In December 2006, Deborah de Souza hosted a programme on stomach cancer on her popular radio health talk show, Body and Soul. It was this same condition, also known as gastric cancer, that claimed her life last Tuesday.

Despite her knowledge of health matters, the 37-year-old 938Live presenter was unaware of her condition stomach cancer is hard to detect in its initial stages. By the time she was diagnosed in January after a bout of gastric pains, the cancer was already in its advanced stage.

Such cases are not uncommon among stomach cancer victims, said doctors whom Today spoke to.

One of the leading causes of death here, stomach cancer is the fifth and seventh most common cancer among Singaporean men and women respectively.

In its early stages, the symptoms can be elusive. More often than not, the cancer which affects about 500 people each year is diagnosed in its more advanced stages.

Said Dr Lee Kuo Ann, associate consultant of the department of radiation oncology at National Cancer Centre Singapore: "Unfortunately, symptoms of early gastric cancer are hard to detect. Those with early gastric cancer either have no symptoms or have symptoms that are indistinguishable from ailments like gastritis or indigestion."

The most common symptom of stomach cancer is dyspepsia, which is pain or discomfort in the upper abdomen, said Associate Professor Jimmy So, a senior consultant of the University Surgical Centre at National University Hospital who had previously worked with Deborah on her health programme on stomach cancer.

But because "this pain can be non-specific", the disease runs the risk of being "misdiagnosed as normal gastric pain", explained Assoc Prof So.

Even so, Dr Lee added that dyspepsia rarely signifies stomach cancer. "Only about 2 per cent of the cases suggest early stomach cancer," he said.

Other symptoms include loss of appetite, passing black stool or vomiting blood. The person may also have difficulty swallowing, persistent abdominal pain and feel full quickly after eating.

Unfortunately, by the time the symptoms described above show up, it often means that the cancer is at a more advanced stage, said Dr Lee. He estimated that approximately two-thirds of all stomach cancer patients are diagnosed in the third and fourth stages of the cancer.

But, it is not all gloom and doom.

Some risk factors such as family history cannot be helped but you can reduce your risk of stomach cancer by making a few lifestyle changes. (See box for other risk factors.)

"You can reduce lifestyle risk factors if you stop smoking, consume more fresh fruits and vegetables, and cut down on foods that contain dietary nitrates such as cured meats and pickled foods," advised Dr Lee.

And as with most cancers, early detection and treatment improves the chances of survival. "If the cancer is detected early, the recovery rate is very high at more than 70 per cent," said Assoc Prof So.

The most efficient way to find out if you have stomach cancer is to go for a gastroscopy examination, which is performed under light sedation by inserting a fibre-optic tube through the mouth. This allows the doctor to see any abnormality in the stomach.

Stomach cancer risk increases with age. Dr Lee advised anyone above 40 with dyspepsia to seek medical advice and possibly go for a gastroscopy examination.

But what about relatively young people who have similar symptoms?

Said Dr Lee: "For those under 40, who are less likely to develop stomach cancer, it is reasonable to have a trial of medical treatment for gastritis. But if the symptoms persist, say after two months, then they can consider a gastroscopy."

He added: "Of course, anyone with symptoms suggestive of the disease in its advanced stage should seek medical attention as soon as possible."

Are you at risk of stomach cancer?

According to Assoc Prof So, people from East Asian countries such as Chinese, Koreans and Japanese are particularly at risk due to our dietary preference for highly salted foods.

A diet that is high in dietary nitrates found in cured meats like bacon, ham, hotdogs and other processed meats and pickled foods as well as a low intake of Vitamin C, also increases your risk of stomach cancer.

Helicobacter pylori infection caused by bacteria that can cause stomach ulcers increases your risk by five times while smokers have a 1.5 times risk of the disease, added Dr Lee.

Other risk factors include age and family history. - TODAY/ar