Modern treatment model for gastric cancer

  Gastric cancer is a common malignant tumor in the digestive tract. Up to now, there is still no effective treatment for advanced gastric cancer, but early diagnosis and treatment can definitely improve gastric cancer and its prognosis. Therefore, the modern treatment mode of gastric cancer has been changed from the previous single surgery and chemotherapy mode to the modern surgery-based comprehensive treatment mode, and the medical development in recent years has led to many new insights in the treatment of gastric cancer.  Early diagnosis: For most patients, gastroscopy is the main means of early detection of gastric cancer. For patients over 40 years old who have upper abdominal discomfort for more than two weeks or have obvious symptoms of gastric disease, as well as those who have black stool, they should go to hospital for gastroscopy in time, and more than 90% of early gastric cancer can be diagnosed through this examination. Since gastroscopy has obvious discomfort, many hospitals have recently developed painless gastroscopy, that is, gastroscopy under anesthesia, to reduce patients’ fear.  Surgical treatment: Up to now, surgical resection is still the means to completely cure gastric cancer, and the 5-year survival rate of early gastric cancer after surgery is over 90%. From the analysis of evidence-based medicine, the careful and standardized surgical operation of surgeons can significantly affect the prognosis of patients. Since lymph node metastasis occurs earlier in gastric cancer, the thoroughness of lymph node dissection often affects long-term survival.  Recently, laparoscopy has been used to perform gastrectomy for gastric cancer, but it is often questioned by the surgical community, mainly because of the thoroughness of the operation, which is currently considered to be used for early gastric cancer and requires good laparoscopic skills. Laparoscopy can provide evidence for further clarification of the presence of intra-abdominal implantation metastasis.  Palliative surgery for gastric cancer is mainly used to resolve complications such as obstruction or bleeding, and is of little use for prolonged survival if there are no complications. The chance of re-surgical resection after recurrence of gastric cancer is generally low, but this opportunity should not be easily passed up.  Drug therapy: It was believed that chemotherapy alone is not very useful for gastric cancer, but with the emergence of new drugs and clinical exploration, reasonable drug therapy can extend the survival period to some extent. The application of perioperative chemotherapy, also known as neoadjuvant chemotherapy, has received more attention from surgeons. The reasonable use of anti-cancer drugs before and during surgery can reduce the metastasis of cancer cells caused by surgery, thus reducing recurrence.  As for the concern of whether perioperative chemotherapy will affect the wound healing of patients, from the results of practice, there is no such problem, but reasonable control of indications is required.  Other treatments: In addition to the above methods, there is another adjuvant treatment for gastric cancer, which may be useful for prolonging survival, such as heat therapy, Chinese herbal medicine, biological therapy, etc. Especially, the prospect of biological targeted therapy is more optimistic.  At present, the general treatment mode of gastric cancer is: early gastric cancer can be cured by surgery alone; mid-stage gastric cancer can be cured by surgery plus drug therapy; advanced gastric cancer is mainly treated by drug therapy.