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Gastric Cancer Treatment   

There is no single treatment for gastric cancer; each person with stomach tumor may be assigned different treatment options depending on the specific characteristics of cancer and state of health. In general, before establishing a treatment plan, your oncologist will consider the size and stage of the tumor. He will also consider your age. However, conventional treatments for stomach cancer include surgery, radiotherapy and chemotherapy.    

Surgical treatment 

Type surgical intervention performed in the treatment of gastric cancer depends on the nature, location and size of the tumor. Based on your condition, your doctor may perform:  

Removal by endoscopy – you will be recommended this surgical technique if you have a small size-tumor. During the surgery, your surgeon inserts a lighted tube with a camera (endoscope) into your stomach in order to reach the tumor and remove it and a margin of healthy tissue surrounding it.  

Partial gastrectomy – if your cancer was detect at early stage (stage 1 for instance), your surgeon may perform a partial gastrectomy to remove portion of the stomach affected by the cancer. After ablation, the remaining stomach will be then reconnected to the first section of the small intestine.  

Total Gastrectomy - total gastrectomy involves complete removal of the stomach. After the diseased stomach is removed, your surgeon will establish a continuity between your esophagus and your duodenum. In general, total gastrectomy is indicated for advanced stomach cancer.  

Splenectomy - In case you have a type T3-T4 cancer associated with swollen/enlarged lymph nodes (lymphadenopathy), your surgeon may perform a splenectomy, partial or complete surgical removal of the spleen. Splenectomy is not always practiced in the treatment of stomach cancer; it puts you at increased risk of infections, including pneumococcal and meningococcal infections. 

Complications related to the surgery  

Stomach cancer surgery can provide good results; however, it is not without consequences. Following surgery for stomach cancer, you may experience intra-abdominal infections and/or pancreatitis. In addition, the gastrectomy may cause:

  • anastomotic disunion
  • ulcer
  • incisional hernia
  • gallstones
  • diarrhea
  • dumping syndrome
  • Deficiency in iron, vitamin B12 and/or folic acid.

Radiation therapy (radiotherapy) 

Radiation therapy aims to destroy cancer cells and shrink the tumor in your stomach. Unlike chemotherapy, radiotherapy treats a specific area in your body; precisely, the tumor and small surrounding health tissue. The radiotherapy can be performed alone or in combination with surgery or chemotherapy. However, radiotherapy alone has not proven its efficacy in the treatment of stomach cancer, unless the tumor is well localized. Therefore, it is sometimes used in the palliative treatment or in cases of obstruction of the orifice above or below the stomach by the tumor. Radiation therapy may also be recommended in cases of gastric bleeding.  

Although radiation therapy is less toxic than chemotherapy, it often causes adverse effects: 

  • fatigue 
  • general malaise 
  • redness and dryness of the skin  
  • nausea and vomiting
  • decreased appetite
  • diarrhea.

Chemotherapy 

Chemotherapy involves taking, mostly intravenously, powerful chemicals to kill cancer cells. The chemotherapy agents act on the DNA of the cells to block certain stages of their division, preventing their proliferation. In cases of metastatic stomach cancer, used as a palliative treatment, chemotherapy improves survival rate and quality of life. However, the results of chemotherapy in the treatment of stomach cancer are conflicting; the drugs are not always effective in most patients.  

Drugs mostly used to treat metastatic stomach cancer are doxorubicin, epirubicin, 5-fluorouracil, methotrexate, cisplatin and docetaxel. The protocol ELF (etoposide, leucovorin, 5-FU) can also be used because of its better tolerability, especially in fragile or elderly patients. 

Chemotherapy is a powerful treatment that causes side effects in most patients:

  • nausea and vomiting 
  • loss of hair 
  • diarrhea 
  • fatigue 
  • chills  
  • shortness of breath 
  • cough  
  • mouth sores.

 

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