1.Does your body tell you that you have stomach cancer?
Almost all people have experienced discomfort in the upper and middle abdomen, which is usually caused by “stomach problems”. Sometimes this discomfort is caused by gastritis or gastric ulcer, sometimes it is a manifestation of stomach movement or dysfunction. Generally, there is no major organic lesion behind the discomfort. Unfortunately, early stage of gastric cancer is often asymptomatic or has only symptoms of upper abdominal discomfort, which is similar to benign diseases and not easy to attract people’s attention, making most patients miss the best time to diagnose and treat gastric cancer, and by the time gastric cancer sends clear signals to the body, the disease has already reached the progressive stage. Compared with physical signals, physical examination is better to detect stomach cancer. Therefore, people over 40 years old should raise their health awareness and advocate regular medical checkups in order to detect early lesions. When there are symptoms of indigestion, or changes in symptoms, or symptoms are not relieved; when there are difficulty in swallowing, vomiting overnight food, vomiting blood, black stool, anemia, abdominal mass, it is more important to seek medical treatment to find out the cause in time.
2.Can blood detect stomach cancer?
In addition to routine biochemical examination, tumor markers can also be checked in blood test. Tumor markers are substances synthesized and released by tumor cells or produced by the body in response to tumor cells during the process of tumor occurrence and proliferation. When tumor occurs in the body, some tumor markers in blood, cells, tissues or body fluids may increase accordingly. It should be noted that elevated tumor markers do not mean that a tumor has occurred, but can also be elevated in some normal people or people with benign diseases. In addition, most patients with gastric cancer do not have elevated tumor markers. Therefore, it is extremely unreliable to judge whether a tumor has occurred by tumor marker test alone.
3.What can be used to confirm the diagnosis of gastric cancer?
There are several clinical methods for the diagnosis of gastric cancer, and the commonly used methods include: gastroscopy, barium gastrointestinal x-ray imaging, CT examination, etc. Gastroscopy combined with biopsy histological examination is the best way to confirm the diagnosis of gastric cancer. The gastric mucosa in the area where gastric cancer occurs will be changed, manifesting as bulging or depression, sometimes with ulcer formation. Gastroscopy can visually observe the morphology of lesions in the stomach, while pathological histological examination can observe the changes of cell morphology, and the combination of the two can confirm the diagnosis of gastric cancer by more than 98%. More importantly, gastroscopy combined with staining examination can detect more early gastric cancers. At present, there are painless gastroscopy programs available, one injection and one sleep, and the examination is completed without any pain. Gastrointestinal barium meal X-ray has unique diagnostic value for infiltrating gastric cancer and is suitable for patients who do not want to undergo gastroscopy. Due to poor sensitivity, CT is generally not used to detect and diagnose gastric cancer. By the same token, ultrasound is also not used to diagnose gastric cancer.
4.Can it be cured?
After the diagnosis of gastric cancer, it is necessary to build up the confidence to overcome gastric cancer, and with reasonable and correct treatment, gastric cancer can be cured. The cure rate of early gastric cancer is over 90%, and the 5-year survival rate of progressive gastric cancer is 40-50%. The so-called reasonable and correct treatment is a multidisciplinary and comprehensive treatment led by surgery, which includes laparoscopic surgery, endoscopic treatment, chemotherapy, radiotherapy, immunotherapy, Chinese medicine treatment, etc. Besides traditional surgery, the treatment mode includes laparoscopic surgery, endoscopic treatment, chemotherapy, radiotherapy, immunotherapy and Chinese medicine treatment. The purpose of treatment is to prolong patients’ survival time and improve their life quality.
5.Does gastric cancer have to be treated by surgery?
Up to now, surgery is still the cornerstone of curing gastric cancer. Without surgery to remove the existing tumor, no other treatment can cure stomach cancer. Of course, with the advancement of technology, the way of surgery has also changed dramatically. Endoscopic treatment can be considered a minimally invasive surgical treatment for a small percentage of early gastric cancers. Removal of superficial gastric cancer lesions under gastroscopy can be equally curative. Laparoscopic surgery is also significantly less hard on patients than conventional open surgery, and postoperative recovery is significantly faster.
6. Are all gastric cancers suitable for surgery?
Not all gastric cancers are suitable for surgery. First of all, the scope of surgery is limited, usually confined to the stomach and adjacent organs around the stomach. For gastric cancer with distant metastases such as liver, lung, brain and pelvis, surgery cannot remove all the lesions. And resection of only intragastric lesions has not been found to be of any therapeutic value in patients without complications such as bleeding, obstruction, or perforation. Therefore, patients with distant metastases should receive chemotherapy-based treatment more often. Second, not every patient’s physical condition is suitable for surgery. Modern medical science has found that age is not the only factor that restricts surgery. Those with cardiac insufficiency, recent heart attack, respiratory insufficiency, weak cough, severe liver and kidney insufficiency and coagulation disorders are not suitable for surgery.
7.Can cancer be treated by multiple surgeries?
Patients with progressive gastric cancer should be treated with radical gastric cancer surgery, which includes subtotal or total gastrectomy, perigastric lymph node dissection and combined organ removal. Generally, a patient has only one chance to undergo radical gastric cancer surgery. Theoretically, recurrence of gastric cancer can be treated by surgery again, but the chance of success is very small. Since radical gastric cancer surgery is complex and difficult to operate, and the surgical thoroughness varies greatly among different operators, patients are recommended to receive surgery in professional gastric cancer treatment centers, which can improve postoperative survival rate and reduce surgical complications.
8.What are the advantages of laparoscopic assisted radical gastric cancer surgery?
Laparoscopy is similar to electronic gastroscope, which is an instrument with a miniature camera. Laparoscopic surgery is an operation performed with laparoscope and its related instruments: a cold light source is used to provide illumination, a laparoscopic lens is inserted into the abdominal cavity, and the images captured by the laparoscopic lens are displayed on a special monitor using digital camera technology, and the doctor performs the operation with special laparoscopic instruments. Laparoscopic-assisted radical gastric cancer surgery mostly adopts the 5-hole operation method, and only a 5-cm incision is needed in the upper abdomen to take the specimen, which can be said to be a less invasive and less painful operation compared with the 20-cm incision in traditional radical gastric cancer surgery. The development of laparoscopic surgery has reduced the pain of incision and shortened the recovery period of patients, which is a rapidly developing surgical item in recent years.
9.What are the risks of cancer surgery?
Gastric cancer surgery is complicated with large anatomical trauma, which is a big blow to patients. The risk of anastomotic fistula is inevitable, especially the chance of fistula in the esophago-jejunostomy anastomosis after total gastrectomy is greater; the process of stripping lymph nodes is very likely to damage the pancreas and cause postoperative pancreatic leakage and abdominal cavity infection. The risk of surgery is further increased by the patient’s own factors, such as huge tumor invading the surrounding organs or serious underlying diseases. The mortality rate of gastric cancer surgery in western developed countries is about 4-10%, but the mortality rate of gastric cancer surgery in Zhongshan Hospital is within 1%, which is the leading level in the world.
10.What issues should patients pay attention to in their life after surgery?
First of all, facing the disease, patients and family members should actively adjust their mentality, be confident and actively cooperate with the treatment. After gastric cancer surgery, they should pay attention to the diet rule, eat less and more meals, and eat 6 to 8 times a day, and each time should not be too much. As long as you want to eat and have no discomfort after eating, you can eat in moderation. Fish and eggs are nutritious and easily absorbed by the body, so the proportion of them in the recipes can be increased appropriately. In order to strive for early recovery, the total amount of food eaten daily should reach more than 70% of the pre-operative level as early as possible. Post-operative patients are often weak, lacking in vital energy and easily sweating, so they can take American ginseng for nourishment. Postoperative patients will have different degrees of abdominal pain in different parts, as long as it is not very serious, it is a normal phenomenon after surgery. The bowel pattern may be abnormal for a period of time after surgery, but there should be anal exhaust every day, and if there is no exhaust at the same time with abdominal pain and bloating, you should stop eating and consult a doctor in time.
11.Does chemotherapy have to be given after surgery?
Whether chemotherapy is necessary after gastric cancer surgery should be decided according to the stage of gastric cancer and the patient’s physical condition. Early stage gastric cancer has a high cure rate after surgery, so chemotherapy is generally not necessary. Patients with progressive gastric cancer can improve their overall survival rate by receiving preoperative or postoperative chemotherapy. Postoperative chemotherapy is recommended if the tumor invades the whole stomach wall or has lymph node metastasis. If there are high risk factors for recurrence of gastric cancer, the decision should be discussed with the doctor. The timing of chemotherapy is usually chosen around 1 month after surgery, when the patient has no or only mild discomfort symptoms, eats well and can move around normally.
12.What are the side effects?
The common side effects after chemotherapy are vomiting, loss of appetite, weakness, diarrhea, pain at the injection site and low white blood cells, etc. Usually, chemotherapy drugs for gastric cancer do not cause severe hair loss. For gastric cancer patients, the vomiting reaction of chemotherapy is more obvious, but the process of chemotherapy can be made easy with the guidance of experienced doctors to apply anti-emetic drugs. Low leukocytes can be complicated by serious infection, which will directly affect the smooth progress of the next course of chemotherapy. Therefore, blood routine should be closely monitored during chemotherapy, and leukocyte-raising drugs can be injected when leukocytes are obviously low.
13.Is there a “good drug” for gastric cancer?
The development of cancer treatment drugs is very fast. Compared with the past, there are more drugs available for gastric cancer treatment. New drugs may have improved efficacy compared with the old ones, and the price is often high. Therefore, patients should fully consider their financial capacity when accepting the treatment plan from their doctors.
14.Do I need regular review after surgery?
Post-surgical follow-up of gastric cancer can receive appropriate guidance to deal with long-term complications such as anemia, and at the same time, recurrence can be timely detected and dealt with accordingly. Usually, you should come to the hospital for examination every 6 months within 2 years after surgery, and after 2 years, you can receive examination once a year. The examination includes blood tumor marker test (CEA, CA199, etc.), CT, gastroscopy and other items.