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 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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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.

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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 greatly on the stage at which it is discovered. Clinically, if there is no recurrence or metastasis within five years, it is considered cured. The treatment of gastric cancer is primarily surgical. Therefore, for early-stage gastric cancer patients, if a surgeon assesses that curative surgery is feasible, it is recommended to perform a radical surgical resection. For stage I gastric cancer patients, the five-year survival rate after surgical treatment can generally reach over 90%, which is quite effective. However, for those with advanced gastric cancer, it is generally incurable. Treatments, including chemotherapy, targeted therapy, or optimal symptomatic supportive care, aim to alleviate the patient's suffering and extend their life, but generally cannot cure advanced gastric cancer.

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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.