Gastric cancer the vile disease

The very mention of the name Ivo Figueiredo, who departed from this world some years ago, brings back great memories of past times spent in his company. He was many years younger than I. The evenings, when we met over a drink or two, evoke reminiscences that I treasure like gold. We would talk about politics, social affairs and what not! It was a delight to hear his tongue-in-cheek comments. He was erudite, witty, realistic and practical. While others could keep arguing about the glass of water, Ivo would rather drink it.

I had unsuccessfully treated Ivo’s father and mother, after they suffered strokes: in those days when facilities in Margão were few and, if you needed a respirator, you had to rush the victim to the Goa Medical College. Ivo’s brother, António, a vivacious, gem of a boy, who was our age and a playmate to my brother Elínio and me, died tragically of leukaemia in the prime of his life. A pall of gloom descended upon us. 

Ivo was a great music lover and connoisseur. Nothing was beyond his grasp. He loved Latino oldies, enjoyed Western classical favourites and adored jazz. He would smoke incessantly and drink sparingly. He suddenly began to complain, for a few days, of bloating of the stomach and severe pain in the epigastrium. I put him through a battery of tests as I thought it could be a case of acute pancreatitis. Soon he approached a surgeon who advised a gastroscopy which revealed advanced gastric cancer. He was put through tedious chemotherapy. I still rue the fact that I didn’t diagnose him earlier. 

This is not the first diagnosis I have overlooked. There are many others! The compensation for a doctor’s failures comes from the “Eureka” moments when we crack the rarest of the rare cases. Pascal, a physicist, poignantly wrote, “Grandezas e misérias da nossa profissão”. In one instant, doctors are placed on a pedestal; soon… a missed diagnosis… the patient dies… and we are buried six feet under the grave! As Ivo’s death became imminent, as if to compensate where I had failed, I showered him with even more love and affection and became his doctor and his nurse as well. Ivo experienced much suffering. Many a time when he lacked the energy to evacuate his bowels, debilitated as he was from chemotherapy, I would gently pass a lubricated gloved finger into his anus and release the recalcitrant fecal bolus to his great relief. Till the end, Ivo couldn’t do without me. When he finally closed his eyes, there were no tears left to cry. 

Gastric Cancer occurs when healthy cells in your stomach start to grow out of control. It gets worse in no time and spreads to other areas of your body. Who Gets Gastric Cancer? Men are more likely to get it than women. There’s a bacterium called “Helicobacter pylori” that causes ulcers and inflammation in your stomach and it is one of the main causes of gastric cancer. It can be treated with antibiotics, which may be another reason why this kind of cancer is less common now than before. The only way to know you have these bacteria is through a blood test. 

You have a higher chance of getting gastric cancer if someone in your family has had one. Things you do every day can affect your chances of getting the disease. Eating too much smoked foods, salted fish, meat, and pickled vegetables can boost your risk, along with not getting enough fruit and vegetables. You also might be more likely to get it if you smoke and drink.

Stomach cancer may remain silent for long or cause tiredness, bloating after you eat even a little, heartburn and indigestion, nausea and vomiting, weight loss for no reason and black stools. To crack the diagnosis your doctor probably will advise a gastroscopy. He will send a tiny camera through a tube down your throat to look into your stomach. If anything doesn’t look right, he will take a tiny piece of tissue -- called a biopsy -- and send it to a lab to look for cancer cells. Your doctor might also suggest a CT (computerized tomography) scan or an MRI (magnetic resonance imaging).

Your treatment depends on the type and location, how far it has advanced, and your overall health. In most cases, surgery to take out the tumor is the first step. Your doctor also might remove part or all of your stomach as well as lymph nodes from other parts of your body where the cancer has spread.

You may have radiation therapy or chemotherapy to shrink the tumour before surgery -- and afterwards as well to kill any leftover cancer cells. These two kinds of therapy are often used together.

Cancer can have a devastating effect on the sufferer and the family but, mercifully, as in Ivo’s case, it could not cripple love, corrode faith or invade the soul; it could not conquer the spirit or steal eternal life. My unforgettable friend Ivo bore his brunt throughout with bravery and fortitude. As he died, and I sat beside him hugging him gently, there was a prayer in his lips and in his ears rang the strains of the jazz song he loved the most: “Poinciana” by Ahmad Jamal. 

RIP dear friend!

(The author is a seniormost consulting physician, pioneer of Echocardiography in Goa.)