cancer, who also had diabetes and hypertension. After thorough counseling, the patient agreed to laparoscopic surgery.
The surgery was successful, and just one day after the operation, the patient could walk around the ward; three days later he ate porridge and was discharged after 6 days. To date, the patient remains healthy and has completed follow-up examinations.
After gastric resection surgery, patients need to adjust their diet: divide meals into smaller portions (6-7 times per day), prioritize soft, easily digestible foods, and limit irritating foods. Due to changes in absorption mechanisms, patients are prone to iron and vitamin B12 deficiencies, so they need regular monitoring and nutritional supplementation.
In addition to physical health, the mental factor plays a significant role. “Physical exercise, maintaining an optimistic mindset and timely follow‑up appointments are three important factors that help patients recover well and detect early if there is a risk of recurrence,” Dr. Long emphasized.
Currently, the Ho Chi Minh City University of Medicine and Pharmacy Hospital is implementing the use of liquid biopsy technique – a method that tests for free circulating tumor cells in the blood. This method can detect early risk of recurrence, offering higher effectiveness compared to regular periodic tests.
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