Stomach Cancer | Abdominal Cancer | Treatment and Prevention

Treatment and prevention of stomach cancer

It is not frequently used because radio resistant tumor that requires doses of external radiation that exceed the tolerance of surrounding tissues.
Therefore, radiation has been mainly used for palliation of pain of advanced cancer.

Because of high recurrence, chemotherapy has also been used as an adjunct therapy and the results however are not encouraging.
Chemotherapy has been used to downstage locally advanced stomach cancer prior to surgery.

It remains the main treatment for cure and palliation of stomach cancer.
Surgery remains appropriate even when there are distant metastases because stomach cancers are not very sensitive to radio and chemotherapy.
So in early stages, local gastric resection and in advanced cases sub-total or total gastrectomy is advisable.
Follow-up
Patients with stomach cancer must be followed up every 4-6mths.
Following radical resection of the stomach, nutritional problems and dumping syndrome are likely.
Vitamin D and calcium mal-absorption may occur. Therefore, proper nutritional advice is given to all patients following surgery like
- Have more frequent small volume meals.
- Avoid fatty and very sugary meals and snacks.
- Avoid drinking water or liquids with meals.
- Prescription of supplements like iron, calcium and vitamin B12 are required.

Many patients with stomach cancer present with abdominal disease or have associated major ailments.
Surgical palliation by bypass, such as gastro-jejunostomy is the only treatment possible.
Palliation of vomiting and gastric stasis may be achieved in 70-90% of patients.
In patients who are poor, surgical risks or who refuse surgery, palliation may be done by endoscopic methods.
Endoscopic therapies like laser ablation, placement of plastic and expandable metallic stents and injection of alcohol have been tried with some success.
Pain is a distressing symptom of advanced cancer.
Adequate pain control can be achieved with medications including liberal use of morphine.

Early screening is the only method for prevention of stomach cancer.
In high prevalence areas, mass screening by radiological and endoscopic tests has been used for detection of stomach cancer.
Recently, serological methods using pepsinogen I/III ration in the serum are being evaluated for identifying those at high risk.
Early endoscopic evaluation may be done in all middle aged and elderly patients presenting with recent onset dyspepsia.
Restriction of salted and pickled foods and regular intake of fresh fruits and green yellow vegetables are useful in the primary prevention of stomach cancer.

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