Interview with Professor Olivier Bouché, gastroenterologist and professor of digestive oncology, University Hospital of Reims.
Has the discovery of the role of a bacterium in the development of stomach cancer led to real progress?
Of course. Indeed, for the first time in oncology, it has been proven since 1994 the role of a bacterium (Helicobacter pylori) in the development of cancer. It is extremely important. It is now known that, in most cases, the cancer of the stomach is of infectious origin.
This means that people at risk can now be screened. When someone in their immediate family has a parent who has developed stomach cancer, they must be screened for gastric endoscopy with biopsies. If the bacterium is present, it can be easily treated and in many cases prevented the development of the disease.
Another significant progress: a new treatment ...
And, indeed, there is now a more effective therapeutic option, for all those whose cancer is metastasized. All those whose HER2 protein is overexpressed in cancer. However, this only affects about 2 out of 10 patients. The anti-HER2 biotherapies, which have already been proven in breast cancers, are now effective in HER2 stomach cancers. Both to prolong life expectancy and to improve the quality of life of patients.
Does diet play an important role in the development of stomach cancer?
Of course. Moreover, before knowing the role of Helicobacter pylori, it was thought that only food was involved in stomach cancer. This is not the only cause, we know it now. However, diet plays an important role. We know that foods too salty or preserved in salt, smoked foods, promote this type of cancer. We also know that people who eat a lot of fruits and vegetables are protected. Fruits and vegetables have antioxidant action.
But it's not just that ...
The cancers of the junction between the esophagus and the stomach (cardia) are more frequent in the big eaters with excess weight. The important negative role of tobacco is also known. Good food hygiene, good weight balance are beneficial. And good hygiene, especially during childhood, because it is a disease transmitted by "dirty hands". The bacterium involved in the development of stomach cancer more often contaminates the most disadvantaged populations, in which the level of hygiene is lower and the diet unbalanced.