Gastric cancer is the third most common cause of cancer-related deaths globally. Stomach Cancer often grows slowly over the years and is usually left unnoticed at the onset of the disease. They are adenocarcinomas (95%) as per histopathological reports. They are typically grouped as intestinal or diffuse types depending on the microscopic details and proximal or distal based on the location of the tumor. The diffuse type usually has a genetic predisposition. Smoking, Helicobacter Pylori infection and high salt intake are the predisposing factors for the intestinal type of gastric cancers. The role of alcohol intake is controversial.
There are different treatment options available for patients with stomach cancer. A multimodality approach is key for good outcomes. There are various treatment approaches such as surgery, radiation therapy, chemotherapy and immunotherapy are used in combination depending on the stage of the disease. Treatment Protocol for an individual patient is finalized after a thorough review of all disease-related reports in a multi-disciplinary meet (MDT) which usually consists of specialist Surgeons, Radiation Oncologists, Medical Oncologists, Pathologists, Radiologists, and Endoscopists. Localized tumors are often treated with curative intent. Tumors that have already spread to distant sites usually treated with palliative intent which means applying measures to relieve the symptoms and improving the quality of life.
Surgery has always been the primary treatment option for stomach cancers. This can differ based on the stage of cancer and the prognosis. The surgeon will remove the tumor and while doing so might cut out with a margin of the healthy tissue as well. This is done to ensure that no cancerous cells are left behind in the stomach. Endoscopic mucosal resection (involves the use of an endoscope to cut off tiny tumors from the mucosal layer), subtotal gastrectomy (a part of the stomach is removed) and total gastrectomy (the entire stomach is removed) are the different surgeries that the surgeon might perform based on the diagnosis
Radiation therapy often used along with chemotherapy in gastric cancer patients. Radiation therapy involves the use of high-energy x-rays or other radiations to kill the cancer cells or keep them from advancing.
Chemotherapy uses drugs to kill the cancer cells or stop them from dividing. When chemotherapy is ingested through the mouth or the injected into the vein or muscle, the medicine enters the bloodstream and attacks the cancer cells throughout the body. This is called systemic chemotherapy. Chemotherapy is advised based on the type and stage of cancer.
Immunotherapy is a treatment that uses drugs to stimulate the patient’s immune cells to attack the cancer cells and kill them. They are commonly used in locally advanced, recurrent or widespread (metastatic) stomach cancer.
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