How is gastric cancer treated?

Written by Liu Liang
Oncology
Updated on September 02, 2024
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The treatment methods for gastric cancer include surgery, chemotherapy, and radiotherapy, as well as broad-spectrum targeted therapies against angiogenesis, such as apatinib. Immunotherapy is also an option. However, the specific treatment plan is based on a comprehensive consideration of various factors, including the stage of the cancer and the general condition of the patient. The principle is that for early-stage gastric cancer patients, if the surgeon assesses that surgery is feasible, then radical surgical treatment is primarily used. For advanced-stage patients who are in generally good condition, chemotherapy is the main treatment, combined with a consideration of whether to undergo radiotherapy. For those in very advanced stages, who may not be in good health or those who have had chemotherapy with poor results, anti-angiogenic drugs like apatinib can be chosen as a subsequent treatment.

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Written by Liu Liang
Oncology
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Does early-stage stomach cancer hurt?

Symptoms of early-stage gastric cancer are generally not very obvious. Some patients may experience subtle symptoms resembling those of gastritis or gastrointestinal ulcers, including non-specific gastrointestinal symptoms such as discomfort and bloating in the upper abdomen, acid reflux, nausea, vomiting, and decreased appetite. In terms of pain, early-stage gastric cancer patients might only experience a sensation of bloating or mild tenderness in the upper abdomen. Severe pain is usually associated with late-stage gastric cancer, occurring when there is extensive abdominal metastasis or tumor progression, and the tumor is large enough to cause significant pain, requiring analgesics for treatment.

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Written by Zhou Zi Hua
Oncology
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What are the symptoms of stomach cancer?

Gastric cancer can cause pain in the upper abdomen. If the condition gradually worsens, it can manifest as persistent pain, postprandial fullness and vomiting, belching, and lack of appetite; upper gastrointestinal bleeding, manifesting as vomiting blood, blood in the stool, and black stools; there can also be difficulty swallowing, weight loss and anemia. If bone metastasis occurs, it can manifest as bone pain and pain in the lower back. If a large amount of ascites appears, it can lead to abdominal distension, with shifting dullness detectable on percussion. If liver metastasis occurs, it can manifest as jaundice, and enlargement of the supraclavicular lymph nodes can also occur.

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Written by Liu Liang
Oncology
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How to treat advanced gastric cancer?

The treatment for advanced gastric cancer is primarily chemotherapy, especially for patients with peritoneal or retroperitoneal lymph node metastasis, or distant organ metastasis such as to the liver or lungs. The treatment primarily involves chemotherapy, specifically choosing either multi-drug intravenous combination chemotherapy or oral monotherapy, such as oral chemotherapy with tegafur capsules, or broad-spectrum targeted therapies like apatinib that inhibit angiogenesis. The choice of treatment depends on a comprehensive consideration of the patient's overall condition. If the patient's general condition is particularly poor and the chemotherapy risk is assessed to be high, then the approach for such advanced-stage patients is primarily the best symptomatic supportive treatment to alleviate suffering as much as possible. Therefore, the treatment plan must be determined based on a comprehensive consideration of the specific situation.

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Written by Zhou Zi Hua
Oncology
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Early symptoms of gastric cancer

The symptoms of early gastric cancer are nonspecific and similar to those of chronic gastritis, gastric ulcers, gastroparesis, and other benign diseases, making it difficult to distinguish. Screening data shows that 40%-60% of patients with early gastric cancer are asymptomatic. The symptoms of early gastric cancer primarily include pain or discomfort in the upper abdomen, loss of appetite, fatigue, vomiting, hematemesis, blood in stools, melena, and difficulty swallowing. Discomfort in the upper abdomen is the most common symptom, followed by pain beneath the sternum. Generally, early gastric cancer does not present specific physical signs, though tenderness in the upper abdomen is relatively common, and some patients may exhibit signs of anemia.

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Written by Liu Liang
Oncology
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Late-stage symptoms of gastric cancer

The common late-stage symptoms of gastric cancer patients include nausea, vomiting, and even a complete inability to eat. There are also symptoms related to the digestive tract such as pain in the upper abdomen and acid reflux, as well as upper gastrointestinal bleeding, such as vomiting blood and melena which are signs of lower gastrointestinal bleeding. Late-stage gastric cancer patients may also experience organ metastasis, leading to corresponding symptoms. For example, metastasis of gastric cancer to the liver can cause abdominal pain and ascites due to hepatic metastatic tumors. Clinical manifestations caused by such metastatic tumors also include metastasis to retroperitoneal lymph nodes in the abdominal cavity, a common site of spread for gastric cancer. Patients may even show symptoms of intestinal obstruction, such as abdominal pain, bloating, nausea, vomiting, inability to pass stool, or even absence of flatus, which are indicators of intestinal obstruction. Consequently, patients might experience weight loss and deteriorate into a cachectic state, marked by poor nutrition and significant weight loss, which are characteristic symptoms of late-stage patients.