By Aria Bendix—
NBC News
Country singer Toby Keith died on Monday at the age of 62, after being diagnosed with stomach cancer in 2021.
Keith announced on the social network X in June 2022 that he had been diagnosed months earlier and had undergone surgery, chemotherapy and radiotherapy.
A year later he told The Oklahoman that his tumor had shrunk by a third and that he was continuing chemotherapy.
He also claimed to have received a drug that helps the immune system destroy cancer cells.
Toby Keith in Nashville in 2022.Jason Kempin/Getty Images for BMI file
His death has prompted renewed calls from doctors to pay attention to signs of stomach cancer, which include heartburn, acid reflux, anemia, nausea, ulcers, pain after eating, sudden weight loss or fullness after eating. eat small amounts.
“A lot of these things are relatively harmless.
But, of course, with cancer, that's the way it grabs you,” explained Fabian Johnston, chief of gastrointestinal oncology at Johns Hopkins Medicine.
Johnston said doctors and patients tend to consider symptoms like acid reflux harmless, which can delay diagnosis.
By the time cancer symptoms appear, many already have advanced disease, he explained.
The American Cancer Society estimates that nearly 27,000 new cases of stomach cancer will be diagnosed in 2024, although the disease remains relatively rare, accounting for about 1.5% of new cancers reported in the country each year.
The average age of diagnosis is 68 years, and men are at slightly higher risk.
Global stomach cancer diagnosis rates have fallen slightly over the past 10 years.
But rates among adults under 50 are rising, for reasons that are unclear.
“There is something going on — something we eat, something we ingest, some combination of modern and current factors — that is causing the rise of these cancers in young people,” said Ben Schlechter, a gastrointestinal oncologist at the Dana-Farber Cancer Institute in Boston.
According to Schlechter, alcohol and tobacco — once common contributors to stomach cancer — are now associated with a minority of cases in the United States, perhaps because people smoke less.
[Good and bad news about cancer: the risk of dying decreases but diagnoses increase]
Instead, many new cases occur in people with chronic acid reflux or infections with a bacteria called
Helicobacter pylori
, which can cause inflammation in the stomach.
However, scientists have not determined exactly why some people with these conditions get cancer and most do not.
For many patients, right now “it is a bad luck disease,” Schlechter said.
“There may be an association with H. pylori
infection
.
There may be a history of heartburn or reflux, but usually it is not so clear," he explained.
Schlechter said stomach cancer is generally aggressive compared to other types of the disease.
“It doesn't mean that people are dying imminently, but that the tools we have to cure them are quite limited,” he said, “people are doing quite well compared to 15 years ago, but we are barely at the level of, for For example, breast cancer, where the vast majority of people are cured with surgery and chemotherapy and things like that.”
Up to 95% of stomach cancers in the United States are adenocarcinomas, which arise in the innermost lining of the stomach.
From there, the cancer can spread to the stomach wall, your body, or the lymph nodes.
Patients whose cancer has not spread usually undergo or receive chemotherapy or immunotherapy or a combination of these options, said Rutika Mehta, of the Gastrointestinal Oncology Program at Moffitt Cancer Center in Tampa, Florida.
“In the most advanced cases, we are not yet in a position to offer patients a 'cure,'” Mehta wrote by email.
However, he added that chemotherapy or immunotherapy can help prolong life, she added.
Doctors are also improving matching patients with treatments that target specific proteins associated with stomach cancers.
For example, some cancers express a gene called HER2, also related to breast cancer.
“Drugs that work in HER2 breast cancer do so to some extent in HER2 gastric cancer.
Now we can administer these drugs to people with stomach cancer and substantially increase the benefits of the treatment,” he explained.
Although disease outcomes are “generally bad,” he concluded, they are “much better than they used to be.”