How to treat advanced gastric cancer?

Written by Liu Liang
Oncology
Updated on September 03, 2024
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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 Liu Liang
Oncology
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Can stomach cancer be cured?

Whether gastric cancer can be cured depends on the stage of the cancer, as well as the patient's own physical condition. For example, early-stage gastric cancer patients, who are diagnosed as early-stage through examinations such as endoscopic ultrasonography and enhanced CT of the chest and abdomen, and assessed by surgeons as suitable for curative surgery, are primarily treated with curative surgery. The prognosis for these early-stage gastric cancer patients is generally good, with a relatively high five-year survival rate. Post-operation, based on the pathological findings, it is decided whether postoperative adjuvant radiotherapy and chemotherapy are necessary. There is hope for curing patients in these early stages through these treatment methods. However, if a patient is found to have advanced-stage gastric cancer, for example with metastases to distant organs like the liver and lungs, the cancer is not completely curable. The purpose of treatment in such cases is to alleviate the patient's pain and extend their survival, but it can’t achieve a curative effect.

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Written by Liu Liang
Oncology
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How to check for gastric cancer?

When clinical symptoms such as nausea, vomiting, gastric distension or upper abdominal pain, acid reflux, or hematemesis, as well as melena occur, it is necessary to consider the possibility of gastric cancer and seek timely medical attention. Completing a gastroscopy and obtaining a biopsy under gastroscopy are essential. If cancer cells are found, this is the most important diagnostic method for confirming gastric cancer. After the diagnosis of gastric cancer, further examinations like endoscopic ultrasound and CT scans of the chest and abdomen are required to assess the approximate stage of the patient and to decide the subsequent treatment plan.

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Written by Ren Zheng Xin
Gastroenterology
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What can stomach cancer patients eat?

Gastric cancer refers to a malignant tumor that occurs in the gastric mucosal epithelium. Special attention should be paid to the diet, appropriately supplementing with multivitamins and consuming more fresh foods, such as fresh green vegetables and fruits. The diet should be diverse to avoid favoring certain foods overly and to ensure the intake of a variety of nutrients. It is also necessary to eat some meat for protein, avoid moldy foods, reduce the consumption of pickled, salted, smoked foods, and those rich in nitrites, and avoid the irritation from strong tea, coffee, and hard liquor. In addition to dietary measures, active treatment for early-stage gastric cancer can include endoscopic mucosal resection, or one may opt for a major gastric resection surgery or radiotherapy, while maintaining a good psychological state and sufficient sleep.

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Written by Liu Liang
Oncology
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Symptoms of gastric cancer

Symptoms of gastric cancer include nausea, vomiting, acid reflux, pain in the upper abdomen, and a sense of fullness and discomfort, especially after eating, which are some of the early symptoms. As the tumor progresses, symptoms can worsen, including pain, vomiting of blood, and black stools indicating upper gastrointestinal bleeding. If the tumor is near the pylorus, it can cause pyloric obstruction, which manifests as acid reflux followed by vomiting of undigested food from the previous night. In the late stages of gastric cancer, patients may experience fatigue, weight loss, severe cachexia, and anemia. These are symptoms of advanced gastric cancer.

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Written by Liu Liang
Oncology
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How is stomach cancer treated?

The treatment for gastric cancer now includes surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy, among others. The specific treatment plan is formulated based on various factors such as the staging of the cancer, the patient's overall condition, and the presence of any underlying diseases, which are all taken into consideration before deciding on a treatment plan. For patients in the early stages who are generally in good condition, surgical resection can be evaluated and is primarily curative. Post-operative treatment decisions, such as whether to pursue adjuvant radiotherapy or chemotherapy, depend on the pathology results and the presence of high-risk factors for recurrence. For patients in advanced stages who are found to have distant metastases upon diagnosis, treatment is primarily chemotherapy. Additionally, there are broad-spectrum targeted therapies against angiogenesis, such as apatinib, which are suitable for patients with advanced gastric cancer or those who do not respond well to chemotherapy, serving as a secondary or tertiary line of treatment. These are some of the treatment methods for gastric cancer. It is crucial that the use of any medication is conducted under the guidance of a doctor.