Stomach Cancer Prevention

Stomach Cancer Prevention 2

Stomach Cancer Prevention 3

Stomach Cancer Prevention 5

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      Detailed Guide: Stomach Cancer

Treatment Choices by Type and Stage of Stomach Cancer

Stage 0: Because stage 0 cancers are limited to the lining layer of the stomach and have not invaded the underlying tissue of the stomach, they are treated by surgery alone. No chemotherapy or radiation therapy is needed. In very early cases of small cancers, they can be treated by endoscopic mucosal resection. In this procedure just the cancer is removed through the endoscope. This procedure is done in Japan where cancers are often detected early because of screening. It is not a standard procedure in the United States where gastrectomy (surgical removal of part or all of the stomach) and lymphadenectomy (removal of the nearby lymph nodes) is usually done.

Stage I: People with stage I stomach cancer will have their cancer surgically removed by a total or partial gastrectomy (the complete or partial removal of the stomach), and removal of the omentum (fatty tissue in the abdomen) and nearby lymph nodes. No additional therapy is usually required for stage IA patients. Those with stage IB disease might be considered for postoperative adjuvant chemotherapy (treatment given after surgery) with an agent such as 5-FU, along with radiation therapy. Studies have shown that this will help many people with stage IB stomach cancer to live longer.

Stage II: People with stage II stomach cancer are treated with surgical removal of all or part of their stomach and an extended lymphadenectomy (removal of more lymph nodes). A recent study has shown that adjuvant chemotherapy (treatment given after surgery) with 5-FU along with radiation therapy helps people with stage II stomach cancer to live longer.

Stage III: Patients with this stage disease should have surgery (unless they have other medical conditions that make them too ill for surgery) because up to 15% of these cancers may be successfully treated. Also, the surgery may help relieve symptoms from the cancer. A recent study has shown that adjuvant chemotherapy with 5-FU along with radiation therapy (treatments in addition to surgery) helps people with stage III stomach cancer to live longer.

Stage IV: Because stage IV stomach cancer has spread to distant organs, a cure is usually not possible. Patients with advanced stomach cancer often need surgery to prevent stomach and/or intestinal obstruction (blockage) or to control bleeding. In some cases, a laser beam directed through the endoscope can vaporize most of the tumor and relieve obstruction without surgery.

Chemotherapy and/or radiation therapy can often help relieve some symptoms but is usually not expected to cure the cancer. The chemotherapy drugs often used include 5-FU, cisplatin, and either epirubicin or etoposide. Docetaxel or irinotecan may also be used. The preferred way to give the 5-FU is by continuous infusion through a catheter (a tube used to inject or withdraw fluids) placed into a large vein. But other approaches may be just as successful. New treatments being tested in clinical trials may benefit some patients. Even if treatments do not succeed in destroying or shrinking the cancer, there are ways to relieve the pain and symptoms from the disease. Patients should tell their cancer care team about any symptoms or pain they experience right way, so they can be effectively managed.

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