A Japanese study by Shoichirio Tsugane and Shizuka Sasazuki examined the role of diet in the development of gastric, or stomach, cancer.

Helicobacter pylori infection is a strong and established risk factor for stomach cancer. After reviewing the evidence from many studies, the researchers found that the risk may also be increased with a high intake of various traditional Japanese salt-preserved foods. Processed meat and N-nitroso compounds may be associated with an increased risk of gastric cancer.

Gastric cancer risk is decreased with a high intake of fruit and vegetables, particularly fruit. The researchers note that it remains unknown what constituents in fruit and vegetables play a role in gastric cancer prevention. Consumption of green tea is also possibly associated with a decreased risk of gastric cancer, although the researchers note that the protective effect is limited to Japanese women, most of whom are nonsmokers.

In late May, the National Comprehensive Cancer Network (NCCN) announced updates to two NCCN Clinical Practice Guidelines in Oncology(TM) -- Esophageal Cancer and Gastric Cancer.

The panel added oral fluoropyrimidine, Capecitabine (Xeloda(R), Roche) as an option for treatment of esophageal and gastric cancer due to favorable Phase III trials. The panel also states that capecitabine may replace 5-FU and oxaliplatin may replace cisplatin in triplet regimens for advanced esophageal and gastric cancer.

Additional updates and the NCCN Clinical Practice Guidelines in Oncology(TM) are available at www.nccn.org free of charge.

Employing modern day pathological and tumor-staging methods, University of Texas Southwestern researchers have concluded that French Emperor Napoleon Bonaparte died from advanced gastric cancer resulting from a chronic bacteria infection, H. pylori bacteria.

While Napoleon's personal physician Francesco Antommarchi stated at the time of Napoleon's death that the ruler of France had died from stomach cancer, an alternative and popular theory that has persisted down through the centuries after his death suggested Napoleon was killed by prolonged arsenic poisoning. Apparently, not so.

By studying historical accounts, the researchers determined that the advancement of gastric cancer was such that even modern day treatments would not have prolonged Napoleon's life. Professor of pathology and internal medicine Dr. Robert Genta stated, "Even if treated today, he'd have been dead within a year."

Napoleon's father died from stomach cancer, but the researchers dismiss that heredity played a role in the development of Napoleon's gastric cancer. Dr. Genta explains, "The ulcerated lesion on the emperor's stomach suggests a history of chronic H. pylori gastritis, which might have increased his risk of gastric cancer. The risk might have been further increased by his diet full of salt-preserved foods but sparse in fruits and vegetables – common fare for long military campaigns."

To learn details of the study into Napoleon's death from gastric cancer, and the methods used by the researchers, read University of Texas Southwestern's Napoleon's mysterious death unmasked.

In previous studies there has not shown to be an increase in survival when adding chemotherapy after surgery for gastric cancer compared with surgery alone. Most U.S. patients that are diagnosed with cancer of the stomach or lower esophagus have locally advanced disease that is hard to cure.

The MAGIC trial represents a landmark study in gastric cancer, as it is the first trial to demonstrate a survival benefit for pre- and postoperative chemotherapy. Researchers studied 503 patients with cancer of the stomach, esphagogastric junction or lower esophagus. One arm of the trial received three preoperative and three postoperative cycles of chemotherapy, the other arm of the study had only surgery.

The trial concluded that the chemotherapy group had smaller resectable tumors with negative margins, fewer patients had advanced nodal disease and the five year survival rate increased by 13 percent. It was noted that this is a significant advance for the treatment of this disease.

Gastric cancer staging by lymph node sampling has a profound effect on patient survival. Survival of patients with gastric cancer can be compromised if the staging is done inadequately. This can happen if too few lymph nodes are removed and analyzed.

A study in an issue of Cancer, a peer-review journal of the American Cancer Society revealed that less than one third of gastric cancer patients had adequate lymph node assessments (ALNA). There was a change in the guidelines of the staging system for gastric cancer in 1997 but since then only minimal improvements have been made.

Compliance with the new guidelines remains poor because the lymph nodes removed and sampled since the change in the guidelines only increased from 9 nodes to 10. The guidelines now say that 15 lymph nodes removed and analyzed should be the standard. The lymph nodes that are tested will show how far the cancer has spread. If you do not have the correct information that the lymph node sampling can provide it can cause the patient to receive incorrect treatments and less survival rates.