M. Dinesh Varma

Some findings to be discussed at a conference in Singapore

  • Five scientific papers to be tabled at the meet
  • Interesting finding on influence of oestrogen receptors

    CHENNAI: A decline in appetite or loss of weight in a patient merits a closer evaluation by the gastroenterologist. And, if the patient is a male who smokes, consumes alcohol and is at `high-risk' in having a family history of this form of cancer, an endoscopy is the rule of the day. All this comes against the backdrop of gastric cancers becoming one of the most common and high-mortality malignancies in men and women.

    "The earlier a gastric cancer is detected, the better the chances of curative intervention," says S. M. Chandramohan, who heads the department of surgical gastroenterology, Government Royapettah Hospital.

    Unfortunately, most gastric cancers are diagnosed in advanced stages where the malignancy has spread to other organs. In such cases, the treatment moves away from the curative to a containment theme, where the focus is on surgically removing the primary tumour site and providing chemotherapy as a palliative measure.

    The urgency shared the world over to develop protocols for early detection and management of gastric cancer has opened up new treatment avenues for this malignancy, which is more common in men.

    The above research on gastric cancer and the findings will be part of the deliberations at the First Asia Pacific Gastric Conference scheduled at the National University of Singapore between November 20 and 22.

    Five scientific papers, including original efforts and two papers that won the first prize at the recent national conference of the Indian Association of Surgical Gastroenterology, will be tabled in the Singapore meet.

    An interesting finding relates to the influence of oestrogen receptors in patients with stomach cancer (adenocarcinomas). This work examined the oestrogen effect in terms of patients' response to drug therapy, building on global data on breast cancer research that showed patients who are positive in relation with oestrogen receptors responded better to chemotherapy (with a drug like Tamoxifen).

    The results indicated that the effects of the oestrogen receptor in stomach cancer could help identify patients who will best respond to oestrogen receptor modulating drugs.

    Another important work was directed at identifying the presence of the TP53 gene, the mutation of which produces gastric cancers. The research findings not only help identify patients who will best benefit from gene therapy but also explore the scope for early detection of disease at the stage of gene mutation.

    The department also examined the role of Epidermal Growth Factor Receptor and the Vascular Endothelial Growth Factor in tumour angiogenesis (tumour-induced growth of blood vessels).