Treatment Options for Gastric (Stomach) Cancer
The goal of treating gastric cancer depends on the stage and individual circumstances of the patient. Here are the objectives of treatment for gastric cancer:
- Curative Treatment: The main goal of treating stomach cancer is to cure it. This is possible when the cancer is found early and hasn’t spread beyond the stomach. In these cases, doctors usually recommend surgery to remove the tumor along with nearby lymph nodes. This approach aims to remove all cancer cells and prevent the cancer from coming back.
- Slowing Progression: If the cancer is advanced or has spread to other parts of the body, curing it may not be possible. Instead, treatment focuses on slowing the disease and helping patients live longer. For this, doctors often use chemotherapy or targeted therapy. Chemotherapy kills or stops cancer cells from growing, while targeted therapy attacks specific molecules that help cancer grow.
- Symptom Control: When neither curing the cancer nor slowing it down is possible, treatment shifts to managing symptoms and improving the patient’s quality of life. Palliative treatments are used to ease symptoms like pain, trouble swallowing, or bleeding. These treatments may include placing a tube to keep the stomach open (endoscopic stenting), using radiation to kill cancer cells, or providing comfort care that focuses on relief rather than treatment.
It's important to note that the effectiveness of different treatments is evaluated based on factors like patient quality-adjusted life-years (QALYs), which consider treatment cost, quality of life, and overall survival. The field of gastric cancer treatment is continuously evolving, with ongoing research into novel approaches like immunotherapy that aim to improve outcomes for patients with advanced disease.
The recommended potential treatments for gastric cancer include:
Initial treatment:
- Endoscopic treatment: For early-stage stomach cancer, the main treatment is endoscopy, where doctors remove cancerous tissue from the stomach lining. This includes procedures like endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD).
- Surgery: If endoscopic treatment isn’t suitable, surgery may be needed. This can be done as open surgery (laparotomy) or with small cuts (laparoscopy) to remove the tumor and affected lymph nodes.
Lifestyle changes:
- Quitting smoking: Stopping smoking can boost overall health and lower the chance of treatment complications.
- Limiting alcohol: Cutting down on alcohol can also improve health and reduce treatment risks.
- Healthy diet: Eating well, with plenty of fruits, vegetables, whole grains, and lean proteins, helps support the immune system and recovery.
- Physical activity: Regular exercise can help maintain a healthy weight and improve well-being.
Medications:
- Chemotherapy: These drugs kill or slow the growth of cancer cells. They may be given before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to kill any remaining cancer cells.
- Targeted therapy: These drugs attack specific molecules that help cancer grow, which can block cancer cell growth and spread.
- Immunotherapy: This treatment helps the immune system fight cancer by boosting its response to cancer cells.
Therapeutic procedures:
- Radiation therapy: High-energy beams kill cancer cells or shrink tumors. It can be used before surgery to reduce tumor size or after surgery to destroy leftover cancer cells.
- Hyperthermic intraperitoneal chemotherapy (HIPEC): This therapy delivers heated chemotherapy directly into the abdominal cavity during surgery, aiming to eliminate cancer cells in this area.
- Normothermic intraperitoneal chemotherapy: Similar to HIPEC, this therapy also delivers chemotherapy into the abdomen but at normal body temperature.
- Pressurized intraperitoneal aerosolized chemotherapy (PIPAC): This therapy uses pressurized aerosolized chemotherapy in the abdominal cavity to target cancer cells.
It is important to note that these treatment options may vary depending on individual factors such as the stage of gastric cancer, overall health, and preferences. It is recommended to consult with a healthcare professional who specializes in gastric cancer for personalized advice and treatment recommendations.