Hi Doctor,

I'm considering getting sleeved but am a little freaked out by the increase in gastric cancer in those with partial gastrectomies due to peptic ulcers. I understand that the peptic ulcer surgeries were different than VGS (different parts of the stomach), but gastric cancer is not an acceptable risk to me. So my question is: has anyone looked at the research and separated out the confounding risk factors such as smoking, heliobacter infection, etc? I'm trying to get the best read on this I can.

Thanks,

Lisa

This would be very helpful information. I too await anything you can share with us on this topic, Doctor. Thanks.

I can't find any studies showing an uptick in gastric cancer due to weight loss surgeries (I am not a doctor, but I'm pretty good at doing medical research).

Do you have a source that indicates that WLS leads to gastric cancer?

By the way, when considering risks and complications of WLS, remember to consider the risks and complications of remaining overweight/obese, and also the percentage of people (3-5% is the number I keep seeing) who are successful at losing weight and keeping it off WITHOUT some sort of surgical intervention. I looked at the numbers long and hard before committing to WLS, and I ultimately decided that the risks of NOT having the surgery were higher than the risks of having it.

The gastric cancer issue you refer to would be with a gastric bypass. The sleeve removes most of the greater curvature of the stomach and is not an ulcerogenic procedure. H.pylori can be tested and cleared with medications. The sleeve stomach can always be scoped for ulcers, tumors, etc so screening for cancers is always possible with a VSG

ouroborus I was asking because of a post by Lisalu, above. She seemed to think that there was a risk of getting the sleeve because of developing ulcers that ultimately lead to cancer. I don't know where she got that information. I had not heard that anywhere else. But I am not a researcher. More of a dingbat really. :-)

I am please to read Dr. Jossart's reply and yours. And I totally get what you're saying about the risks of being obese.

Thanks for the info!!

I'm afraid I didn't express myself well in the original email. What I am concerned about Is a POSSIBLE risk of stomach cancer. I apologize in advance for this being a long post. No, there is no literature out there connecting vsg with gastric cancer. Vsg is too new for us to know any possible long term effects. I was scanning the medical literature to see if there were other studies that might give us clues about the long term sequelae of vsg. What I did find was complicated and hard to generalize from. Before routine treatment of ulcers with antibiotics, doctors sometimes removed all or part of the stomach. 25 years or so after this stomach ulcer surgery, there was some increase in gastric cancer. This is NOT to say that vsg will cause cancer, but it is something to look at. We don't know why these former ulcer patients got more caner. It might be because they had ulcers which is a known gastric cancer risk factor. It might be because they smoked more (they did, according to one study.) it might have been because they ate a diet of bacon and hot dogs. It might be due to their previous stomach surgery. Even if their stomach surgery had some effect on the development of cancer, that doesn't necessarily mean vsg would have the same effect. It turns out that they removed a different part (the lower half) of the stomach in the ulcer patients.

It all comes down to me being a bit nervous about having a new surgery. I'm considering this surgery so I can remain healthy for my son. It would stink if I were making things worse. I do tend to worryabout cancer because my mom died of lymphoma.

I'm afraid I didn't express myself well in the original email. What I am concerned about Is a POSSIBLE risk of stomach cancer. I apologize in advance for this being a long post. No, there is no literature out there connecting vsg with gastric cancer. Vsg is too new for us to know any possible long term effects. I was scanning the medical literature to see if there were other studies that might give us clues about the long term sequelae of vsg. What I did find was complicated and hard to generalize from. Before routine treatment of ulcers with antibiotics, doctors sometimes removed all or part of the stomach. 25 years or so after this stomach ulcer surgery, there was some increase in gastric cancer. This is NOT to say that vsg will cause cancer, but it is something to look at. We don't know why these former ulcer patients got more caner. It might be because they had ulcers which is a known gastric cancer risk factor. It might be because they smoked more (they did, according to one study.) it might have been because they ate a diet of bacon and hot dogs. It might be due to their previous stomach surgery. Even if their stomach surgery had some effect on the development of cancer, that doesn't necessarily mean vsg would have the same effect. It turns out that they removed a different part (the lower half) of the stomach in the ulcer patients.

It all comes down to me being a bit nervous about having a new surgery. I'm considering this surgery so I can remain healthy for my son. It would stink if I were making things worse. I do tend to worryabout cancer because my mom died of lymphoma.

I completely understand your cancer concern. Cancer runs in my family like our blue eyes.

The DS procedure has been performed much longer than the sleeve, and I haven't seen any connection between the DS and a higher incidence of stomach cancer. The DS procedure is the 2 part WLS with the sleeve being the first step.

lisalu, I'm getting ready to have the revision surgery from band to sleeve and I am hypersensitive about any potentially negative problems with the sleeve surgical procedure. So I am glad that you brought the subject up and got some feedback.

Before I got the band, I just read all the positive comments and literature and conveniently ignored the problems one might develop with the band. I don't want to make the same mistake again. I want to be aware of anything that could cause me to eventually regret the surgery.

Btw, my mother and my sister both died from breast cancer. I was very worried for several years about developing breast cancer myself. I finally decided that I was wasting a lot of years living in fear. In fact it has been 20 years since my mom died and 17 since my sister died. So I'm glad that I let it go and stopped worrying about breast cancer. Now don't get me wrong, I do get yearly mammograms and I do self-exams on a regular basis, but I just don't think that I am bound to get it because members of my family did. For what it's worth...