A punch in the gut; see your doctor if your stomach doesn't feel right

by Paul Arco
OSF Healthcare

It was a little more than a year ago when country music star Toby Keith shocked fans with the news that he had been diagnosed with stomach cancer in the fall of 2021. The 62-year-old Keith revealed that he spent six months undergoing surgery, chemotherapy and radiation treatments and had to cancel all of his concert dates.

But now, he’s feeling better. According to Keith, he’s continuing chemo, but his tumor has shrunk and his blood work has improved. So much that the singer is hoping to return to the road this fall if he continues to feel good.


There are about 26,000 cases that occur in the United States a year including 11,000 deaths. Stomach cancer accounts for about 1.5% of all cancers.

Stomach cancer, also known as gastric cancer, is the growth of cancer cells in the lining and wall of the stomach. While breast, colon and prostate cancers tend to get more media attention, stomach cancer is nothing to ignore.

Stomach cancer symptoms aren’t always easily identified. Feeling bloated after eating, heartburn, upper abdominal pain and unintentional weight loss are just some signs of a potential problem.

“Unfortunately, with stomach cancer, you don't see symptoms when it's early,” says Katie Nagel, an oncology nurse navigator for OSF HealthCare. “But as it starts to progress, you might see some symptoms that include nausea, vomiting, you feel full quicker than you usually do, fatigue. You might notice blood in your stool. It's important to know that most of the time those don't mean cancer, but it's important to let your doctor know if those persist.”

There are about 26,000 cases that occur in the United States a year including 11,000 deaths. Stomach cancer accounts for about 1.5% of all cancers.

Risk factors for stomach cancer include:

  • Age - most people are diagnosed with stomach cancer in their late 60s or older
  • Sex – stomach cancer is more common in men than women
  • Obesity – being overweight may increase the risk of stomach cancer
  • Race – stomach cancer is more common in Hispanics, African Americans and Asians
  • “A lot of risk factors are ones that we can control,” says Nagel. “That includes smoking tobacco, heavy alcohol consumption, which is three or more drinks every day. And then a diet high in sodium and a diet high in processed meats. Obesity in general, puts you at higher risk.”

    If you experience any of these symptoms for more than a few weeks, Nagel stresses the importance of making an appointment with your primary care physician as soon as possible. “Just pay attention to your body,” she says. “Don't talk yourself out of letting your doctor know if you've noticed a lingering symptom or even anything that might seem small, but that might be the very early start of something that's going to get bigger. Everything is more treatable the earlier we catch it, so just listen to your body and talk to your doctor.”

    While there isn’t screening for stomach cancer like there is for colon and breast cancer, Nagel says there are things you can do, including diet modification, exercise and avoiding a sedentary lifestyle.

    The good news is incidence rates of stomach cancer have dropped about 1.5% every year in the last decade in the U.S.

    Advances in the treatment of stomach cancer, which include chemotherapy, immunotherapy and surgery, have made an impact as well.

    And celebrities like Toby Keith sharing their story can only help when it comes to awareness of this disease.

    “That is also drawing awareness to the issue, and I think makes people feel less alone," says Nagel. "I'm not the only person in the world that has this, other people are going through something similar and makes you feel a little bit better, a little less alone.”


    Op-Ed | A shade off

    by Anthony J. Cortese

    Imagine you sit on the admissions committee of a major medical school where only one slot remains available for the 2023 entering class. You must select between two candidates: one Latino, one white—both qualified.

    Liam, the white student, is the son of an affluent lawyer. He scored 507 out of a possible 528 points on the MCAT; his GPA is 3.76. The son of a poor immigrant from Mexico, Jesse has the same MCAT score and GPA. Liam graduated from UCLA in four years with a pre-med major and a minor in business. Jesse graduated from Cal Poly San Luis Obispo in five and a half years with a biology major.

    Whom do you choose? Do you expand the opportunities for minorities to compensate for previous discrimination?

    “Affirmative action is reverse discrimination,” one person opines. “We should select the most qualified person. We should not discriminate against an applicant simply because he’s affluent.”

    “I’m disgusted with these social programs that liberals are shoving down our throats,“ remarks another. “The government has no right fiddling in the business of private schools. Liam graduated from one of the nation’s most prestigious universities while Jesse matriculated through an obscure school and took much longer to graduate. ”

    “But Jesse has had fewer opportunities than Liam,” another remarks. “Given the same entitlements, he would have scored higher than Liam. I’m sure Jesse took longer to graduate simply because he had to work to help support his family.”

    “Since there are fewer minorities in the healthcare field,” someone states, “We must give Jesse this opportunity.”


    “It bothered me to hear stereotypes about minorities.”

    Someone who had yet to speak finally chimes in, “Let’s use a mile footrace as example: Two runners, one white, one black. The race begins. The white runner dashes out for an early lead. The black runner, as it turns out, has a 20-lb. iron ball attached to a chain around his ankle. He can barely move; yet he perseveres. Someone yells, “That’s not fair!”

    “The official unlocks the ball and chain but even so the black runner remains far behind. It’s still not fair even though both runners now are unfettered. Equal treatment is not enough. We must compensate for previous inequality.”

    The argument continues, the dialogue full of passion, adamancy and outrage. No consensus emerges.

    The “committee members” are actually SMU students role-taking in my “Minority-Dominant Relations” class offered through the Sociology Department and Ethnic Studies program. We examine ethnic groups with unequal power in the US. In order to delve into social inequality, students scrutinize their own assumptions, stereotypes and prejudices.

    “It was a tense and painful discussion,” says a Black female. “Some of us carried on our debate after class and into the next day at the student center. Some began to recognize attitudes in themselves that they didn’t know existed. “

    “It bothered me to hear stereotypes about minorities,” states a Latino on the football team. “But that’s part of the learning process in this course.”

    As students debate, I remain in the background, walking quietly among discussion groups, watching, listening, taking mental notes. I have engaged in such observation all my life, as the son a Mexican American mother whose family is from San Miguel de Alto, Jalisco and a father who had immigrated to the US from Sicily and had never graduated high school.

    Democracy is more than majority rule— more than a mama puma, her cub and a white-tailed deer voting on what to have for lunch. It is also the protection of minority rights to prevent dominion of the minority by the majority. Diversity ensures respect for distinctive identities and protects those at greatest risk of being displaced and alienated internally within the US. On September 17, 1787, the Constitution's framers codified minority rights by structuring equality between states in the Senate (and representation of state populations in the House).

    Apparently, SCOTUS never seemed to mind that affirmative action for white males has traditionally prevailed in society’s economic, political, military, educational, law enforcement and criminal justice institutions. Legacy admissions continue affirmative action for white males. Large, pervasive and disproportionately high rates of student loan debts perpetuate social stratification.


    Diversity is not a zero-sum game. Society suffers when diverse elements are excluded from decision-making processes and leadership positions.

    Lack of diversity harms both individual victims of exclusion and society at large. The harm to individuals, especially children, includes damage to psyches (depression, internalized anger, lowered self-esteem). There are also physical harms (high blood pressure, rapid shallow breathing, insomnia). Finally, lowered monetary and social opportunities pressure minorities to recoil from exclusive and discriminatory settings and become guarded and vigilant. If you do not have a seat at the table, you are probably on the menu.

    Diversity is not a zero-sum game. Society suffers when diverse elements are excluded from decision-making processes and leadership positions. The most serious harm is at the macro societal level. Societies have used affirmative action for white males to stereotype categories of people as unintelligent, dangerous, or menacing. Such labels have been used to justify slavery, segregation, removal of indigenous people and genocide. Lack of diversity is perhaps most treacherous when its effects are slow-developing, largely unnoticed and toxic like carbon monoxide.

    The lack of diversity is dysfunctional; it silences and marginalizes minorities depriving communities of their voices and contributions. The goal of the First Amendment is to energize speech and dialogue. A society without diversity curtails the spirit of the debate of ideas. It reveals to minorities nothing of which they are not already aware. It censors minorities and emboldens the majority with entitlement. Lack of diversity has damaging consequences, conveys exclusive uncertainty for youth, and desensitizes a society with ramifications that can extend from crucial injustice to outright atrocity. If we fail to take affirmative steps, the social unrest and violence proceeding the murder of George Floyd while in police custody will inescapably pale in terms of what lies ahead.


    Anthony J. Cortese is Professor Emeritus of Sociology, Dedman College of Humanities and Sciences, SMU, Dallas Texas and sits on the Board of Directors of SMU’s Retired Faculty Association. Cortese has served as Director of Chicano Studies, Colorado State University and Director of Ethnic Studies and Director of Mexican American Studies at SMU.


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