Management of cancer of the stomach in Mulago hospital Kampala, Uganda

Abstract

Objective: To determine the clinical presentation, mode of investigation and management of gastric cancer at New Mulago Hospital. Design: Prospective descriptive study. Settings: Three general surgical wards, Department of Surgery, New Mulago Hospital. Subjects: Thirty five patients were studied within 12 months. Results: Gastric cancer was found to be prevalent in tribes inhabiting volcanic areas of south western Uganda especially the Banyankole (25%). The commonest mode of clinical presentation was epigastric pain, weight loss, constipation, epigastric tenderness, palpable epigastric mass and anaemia. The most accurate mode of investigation was by endoscopy followed by barium meal. The commonest locality was the pyloric atrium (40%) histologically adenocarcinoma (95.5%) predominated. Gastric cancer was found to be more common in patients with blood group O+ve. All patients had been subjected to some kind of medical treatment especially with antiacids, H2 receptor antagonists which contributed to the delay in presentation. The majority of patients (94.5%) presented with advanced disease and no curative surgery was possible. Conclusions: These results show that early diagnosis of gastric cancer is still a dream at Mulago hospital since most patients present with advanced disease. To address this problem, all health workers should be sensitised on symptoms and signs for early aggressive investigation or an early referral to enable early diagnosis of gastric cancer. The investigatory capacity of rural hospitals should be boosted to enable early detection of gastric cancer.