Stomach cancer like many other cancers if diagnosed at an early stage can give 90% better results. After diagnosis of stomach cancer, staging is done before initiating the treatment. Modalities used to stage stomach cancer include- endoscopy, computed tomography (CT Scan), MRI abdomen, PET scan and laparoscopy. A simple form of stomach cancer can be staged as follows:
Stage I. Cancer is limited to the top layer of tissue that lines the inside of the stomach. Cancer cells may have also spread to 1-2 nearby lymph nodes.
Stage II. Cancer has grown into the deeper muscle layer of the stomach wall and spread to nearby lymph nodes.
Stage III. Cancer may have grown through all the layers of the stomach and spread to nearby structures OR may have spread more extensively to the lymph nodes.
Stage IV. Cancer has spread to the distant areas of the body.
Treatment of stomach cancer depends upon the extent and spread of the cancer in and around stomach. Surgery is the cornerstone treatment for localized stomach cancer. Complete tumor resection with negative margins along with regional lymph nodes remains the standard goal of surgery. Treatment options include:
- Endoscopic resection for very early cancers- it is applied in very early cancer and involves removal of cancerous lesion only without dissection of lymph nodes.
- Subtotal (partial) gastrectomy
- Total gastrectomy
Above two options include removal of part of stomach or whole of the stomach depending upon the location and size of the tumor with surrounding lymph nodes. Continuity of gastro-intestinal tract is maintained by interposing segment of small intestine in between.
- Chemotherapy (use of drugs)- chemotherapeutic drugs are usually given after surgery depending on the final biopsy report or in advanced cases where surgery is not indicated. Sometimes chemotherapy is given before surgery to decrease tumor burden.
- Radiotherapy- it may be combined with chemotherapy in some cases.
- Palliative surgery is done for cancers that cannot be removed completely.
- Targeted therapy or immunotherapy may also be helpful in advanced stomach cancers.
- Best Supportive Care- in advanced disease when surgery is not possible and patient is not fit for chemotherapy and radiotherapy, supportive care is given for symptom relief.
Awareness of the early symptoms of disease and timely treatment at specialized centres help in achieving satisfactory results.