How is stomach cancer treated?

Written by Liu Liang
Oncology
Updated on September 21, 2024
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The treatment for gastric cancer now includes surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy, among others. The specific treatment plan is formulated based on various factors such as the staging of the cancer, the patient's overall condition, and the presence of any underlying diseases, which are all taken into consideration before deciding on a treatment plan. For patients in the early stages who are generally in good condition, surgical resection can be evaluated and is primarily curative. Post-operative treatment decisions, such as whether to pursue adjuvant radiotherapy or chemotherapy, depend on the pathology results and the presence of high-risk factors for recurrence. For patients in advanced stages who are found to have distant metastases upon diagnosis, treatment is primarily chemotherapy. Additionally, there are broad-spectrum targeted therapies against angiogenesis, such as apatinib, which are suitable for patients with advanced gastric cancer or those who do not respond well to chemotherapy, serving as a secondary or tertiary line of treatment. These are some of the treatment methods for gastric cancer. It is crucial that the use of any medication is conducted under the guidance of a doctor.

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Oncology
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What are the symptoms of gastric cancer?

The symptoms of gastric cancer patients are generally common gastrointestinal symptoms such as nausea, vomiting, acid reflux, and discomfort and bloating in the upper abdomen, especially aggravated after eating. As the condition progresses, symptoms may include vomiting blood or black stools. When the cancer invades surrounding organs, clinical symptoms such as abdominal effusion, abdominal distension, and pain may occur. If the tumor is located near the pylorus and causes pyloric obstruction, symptoms of pyloric obstruction will appear, such as gastric retention, acid reflux, and vomiting of overnight food. Additionally, if the tumor bleeds, it may cause severe vomiting of blood. Therefore, different stages of the disease present different symptoms. If gastric cancer progresses to the late stage with metastasis to distant organs, clinical manifestations corresponding to the sites of metastasis will also appear.

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Symptoms of gastric cancer

Symptoms of gastric cancer include nausea, vomiting, acid reflux, pain in the upper abdomen, and a sense of fullness and discomfort, especially after eating, which are some of the early symptoms. As the tumor progresses, symptoms can worsen, including pain, vomiting of blood, and black stools indicating upper gastrointestinal bleeding. If the tumor is near the pylorus, it can cause pyloric obstruction, which manifests as acid reflux followed by vomiting of undigested food from the previous night. In the late stages of gastric cancer, patients may experience fatigue, weight loss, severe cachexia, and anemia. These are symptoms of advanced gastric cancer.

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What are the symptoms of stomach cancer?

Symptoms of gastric cancer, especially in the early stages, generally include nausea, vomiting, loss of appetite, discomfort or bloating in the upper abdomen, pain, and acid reflux as some of the gastrointestinal symptoms, as well as vomiting blood and black stools. Black stools are tar-like stools, and their occurrence indicates bleeding in the upper gastrointestinal tract. Additionally, if the tumor causes pyloric obstruction, the patient will vomit food eaten the night before, be completely unable to eat, and experience a significant weight loss. In even more advanced stages, gastric cancer patients may develop a cachectic state.

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Oncology
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Late-stage symptoms of gastric cancer

The common late-stage symptoms of gastric cancer patients include nausea, vomiting, and even a complete inability to eat. There are also symptoms related to the digestive tract such as pain in the upper abdomen and acid reflux, as well as upper gastrointestinal bleeding, such as vomiting blood and melena which are signs of lower gastrointestinal bleeding. Late-stage gastric cancer patients may also experience organ metastasis, leading to corresponding symptoms. For example, metastasis of gastric cancer to the liver can cause abdominal pain and ascites due to hepatic metastatic tumors. Clinical manifestations caused by such metastatic tumors also include metastasis to retroperitoneal lymph nodes in the abdominal cavity, a common site of spread for gastric cancer. Patients may even show symptoms of intestinal obstruction, such as abdominal pain, bloating, nausea, vomiting, inability to pass stool, or even absence of flatus, which are indicators of intestinal obstruction. Consequently, patients might experience weight loss and deteriorate into a cachectic state, marked by poor nutrition and significant weight loss, which are characteristic symptoms of late-stage patients.

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How to check for gastric cancer?

Gastroscopy is very important in the examination of gastric cancer, and taking a biopsy under gastroscopy is an important means of diagnosis. Other examinations include endoscopic ultrasound or enhanced abdominal CT and chest CT to assess the staging of the patient. With endoscopic ultrasound, we can see which layer of the stomach wall the tumor has invaded and then combine it with chest and abdominal CT scans to assess whether there is distant metastasis. Diagnosis requires gastroscopy with a biopsy taken during the procedure.