For 53 years, Madam Dolly Kong, now 71, made do with only a quarter of her stomach. Then, two years ago, she lost the rest of it.

It was in 1955, at the age of 18, that she had three-quarters of her stomach removed after she was diagnosed with gastric ulcers.

In 2006, she was found to have stomach cancer and the rest of it was removed.

She allowed it to be donated for cancer research.

Between the two stomach operations, she was diagnosed with diabetes in 1981 and suffered a stroke in 1989.

All through her ordeals, however, she remained strong and her zest for life is apparent in her independence and her love offood.

'I must have chilli when I eat, otherwise I do not have the appetite,' said the part-Peranakan (Straits-born) woman, who relishes her assam ikan (fish curry).

Given her condition, it is important for Madam Kong to remind herself to eat just the right amount. Food now goes straight from her gullet to her small intestine.

Despite her health problems, she still takes a 15-minute walk from her home in Commonwealth Avenue to the Tanglin Halt market almost daily.

When she hankers for durians, she will buy three of the fruit for about $10 from the market and lug them home.

Her left leg is weak due to the stroke but a determined Madam Kong takes a bus and train ride to the Lavender food court every week just to eat her favourite beef noodles.

'I can eat only a little at a time though or I will be sick,' she said.

She relishes her independence. After church on Sundays, she goes to Chinatown and walks around for three or four hours to window-shop - again, all on her own.

When tired, she goes to a coffee shop to relax over a cup of teh-c (tea with evaporated milk), as she cannot have sugar due to her diabetes.

Despite her activities, Madam Kong does not think she is fit and regrets not being able to dance like she did when she was younger.

The widow and mother of two daughters dotes on her six grandchildren. Every Wednesday, she picks up granddaughter Konstanze, 11, from school and makes her a meal.

Madam Kong is determined to continue living on her own, said her 45-year-old daughter who did not want to be named. She explained that her mother had stated her preference even after her last surgery.

The feisty granny, who is now cancer-free, has this advice for other stomach cancer patients: 'The first thing is to learn to adjust your eating habits. If something causes pain, just stop eating it.'

Gastric cancer's sixth most common here

Gastric cancer, more commonly known as stomach cancer, is the fourth and sixth most common cancer in men and women respectively in Singapore.

Each year worldwide, some 700,000 people are diagnosed with the condition. However, it can easily be mistaken for peptic ulcers as both conditions have the same main symptom: abdominal pain.

Stomach cancer patients like Madam Dolly Kong end up having some, or all, of their affected stomach removed.

Dr Jimmy So, senior consultant at the National University Hospital, said it is possible to live without a stomach because the small intestine is able to digest carbohydrates, fats and proteins.

What the small intestine cannot do, however, is to absorb vitamin B12. Hence, patients like Madam Kong have to get vitamin B12 jabs thrice a year. The body needs this vitamin to produce red blood cells and to keep the central nervous system functioning.

Dr So also said that for someone like Madam Kong, food goes straight from the gullet to the small intestine. This means she can only eat small amounts each time, even though there is no restriction to what she can eat.

As her cancer was detected at stage one, Madam Kong did not have to undergo chemotherapy.

'When part of the stomach is removed, there is digestive enzyme reflux from the small intestine back into the stomach and over long periods of time, this can cause cancer which is what happened in Madam Kong's case,' said Dr So.

Stomach cancer has many predisposing factors. If a person's diet is high in salt, lacks vitamin C and is high in preservatives (nitrosamines), he will have an increased risk of getting stomach cancer. Smoking is also another predisposing factor.

Infection with the bacteria Helicobacter Pylori is another well-known factor, even though the method of transmission of this bacteria is currently unknown.

As with most cancers, stomach cancer may be hereditary. Also, the Chinese seem to be more susceptible to it than Malays or Indians.

This article was first published in Mind Your Body, The Straits Times on Nov 13, 2008.