Ask an expert about stomach cancer (UCLH web chat) 

Could your persistent heartburn be cancer?

The focus of the latest NHS ‘Be clear on cancer’ campaign has been on the signs and symptoms of stomach cancer – which can include persistent heartburn.
Our webchat was hosted by Professor Muntzer Mughal, an honorary clinical professor in surgery, consultant surgeon and head of upper gastro-intestinal services at UCLH.

Professor Mughal specialises in surgery for benign and malignant conditions and is an expert on what’s causing your heartburn, indigestion and other reflux conditions – and what the next steps are in terms of diagnosis and treatment.

You read a transcript of the web chat below.

2:31 UCLH: 
Good afternoon and welcome to our web chat. We will begin at 3.15pm but you can submit your questions now in preparation for the chat. Please note: your questions will not appear in the main chat window until after 3.15pm.

Professor Muntzer Mughal, will be joining us to take your questions on stomach cancer and will try to answer as many questions as possible within the hour long web chat.
3:08 Professor Muntzer Mughal: 
Welcome to our web chat on the subject of cancer of the stomach and gullet. My name is Professor Muntzer Mughal, an honorary clinical professor in surgery, consultant surgeon and head of upper gastro-intestinal services at UCLH and I am ready and waiting to take your questions.
Public Health England have launched a campaign to increase awareness of cancer of the stomach and gullet. Cancer of these two organs affects 12900 people in the UK every year and unfortunately, most cases are diagnosed late. When these cancers are diagnosed in the early stages, the 5-year survival is 80%, compared to 3% for late stage disease. If you have suffered from heartburn regularly for more than three weeks or have noticed that food sticks when you swallow, you should see your GP. The GP will refer you for tests if he/she thinks they are necessary.
3:15 [Comment From WallaceWallace: ] 
Where is the best place to find more information and advice? I need a trusted source online please.
3:17 Professor Muntzer Mughal: 
Hi Wallace, I would recommend It has a good range of factsheets in different formats, including easy to read.
3:17 [Comment From IsabelIsabel: ] 
What are the early signs that I should look out for?
3:20 Professor Muntzer Mughal: 
Hi Isabel, early signs are quite subtle because we all suffer from stomach upsets and indigestion. But as I have stated in my introduction, regular heartburn for more than three weeks, a feeling of blockage when you eat and feeling full after relatively small portions are the symptoms we are asking people to report to their GPs.
3:20 [Comment From FrancesFrances: ] 
Are there any tests I can do to check for symptoms? I'm worries about what happens if I go to the doctors!
3:23 Professor Muntzer Mughal: 
Hi Frances, the main test is an endoscopy. This is a telescope examination of the gullet and stomach. It takes only 20 minutes and you can be sedated for it (most people have it under sedation). The test will be requested by your GP.
3:23 [Comment From GuestGuest: ] 
My mother had stomach cancer and then got another primary in her oesphagus. I suffer with gastritis and oesphagitis. Does this make me more prone to stomach cancer like my mother. Thank you
3:27 Professor Muntzer Mughal: 
Hi Guest, It is unusual for one person to get a cancer of the stomach and the oesophagus. However, less than 5% of these cancers have a hereditary basis. Have you any close relatives who have also had these cancers? I presume you have had an endoscopy where the diagnosis of gastritis and oesophagitis was made. There is some evidence that a long history of acid reflux does increase the risk of oesophageal cancer.
3:27 [Comment From PhilipPhilip: ] 
do persistent 'burps' indicate anything?
3:29 Professor Muntzer Mughal: 
Hi Philip, Burps without heartburn are not indicative of anything sinister.
3:29 [Comment From JeremyJeremy: ] 
Are there foods/drinks I should avoid to prevent this form of cancer? Is diet in any way related?
3:32 Professor Muntzer Mughal: 
Hi Jeremy, It is not so much foods to avoid as foods to eat in order to minimise the risk. It is established that a diet rich in fruit and vegetables minimises the risk. These cancers also have a higher incidence in overweight people and those who drink excessively, and those who smoke. So the recommendation is to watch your weight, eat plenty of fruit and vegetables and cut down on alcohol and smoking, if this applies to you.
3:33 [Comment From PhilipPhilip: ] 
3:33 Professor Muntzer Mughal: 
You are welcome Philip.
3:34 [Comment From SimonSimon: ] 
Would cancer of the stomach or gullet show up as blood in my poo? Or is that just bowel related?
3:36 Professor Muntzer Mughal: 
Hi Simon, these cancers can bleed, but the bleeding is slow and the blood has to travel a long distance to get to your poo. As such, you are unlikely to see it as red blood in the poo. Obviously recognisable blood in the poo is much more likely to arise from the colon and back passage.
3:36 [Comment From EstherEsther: ] 
can stomach cancer be found early and what cause stomach cancer
3:41 Professor Muntzer Mughal: 
Hi Esther, we are hoping that the public awareness campaign will lead to earlier detection of these cancers. A number of different factors come together to cause stomach cancer. It is more common in countries where the dietary intake of salt is high. It is also associated with a bug called Helicobacter pylori which lives in the stomach lining. The good news with stomach cancer is that the incidence is going down. We think this is due to better living conditions and better diets.
3:41 [Comment From Mrs myersMrs myers: ] 
Thanks professor, no other family with stomach or oesphageal cancers, just my Mum had it. Yes I had a endoscopy and am on tablets to help. What does it mean when you have inflammation at the opening of the stomach and the exit? Thank you
3:45 Professor Muntzer Mughal: 
Hi Mrs Myers, if there are no other close relatives with this condition, it is unlikely that there is a hereditary component. I presume inflammation at the opening of the stomach means the junction between the stomach and the oesophagus. This is quite common with acid reflux. I assume that the tablets you are on are to suppress acid, and these should help to control the acid and therefore the inflammation.
3:45 [Comment From GuestGuest: ] 
I am on lansaprozole for heart burn. Had a camera down throat 5 years ago that showed slight irritation, grade 2 of gullet. Now going for another camera as still getting heartburn, throat feels like blocked with catarrh and probably in my mind but some foods feel like they stick. Very scared. Cod this potentially be cancer. Mother had cancer of gullet
3:48 Professor Muntzer Mughal: 
Dear Guest, I think it is appropriate that you are having another endoscopy. Inflammation of the oesophagus can cause you to feel that food is sticking. Hopefully the endoscopy will not show anything sinister and help your doctors how to treat your reflux more effectively.
3:48 [Comment From EstherEsther: ] 
3:49 Professor Muntzer Mughal: 
It is a pleasure Esther.
3:54 [Comment From HillaryHillary: ] 
I am only 22 years old but I do get heartburn every now and then. Is it more likely in older people though or men/women?
3:57 Professor Muntzer Mughal: 
Hi Hillary, 9 out of 10 people diagnosed with these cancers are above the age of 50 and it is twice more common in men. On that basis, you are not in a high risk group, in addition to which your symptoms are occasional.
3:57 [Comment From Mrs myersMrs myers: ] 
3:57 Professor Muntzer Mughal: 
It is a pleasure Mrs Myers.
4:02 Professor Muntzer Mughal: 
Here are some useful links for further information about stomach and oesophageal cancer:

Thank you for joining us today in our live web chat. We hope you found the chat useful and some of your questions have been answered.

 Useful links