Medical treatments

The treatments of stomach cancer vary depending on the stage and degree of malignancy (grade) of the cancer. Often, several therapies are combined, such as surgery, radiotherapy or chemotherapy.

The choice of treatment is subject to multidisciplinary consultation (at least 3 different specialists must be present: gastroenterologist, oncologist, surgeon. personalized treatment plan is developed for each person with stomach cancer, depending on the grade and extent of their disease.

La surgery is the only treatment that can eliminate the tumor and lead to a real cure. Sometimes it is not possible to completely remove the tumor because of its size or because the cancer has spread to other organs. In these cases, treatments are available to slow the progression of the disease and relieve the symptoms.

surgery

Surgery involves removing the affected part of the stomach and nearby lymph nodes.

If the tumor is very superficial (limited to the mucosa under the control of endoscopic echo, and in selected individuals), endoscopic resection is possible in a referral center. This involves removing the tumor without opening the abdomen, but passing a flexible tube through the mouth to the stomach in order to slide the instruments.

Depending on the location of the tumor in the stomach, the surgeon removes part of the esophagus (proximal cancer), or the small intestine (distal cancer). There are 2 techniques: partial gastrectomy, for cancers of the distal part of the stomach, or the total gastrectomy.

the surgeon performs an oeso-gastric anastomosis, which consists in stitching together the two parts of the operated on the esophagus and the stomach to restore continuity. This helps to keep a “gastric stump” (a piece of stomach) or to obtain an eso-jejunal passage where the esophagus is directly connected to the small intestine (anastomosis of the esophagus to the small intestine).

If you cancer is more extensive, affecting other nearby organs, it may be necessary to perform a more extensive surgery also concerning neighboring organs, mainly the spleen.

After undergoing a gastrectomy even total, it is still possible to eat well. However, since the capacity of the stomach is reduced (presence of a gastric stump or total absence of stomach), the operated person must adapt his diet, for example by taking smaller meals, but more in number. Patients who have had a gastrectomy should also take certain Dietary supplement, such as vitamin B12.

Chemotherapy

In stomach cancer, chemotherapy is usually used to kill the cancer cells.

In the case of localized cancer, the medical team may offer chemotherapy before the operation (chemotherapy preoperative) which decreases the size of the tumor, making it easier to remove the tumor afterwards Chemotherapy can also be done after the operation (chemotherapy postoperative) 6 to 8 weeks after surgery, in order to reduce the risk of recurrence.

In the case of metastatic cancer or inoperable tumor, chemotherapy is the standard treatment. It aims to limit the progression of the disease, relieve symptoms, improve quality of life. This is called chemotherapy palliative.

There are many protocols, and several ongoing therapeutic trials to define the best and increasingly effective treatments.

La cellular microbiology has made it possible to better understand the mechanisms of tumor growth, and to develop targeted therapies. It has been demonstrated on gastric cancer cells and on metastases of “HER2” proteins. In the case of a positive receptor, chemotherapy is added to “monoclonal antibodies”, which block the process of division and development of cancer cells. They also stimulate the immune system to help destroy cancer cells.

Chemotherapy can be given intravenously or orally. Chemotherapy drugs attack cancer cells, but they also damage some healthy cells. To give the body time to recover, chemotherapy is given cyclically. The Side effects are multiple: nausea, vomiting, fatigue, loss of appetite, hair loss and increased risk of infection.

Radiotherapy

La radiotherapy is little used in cases of stomach cancer. It can be done before, but most often after surgery, in combination or not with chemotherapy, which aims to potentiate radiotherapy. This is called “radio sensitizing chemotherapy”. It can also be used to relieve pain associated with a tumor that cannot be removed.

This treatment involves directing ionizing rays at a specific location on the body to destroy cancer cells that have formed there. As the high energy rays also damage healthy cells, this therapy has different Side effects which are more or less bothersome, depending on the person being treated. She may feel tired, or notice that the skin in the irradiated area is red and sensitive. Radiation therapy for a stomach tumor can cause diarrhea, indigestion, or nausea. The side effects of radiation therapy wear off after treatment, when healthy cells have regenerated.

Complementary approaches

Consult our Cancer file to learn about all the complementary approaches that have been studied with people with cancer, such as acupuncture, visualization, massage therapy and yoga. These approaches may be suitable when used in conjunction with complement medical treatment, and not as a substitute for it.