Stomach cancer is usually only detected once it has progressed or spread, making treatment more difficult. As with most cancers, the treatment options are radiotherapy, chemotherapy, surgery, or a combination of the three.
Treatment for stages 0 and 1 usually involves only surgery, often a partial gastrectomy (where part of the stomach is removed). If needed, the abdominal lymph nodes may also be removed. For stages 2 and 3, a gastrectomy is done along with removal of abdominal lymph nodes. To reduce the very high recurrence rate, doctors often recommend additional chemotherapy and radiotherapy after surgery.
For stage 4, treatment is aimed at easing the symptoms. This can involve surgery, chemotherapy, or radiation therapy.
Surgery
Surgery is the most common treatment for gastric cancer, and usually a gastrectomy is performed. If the cancer was caught early enough, the surgeon may be able to remove only a part of the stomach, called a partial or subtotal gastrectomy. If the entire stomach is removed, this is called a total gastrectomy.
Following a gastrectomy, nutrition becomes an issue. For those who have had a partial gastrectomy, a fairly normal diet might be resumed after healing, but for patients who have had a total gastrectomy, certain changes need to be made because the food will now go straight from the esophagus to the small intestine. One example is vitamin supplementation. A monthly injection of vitamin B12 may be needed since it can't be absorbed from the diet.
To help with digestion and comfort, dieticians can suggest an appropriate diet, most likely high in protein and low in sugar. They'll also recommend frequent small meals rather than three square meals a day.
Some people with total gastrectomies experience dumping syndrome, which includes nausea, vomiting, cramping, diarrhea, and dizziness. This is caused by the food entering the intestine too quickly, without benefit of the stomach acids breaking it down. Eating smaller meals more frequently can help reduce this discomfort.
Chemotherapy
Chemotherapy involves taking medication to fight the cancer. In stomach cancer, the chemotherapy is generalized or systemic, and is usually taken intravenously, but can be administered orally in some cases.
Because chemotherapy circulates throughout the body, more of the body systems are affected by the treatment. Side effects from chemotherapy include:
- diarrhea
- fatigue
- hair loss
- increased risk of infections
- mouth sores
- nausea and vomiting
Radiotherapy
Radiation therapy is an external treatment to kill the cancer cells. The radiation is aimed directly at the tumours in an effort to shrink them. Radiotherapy may be done before surgery in some cases to shrink the tumour.
Several side effects are typical of radiotherapy. They include:
- decreased appetite
- diarrhea
- fatigue
- nausea and vomiting
- red, dry skin at the radiation site
It seems that some cases of stomach cancer might be prevented. Some people from Japan, which has one of the highest rates of stomach cancer in the world, decrease their chances of developing the cancer when they move to an area with a lower rate. This suggests that environmental factors are involved.
The risk factors listed above, including diet, can provide a clue to how we might reduce our chances of developing cancer:
- Stop smoking.
- Eat a healthy, balanced diet including regular servings of fresh fruit and vegetables.
- Don't abuse alcohol.
- Be aware of the risk factors and be sure to talk to your doctor about any concerns or symptoms.
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