I. The current situation of gastric cancer patients in China: high incidence rate, low early diagnosis rate and high mortality rate
In many western countries, the incidence rate of gastric cancer has been on a decreasing trend; however, in many regions of China, the incidence rate and mortality rate of gastric cancer have been increasing year by year in the past 20 years. At present, there are nearly 200,000 new cases of gastric cancer in China every year, accounting for 17.2% of all malignant tumors, ranking at the forefront of malignant tumor incidence. About 160,000 people die from gastric cancer every year, and its mortality rate accounts for 23.02% of all malignant tumor deaths, ranking first in cancer deaths.
Gastric cancer patients in China are characterized by small proportion of early stage at diagnosis, large proportion of late stage, high mortality rate and low survival rate. From the 1980s to the present, the proportion of early-stage gastric cancer patients in China has been hovering between 4% and 10%; while in Japan, which has the highest level of gastric cancer diagnosis and treatment, the proportion of early-stage gastric cancer patients is as high as 50% to 70%. In China, there are few cases of stage I gastric cancer at the time of diagnosis, and the 5-year survival rate of gastric cancer in the 1990s was 18% to 19%. The latest information shows that compared with the 1990s, the 5-year survival rate of gastric cancer has only increased by about 10%.
Apart from dietary habits and health awareness, the lack of public awareness and acceptance of gastroscopy is one of the main reasons for this situation.
Early symptoms of gastric cancer
The 5-year survival rate of early gastric cancer patients after surgery is over 90%. Among them, the 10-year survival rate of small gastric cancer and micro gastric cancer at the initial stage can reach 100%. Therefore, early diagnosis of gastric cancer is of great significance to improve the efficacy of gastric cancer.
80% of patients with early gastric cancer have no clinical symptoms, and even if a few patients have symptoms, they are some non-specific symptoms, such as loss of appetite, early satiety, abdominal discomfort and so on. These symptoms are not unique to gastric cancer and can be easily confused with functional dyspepsia, gastritis and gastroduodenal ulcer. Experts especially remind us that we should not simply judge our condition based on some symptoms and buy medicine from pharmacies for treatment. This is very unscientific and will most likely affect the timely detection and treatment of stomach cancer.
Since there are no specific symptoms in the early stage of gastric cancer, which makes the diagnosis difficult. Therefore, once the above-mentioned symptoms appear, one should go to hospital and receive gastroscopy in time. Especially, patients with family history of gastric cancer, or patients suffering from chronic atrophic gastritis, gastric ulcer, gastric mucosal intestinal and atypical hyperplasia and those who have undergone gastrectomy should pay high attention to it.
III. Diagnosis of gastric cancer.
Gastroscopy is the first choice examination method to diagnose gastric cancer. Gastroscopy is clear and can directly observe the lesions of gastric mucosa, especially for bulging, swollen and ulcerated lesions, biopsy can be done at the same time to make a clear diagnosis soon.
In order to reduce the discomfort and pain caused by gastroscopy, Wuhan Sixth Hospital has taken the lead in carrying out painless gastroscopy, which greatly facilitates the patients with gastric diseases and improves the detection rate of early gastric cancer at the same time.
IV. Treatment of Stomach Cancer
The treatment of gastric cancer is a comprehensive treatment mainly based on surgery, including surgery, chemotherapy, radiotherapy and targeted therapy. Among them, surgical resection is the most crucial.
(I) Surgical treatment.
Radical surgery: also known as curative resection, the primary lesion of gastric cancer is removed together with the surrounding tissues and the corresponding regional lymph nodes, without leaving any cancerous tissues. The key to radical surgery is to remove enough regional lymph nodes. Foreign studies have found that the number of lymph nodes removed in gastric cancer surgery is closely related to the survival time of patients after surgery.
(ii) Other treatment methods.
Adjuvant chemotherapy after radical surgery can enable patients with gastric cancer to obtain the best treatment effect; radiotherapy can be used as a supplement to surgical treatment. For patients with intermediate and advanced gastric cancer, chemotherapy and radiotherapy can be administered before surgery to improve the surgical resection rate and treatment effect.
In recent years, targeted therapy has been emerging, which brings new hope to some patients with middle and late stage gastric cancer.
V. Experts remind.
1. One truth: early gastric cancer has good curative effect, early detection is most important.
2. One reminder: early symptoms have no characteristics; once they appear, seek medical treatment early.
3. One misconception: Gastroscopy is not scary, painless gastroscopy can solve your worries.
4.One method: radical surgery is the most critical, adjuvant treatment is effective.