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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Can stomach cancer be cured? Can stomach cancer be cured?

Early-stage gastric cancer patients can undergo curative surgery, and then decide whether postoperative adjuvant radiochemotherapy is needed based on the specific pathological type and the presence of high-risk recurrence factors. Through these treatments, a cure can be achieved. Generally, if there is no recurrence or metastasis within five years, it is considered cured. For example, patients in stage IA, even without adjuvant chemotherapy, have a relatively high five-year survival rate, generally above 90% after curative surgery. However, if it is found to be advanced-stage, such as initial detection showing distant metastases to the liver, lungs, etc., these patients are primarily treated with systemic chemotherapy or symptomatic palliative care. In such cases, a cure is not achievable. Therefore, whether a cure is possible depends on the stage of gastric cancer and factors such as the patient's basic physical condition.

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Early manifestations of gastric cancer

The early signs of gastric cancer may include nausea, vomiting, or mild acid reflux, which are symptoms similar to those of gastritis, stomach ulcers, or duodenal ulcers. Therefore, initially, these patients may not take their condition seriously, assuming they might just have gastritis or peptic ulcers. These are some of the early manifestations of gastric cancer, and some patients may also experience discomfort and a feeling of fullness after eating.

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Oncology
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What are the symptoms of gastric cancer?

The symptoms of gastric cancer patients are generally common gastrointestinal symptoms such as nausea, vomiting, acid reflux, and discomfort and bloating in the upper abdomen, especially aggravated after eating. As the condition progresses, symptoms may include vomiting blood or black stools. When the cancer invades surrounding organs, clinical symptoms such as abdominal effusion, abdominal distension, and pain may occur. If the tumor is located near the pylorus and causes pyloric obstruction, symptoms of pyloric obstruction will appear, such as gastric retention, acid reflux, and vomiting of overnight food. Additionally, if the tumor bleeds, it may cause severe vomiting of blood. Therefore, different stages of the disease present different symptoms. If gastric cancer progresses to the late stage with metastasis to distant organs, clinical manifestations corresponding to the sites of metastasis will also appear.

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Oncology
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What is early-stage gastric cancer?

In the early stages of gastric cancer, the tumor is confined to the mucosa or submucosa, regardless of whether there is regional lymph node metastasis or not; this is still classified as early-stage gastric cancer. The treatment for early-stage gastric cancer primarily involves curative surgery, which is the first option unless the patient is of advanced age or has severe underlying diseases that prevent tolerance of surgical treatment. Excluding these cases, surgical treatment is generally the first choice. Furthermore, the outcome of surgical treatment for patients with early-stage gastric cancer is generally quite positive, with a five-year survival rate typically exceeding 80%.