What it feels like: Soccer, strength and life after stomach cancer

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Most of us get a bit of heartburn after powering down a dish like an enchilada with three-pepper heat, right? If it’s bothersome, we take an antacid and move on.

This is exactly what Carlos Parra did, shrugging off that uncomfortable burning sensation and carrying on with his day-to-day. But more than two years ago, that burning sensation just got worse and he had a hard time eating anything at all.

The Burnaby, B.C. man had never had any health problems (except a cyst in his neck that was removed when he was five), he plays in a men’s soccer league, and has a job he loves as a flooring sales consultant for contractors, designers, architects and retail customers at a showroom. By all accounts, he was in great shape.

But his wife Ana, who is his “rock,” pushed him to see his doctor. He did and got a prescription medication for heartburn and acid reflux. He even tried to figure out what he could and couldn’t eat, but nothing helped. His symptoms only intensified and he knew there must be something wrong.

“It became this very odd feeling, like there was this pressure,” Parra, 63, says of his symptoms. “It almost felt hard. And I couldn’t eat, so I would get full really fast and it felt like food was not going down, like it was getting stuck. I thought maybe it was a blockage.”

He went back to his doctor, told him the medication was not helping and that he needed to get it checked out, requesting an upper endoscopy. The procedure?is where a thin flexible tube with a camera on the end is inserted down your throat to view the upper digestive system. The endoscopy was scheduled for October 4, 2022 and a week later on October 11, his doctor phoned him with the crushing news: he had stomach cancer.

“It was quite a blow. I was just in shock. You hear about all the other cancers like breast cancer and colon cancer and pancreatic cancer, but I had never heard of stomach cancer. I didn’t know anything about it.”

Parra?was home alone on his day off when he got the call. His wife was at work and he had to steady himself before he called her.

“Honestly, I was totally numb and things start going through your head that shouldn’t be and everything starts rushing by. You start thinking the worst because anything attached to cancer, it’s always the negative,” he admits. Stomach cancer is even more of an unknown and silent killer because it can take a long time to diagnose and by that point, it may be too late.

Of gastrointestinal, or GI cancers, stomach cancer is the most common, and estimates suggest that 4,000 Canadians will be diagnosed with stomach cancer in 2024, according to the Canadian Cancer Society. About 2,000 Canadians will die from stomach cancer in 2024. It’s more prevalent in men than women, with people over 50 most often diagnosed – but that’s changing.

Parra’s medical oncologist from BC Cancer in Vancouver, Dr. Howard Lim, is on the medical advisory board of the Stomach Cancer Foundation of Canada, also called My Gut Feeling. He specializes in GI cancers and wants to increase awareness of higher rates of stomach cancer in younger people (an alarming trend we’re seeing in all cancers) and East Asian populations, especially in multicultural Vancouver where many immigrants come from areas where stomach cancer rates are higher, so they should be considered for scopes sooner.

“We see much higher rates in Japan, Korea and China, and part of that’s environmental and diet. We know that more fermented foods and sometimes environmental things like bacteria can lead to increasing risks of stomach cancer,” he says, adding that Asia has a well-defined screening program. “So that’s why in North America it’s a bit more downplayed, mainly because we don’t see as much, but we do have a large immigrant population and we see more stomach cancer in that population.” With the overall rate of stomach cancer in Canada being fairly low, Lim says carrying out endoscopies on everyone isn’t feasible, but practitioners need to be more targeted about assessing those who are at higher risk.

Guidelines for improvements are in development, he says, but he wants people to be aware of the big red flags that could be stomach cancer: “If you’re having unintentional weight loss and you see a drop of 10 to 15 lbs. in a month or two, when you’re eating food feels like it is sticking and you’re feeling very bloated or you’re throwing up after a lot of meals, which is very unusual for many people.”

Otherwise, the most common symptom is heartburn, where 90 per cent of the time it’s not cancer, it’s just heartburn.

National Stomach Cancer Awareness Day is happening November 30 when landmarks around the world, including Vancouver’s city hall, the legislature domes in Yellowknife and the CN Tower in Toronto, light up in periwinkle blue to bring attention to stomach cancer and raise funds for therapy development.

Through BC Cancer, Lim is part of a national research grant from My Gut Feeling looking at nutrition support and survivorship for stomach cancer patients and evaluating the role of the microbiome. He is involved in genomics, clinical trials, teaching, research ethics and drug access – and applauds the efforts of the patient advocacy group for spearheading academic research and collaboration.

“The main thing is trying to figure out what are the nutritional deficiencies in patients who aren’t digesting food properly or have actually had part of their stomach removed,” he explains of the current project. “How do we help?educate patients about the nutrients that you need to have supplemented.”

For Parra, stomach cancer didn’t stop him.?He played league soccer even through his chemotherapy because he needed an outlet. And he continues to be determined to keep up with his nine grandkids.

“I always have a positive outlook in life and whatever comes, you just have to deal with it.”

His stomach cancer was confirmed as stage 2 and very aggressive. The cancer was in his stomach lining and his entire stomach needed to be surgically removed. If it had been left untreated for longer, it could have started damaging other organs. So he started in November with eight rounds of chemotherapy every second week, but suffered the avalanche of side effects: weight loss, loss of taste, neuropathy of feet and hands (numbness and tingling where he couldn’t touch anything cold without having a burning sensation), tiredness, nausea, foggy brain, mood swings. He still gets very emotional quickly, which is new for him. “It changes you,” he says of cancer, unsure of how to describe coming out the other side of it.

His surgery, a full gastrectomy, went as planned in March 2023 through laparoscopy with five?smaller incisions around the abdomen. The entire stomach was removed, including 21 lymph nodes and a small piece of the esophagus as well, before reattaching the intestine directly onto the esophagus. He was hospitalized for three days and went home to begin the recovery. “Basically what they do is grab the intestine tube and then they hook it up to your esophagus and it becomes more of a straight line.”

But his first question to the surgeon after the procedure was how soon could he play soccer again. He laughs, because that’s all that he had on his mind at the time and he needed desperately to focus on the good.

Recovery, however, was painful and he experienced?lack of appetite, he lost 35 lbs. (mostly muscle mass) and went from a size 36 waist to size 32 (his size in high school).?He had to learn how to swallow again and used a child’s sippy cup for some of the rehabilitation. His skin sensitivity to cold got even worse. “This was winter, and when I went out, I had to cover my face with a balaclava because my breathing through my nose would just burn. It was a weird, weird sensation.”

Now he’s fully recovered and cancer-free for the last 19 months. As for eating to fuel his body, that continues to be a challenge. How do you survive without a stomach? It’s extremely difficult for patients to absorb nutrients and Parra has regular B12 shots.?He snacks often and eats small portions throughout the day, and he’s supposed to eat more protein. But it’s almost impossible for him to gain weight because his body “flushes it out” no matter how much he consumes.

As he puts it, “It feels like I’m shrinking.” But he has been able to get back to work, play soccer and travel. “I feel good because I’m still playing, I can run fast and?I can do all those things.”

That kind of quality of life is a rising focus in stomach cancer, and cancer in general, as Lim explains. “We have more therapies available in Canada that have been approved for patients where even if it’s not curable, patients are living longer,” he adds. The hope is that cancer can become a chronic disease that is easier to live with.

“There’s still lots for us to do, but in the next five years, we need to?understand stomach cancer better so that we can prevent it. And if we can’t prevent it, then treat it better.”