I. About Stomach Cancer
The stomach is an organ for storing and digesting food and is located between the esophagus and the small intestine. The stomach wall is composed of several layers of muscles that stir and pulverize food by peristalsis. The stomach wall can be divided into five layers from inside to outside: mucosal layer; submucosal layer; muscular layer; subplasma layer; and plasma layer.
What is gastric cancer?
When abnormal cells grow and form a lump, it is cancerous, and this lump is called a tumor. Stomach cancer is a malignant disease that starts in the inner layer of the stomach. It first occurs in the innermost layer of the stomach and can spread to the whole stomach and other organs of the body.
III. Risk factors of gastric cancer.
Helicobacter pylori infection; smoking; advanced age; someone in the family has suffered from gastric cancer; large consumption of smoked or pickled food.
What are the manifestations of stomach cancer?
Stomach cancer can be asymptomatic, but the more common symptoms include weight loss, nausea, vomiting, loss of appetite, abdominal pain, etc.
V. What is the staging?
Once the examination to determine the size and location of the tumor and whether it has spread to other parts of the body is completed, staging can be performed. Staging is a necessary step to develop the best treatment plan, and the doctor will prescribe a series of checklists and discuss with you in detail.
VI. How to treat gastric cancer?
Treatment of gastric cancer includes surgery, chemotherapy, radiotherapy, immunotherapy, Chinese herbal medicine treatment, clinical trial, etc. Doctors decide the treatment plan according to the size, location, stage of tumor and patient’s own condition, which can be a single treatment or a combination of several treatments at the same time.
1.Surgery.
Surgery is the common treatment for early gastric cancer. Surgery is gastrectomy, which is divided into partial gastrectomy and total gastrectomy. Sub-total gastrectomy is to remove the cancerous part of stomach, nearby lymph nodes and some other adjacent organs. In total gastrectomy, the entire stomach, surrounding lymph nodes, part of esophagus and small intestine are removed, and then the esophagus and small intestine are joined and reconstructed so that the patient can continue to eat and swallow.
2. Post-surgical treatment.
Gastrectomy is a major surgery, in the first few days after the operation, the doctor will give intravenous nutrition by hanging water, and then will gradually give liquid, soft food or even solid food. After the operation, the patient may feel full with a small amount of food, and the doctor will usually recommend eating less and more meals. A good recovery diet allows for adequate caloric and protein intake, which helps prevent weight loss, promotes physical recovery, and rebuilds normal tissue. Since good nutrition is important for post-operative recovery, the doctor will guide the patient’s diet to ensure a balanced meal. If the patient receives a total gastrectomy, as he cannot absorb vitamin B12 normally at this time, additional supplementation is needed routinely.
3.Chemotherapy.
Chemotherapy is the use of drugs to kill cancer cells, either with one or in combination with several different drugs. These drugs enter the blood system and thus spread all over the body to kill cancer cells that have spread outside the stomach. There are several different routes of chemotherapy, such as intravenous chemotherapy and oral chemotherapy. Patients can receive chemotherapy as an inpatient, as an outpatient or even as an out-of-hospital home chemotherapy. Chemotherapy drugs not only kill cancer cells, but may also damage normal tissue cells, so they can have toxic effects. The treatment team in the hospital will explain the treatment plan and the effects of chemotherapy drugs to the patient in detail. Common toxic side effects may include: nausea, vomiting, diarrhea, fatigue, hair loss, decreased blood cells (which may increase the risk of infection and bleeding), etc.
4.Radiotherapy.
Radiotherapy is the use of X-rays or other high-energy rays to kill cancer cells and shrink the tumor. Radiotherapy affects only the cancer cells in the area that is irradiated. It is usually an external radiation treatment using a beam of rays emitted by a machine outside the body. Combination chemotherapy is usually required to prevent the growth of tumor cells in other areas. Possible side effects of radiation therapy: skin damage, gastritis, indigestion; heartburn and ulcers; intestinal cramps and diarrhea due to radiation enteritis; poor appetite; nausea, vomiting; fatigue. Doctors will use drugs to reduce these side effects.
5. Chemoradiotherapy.
Chemoradiotherapy is a combination of radiotherapy and chemotherapy, which can improve the efficacy of single modality treatment; it can be done before surgery to shrink the tumor, or can be started after surgery to kill the cancer cells remaining in the body.
6.Chinese medicine treatment.
Gastric cancer belongs to “stomach pain”, “regurgitation” and “accumulation” in TCM, so the treatment is based on the combination of tonifying qi, strengthening spleen and benefiting kidneys, helping the liver and regulating qi, harmonizing the stomach and lowering rebellion, resolving phlegm and softening hardness, clearing heat and detoxifying, invigorating blood and removing toxins.
7. Clinical trials.
Conducting clinical trials can discover the best way to treat gastric cancer with chemotherapy. New chemotherapeutic drugs under research for tumor treatment are being used more and more widely and as a means to alleviate the disease. Your doctor will inform you whether you are suitable to participate in a clinical trial.
VII. What kind of follow-up is needed?
After treatment is completed, patients need routine follow-up examinations. At each visit, the doctor will check for recurrence and metastasis. The examinations include physical examination, radiology, CT, routine blood, laboratory tests such as liver and kidney functions, and gastroscopy.