Stomach cancer, medically known as gastric cancer, is a formidable adversary that requires a comprehensive approach to treatment. With advancements in medical science, patients facing this diagnosis have access to a range of treatment options tailored to their specific circumstances. It is essential to comprehend this condition for early detection and effective treatment.
Stomach cancer can be categorized into several types, each with distinct characteristics:
Adenocarcinoma
This is the most common type of stomach cancer, accounting for the majority of cases. It originates in the cells that form the stomach lining's mucus-producing glands.
Lymphoma
This type of stomach cancer affects the immune system tissue found in the stomach wall's lymph nodes.
Gastrointestinal Stromal tumours (GISTs)
GISTs are rare tumours that can develop anywhere in the digestive tract, including the stomach. They may be cancerous or non-cancerous.
Carcinoid Tumours
These tumours are slow-growing and typically do not cause noticeable symptoms until they reach an advanced stage.
Neuroendocrine tumours (NETs)
NETs can form in the stomach's neuroendocrine cells, which release hormones into the bloodstream. Most stomach NETs are non-cancerous, but some can be malignant.
Symptoms
Early detection of cancer is important for successful treatment. Being aware of the symptoms can help prompt medical evaluation. Common signs of stomach cancer may include:
Indigestion or heartburn
Persistent indigestion or discomfort after eating.
Unexplained weight loss
Significant and unexplained weight loss over a short period.
Abdominal pain
Pain or discomfort in the upper abdomen, which may be vague or severe.
Nausea and vomiting
Frequent nausea or vomiting, sometimes with blood.
Loss of appetite
A reduced desire to eat and a feeling of fullness even after consuming small amounts.
Difficulty swallowing
Discomfort or pain when swallowing, known as dysphagia.
Bloody stools
Dark, tarry stools or blood in the stool, which may appear black.
Fatigue
Persistent tiredness and weakness.
Common Treatment Options
Effective treatment for stomach cancer typically involves a multidisciplinary approach that combines surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy. The specific treatment plan depends on factors such as the cancer stage, type, and the patient's overall health. Combining therapies is often necessary to achieve the best outcomes, especially in advanced cases. Common treatment options include:
Surgery
Surgery plays a central role in treating stomach cancer. Depending on the extent of the disease, surgical options may include partial or total gastrectomy (removal of part or all of the stomach), lymph node dissection, and in some cases, esophagogastrectomy (removal of the esophagus and part of the stomach). Minimally invasive techniques, such as laparoscopic surgery, offer quicker recovery times and reduced scarring.
Chemotherapy
Chemotherapy is commonly used to treat stomach cancer and may be administered before or after surgery, depending on the case. Chemotherapy drugs are designed to target and destroy cancer cells, preventing their growth and spread. Combination chemotherapy regimens have been developed to enhance treatment effectiveness, and advances in supportive care have improved the management of side effects.
Radiation Therapy
This therapy uses high-energy beams to aim to eliminate cancerous cells. It is often employed alongside surgery and chemotherapy to shrink tumours, reduce symptoms, and improve the likelihood of complete cancer removal during surgery. Advanced techniques, such as intensity-modulated radiation therapy (IMRT), allow for precise targeting while sparing healthy tissue.
Targeted Therapy
Targeted therapy drugs, such as trastuzumab and ramucirumab, focus on specific molecules or pathways involved in cancer growth. These therapies are often used in combination with chemotherapy or as a second-line treatment for advanced stomach cancer, offering more precise and effective options with fewer side effects.
Immunotherapy
Immunotherapy has emerged as a promising avenue for the treatment of stomach cancer, particularly in cases where other treatments have not been effective. Immune checkpoint inhibitors, such as pembrolizumab and nivolumab, enhance the body's immune response to combat cancer cells. Immunotherapy has shown potential in extending survival and improving the quality of life for some patients.
Brief about the Surgical Procedure
Surgical procedures for stomach cancer may vary based on the cancer's stage and location. Here are some common approaches:
Gastrectomy
Gastrectomy is a cornerstone of stomach cancer treatment, involving the surgical removal of the stomach. Depending on the extent of the cancer, surgeons may perform a partial gastrectomy, removing only the portion of the stomach affected by cancer, or a total gastrectomy, which removes the entire stomach. The choice between these options depends on factors like the cancer's stage and location.
Lymphadenectomy
Lymph nodes near the stomach may be removed to check for cancer spread.Lymph node dissection is a surgical procedure that involves removing affected lymph nodes to prevent further cancer spread. This procedure is typically performed during gastrectomy.
Endoscopic Resection
Early-stage stomach cancers can sometimes be removed using an endoscope, a long, flexible tube with a camera and surgical tools.
Palliative Surgery
For patients with advanced stomach cancer or those who are not candidates for curative surgery, palliative surgery may be considered. This aims to alleviate symptoms and improve the quality of life. Procedures such as gastrojejunostomy can help restore normal food passage and reduce discomfort caused by tumour blockages.
Reconstruction
After gastrectomy or esophagogastrectomy, surgeons perform reconstruction to restore digestive function. Various techniques are employed to reconnect the remaining portion of the oesophagus or stomach to the small intestine. These procedures are crucial for ensuring that patients can continue to eat and digest food effectively.
Stomach cancer is a challenging disease, but early detection and a tailored treatment plan can significantly improve outcomes. Consultation with healthcare professionals is essential for accurate diagnosis and appropriate treatment decisions.
With these treatment options and advancements in medical science, individuals diagnosed with stomach cancer have reason for hope and the possibility of effective treatment. Collaborative efforts between patients, caregivers, and healthcare providers are essential to navigate this challenging journey towards recovery and healing.
Patients will need time to physically and emotionally recover following stomach cancer surgery. During this time, assistance from family, friends, and support groups can be extremely helpful.
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Dr. Raajit Chanana
Speciality: Medical Oncology (Hemato-Oncology)
Experience: 15+ Years
