Determine the stage of stomach cancer
Stages of stomach cancer help your doctor decide which treatment method is best for you. Tests and procedures used to determine stage of cancer include:
- Imaging test: Tests may include CT and positron emission tomography (PET).
- Probe surgery: Your doctor may recommend surgery to look for signs that your cancer has spread beyond the esophagus or stomach, in your chest or abdomen. Exploratory surgery is usually done by laparoscopy. This means that the surgeon makes some small incisions in your abdomen and installs a special camera to transfer the images to a monitor in the operating room.
Other tests may be used, depending on the patient’s condition.
Treatment of stomach cancer is determined
Early-onset stomach cancer can be a silent threat, usually causing few or no symptoms until the disease develops into a more advanced stage and is harder to treat.
Stage 0 cancer is limited to the inner lining of the stomach and does not develop into the deeper layers, they can be treated with surgery arts alone. No need chemotherapy or radiation.
Surgery with partial or total gastric bypass is usually the main treatment for these cancers. Nearby lymph nodes are also removed.
Currently resection endoscopy is the standard treatment for stomach cancer early stages, when the disease has spread to the ability of lymph nodes is very low.
Endoscopy allows doctors to see clearly inside the body. The doctor brings the endoscope down the patient’s throat and to the affected area. Using specialized tools and techniques, they eliminate early stage cancer.
Doctors use these two types of colonoscopy to remove cancer from the lining of the stomach:
- Endoscopic mucosal resection (EMR): removes abnormal areas in the gastric mucosa. The doctor uses a long flexible tube with a small camera and light at the head to look inside the stomach of friend. They then removed the abnormal area by passing special tools through the tube.
- Endoscopic mucosal dissection (ESD): using much newer techniques that allow doctors to remove damage in one piece. Lesion analysis in one piece helps pathologists learn more about cancer so they can develop more targeted treatments. ESD reduces the risk of stomach cancer coming back to a lower level.
In stage IA, the cancer has spread completely through the innermost lining of the stomach wall. There is no cancer in the lymph nodes.
For cancer stage IA cancer usually removed by surgery gastrectomy or half full. Nearby lymph nodes are also removed.
Endoscopic resection is rarely an option for some small stage Ia cancers. No further treatment is required after surgery.
Stage IB cancer has spread completely through the mucosa and is found in up to 6 lymph nodes near the tumor, or it has spread to the middle layer of the stomach wall
The main treatments for stage gastric cancer is surgery gastrectomy or half full. Chemical treatment or chemotherapy (chemotherapy plus radiotherapy) may be given before surgery to shrink the cancer tries and eliminates easier.
After surgery, the patient had lymph nodes removed when surgery did not show signs of cancer spread without further treatment.
Doctors will often recommend chemotherapy or chemotherapy alone after surgery. Patients who have received chemotherapy before surgery may receive the same chemotherapy after surgery to reduce the risk of cancer coming back.
If cancer is found in lymph nodes treated with chemotherapy, chemotherapy or a combination of both is usually recommended.
Stage II the cancer has spread completely through the mucosa and is found in 7-15 lymph nodes near the tumor, or it has spread to the muscle layer and is found in up to six lymph nodes near the tumor, or it has spread to the outermost serum layer but not to the lymph nodes or other organs
The main treatment for stage II stomach cancer is surgery to remove all or part of the stomach, egg cells and nearby lymph nodes.
Many patients receive chemotherapy or chemotherapy before surgery to try to shrink the cancer and make it easier to remove.
Postoperative treatment may include chemotherapy or chemotherapy.
In patients who do not have the health conditions to undergo surgery, the main treatment is chemotherapy or radiation .
At this stage, the cancer may have spread through all layers of the esophagus or stomach and spread to nearby structures. Or it may be a smaller cancer that has spread to the lymph nodes more.
Surgery is the main treatment for patients at this stage.
Some patients can be cured with surgery along with other treatments, while for others surgery can help control cancer or help reduce symptoms.
Some people may have chemotherapy or chemotherapy before surgery to try to shrink the cancer and make it easier to remove. Patients who receive chemotherapy before surgery may also receive chemotherapy afterwards. For patients who do not get chemotherapy before surgery and for those who have had surgery but have some cancers left behind, postoperative treatment is usually chemotherapy.
Alternative treatments are chemotherapy or radiation for patients who are unwell to perform surgery.
Stage IV cancer has spread to the organs next to the stomach and to at least one lymph node, or to more than 15 lymph nodes or other parts of the body.
Stage IV stomach cancer has spread to distant organs, so treatment is often impossible. But regular treatment can help control cancer and help reduce symptoms. This may include surgery such as gastrectomy or even subcutaneous gastrectomy in some cases to keep the stomach or intestines from clogging or controlling bleeding.
In some cases, using a laser illuminated through an endoscope can destroy most tumors and reduce congestion without surgery. If necessary, a stent may be placed where the esophagus and stomach meet to help keep it open and allow food to pass through it. This can also be done at the junction of the stomach and small intestine.
Chemotherapy or radiation can often help reduce cancer and relieve some symptoms as well as help patients live longer, but are often not expected to cure cancer. The combination of the most commonly used chemical drug, but which one is best is unclear.
Targeted therapy may also be helpful in treating advanced stomach cancer. Trastuzumab ( Herceptin ) may be added to chemotherapy for HER2-positive tumor patients. Ramucirumab ( Cyramza ) may also be an option at some points. It may be supplied by itself or added to chemistry. The immunotherapy pembrolizumab ( Keytruda ) may also be an option at some point.
Nutrition is a problem for many patients with stomach cancer. Assistance is available from nutrition counseling to placing a tube into the small intestine to help provide nutrition to those who have difficulty eating, if needed.
Stomach cancer recurs
Cancer that returns after the initial treatment is called recurrent cancer. The treatment options for recurrence are usually the same as for stage IV cancer.
But the treatment also depends on where the stomach cancer recurs , the treatment a person has and the person’s general health.
New clinical trials or treatments may be an option and need to be considered.
Reference Source for treatment of stomach cancer by stages:
PGS.TS. Trần Ngọc Ánh hiện là Bệnh viện Đại học Y Hà Nội, Phó giáo sư chuyên ngành Nội Tiêu hóa Trưởng Khoa Nội tổng hợp-u hóa của Trường Đại học Y Hà Nội. Bác sĩ tư vấn tại Nhà Thuốc ThuocLP.
Trình độ chuyên môn, Học hàm- Học vị:
Tốt nghiệp hệ Bác sĩ đa khoa, Trường Đại học Y Hà Nội
Tốt nghiệp Thạc sỹ chuyên ngành Nội khoa, Trường Đại học Y Hà Nội
Tốt nghiệp chương trình đào tạo chuyên khoa chuyên ngành Tiêu hoá, Trung tâm Viện Trường Henri Mondor, Đại học Paris 6, Cộng hòa Pháp 1996-1997; 1999
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Tốt nghiệp chương trình đào tạo chuyên khoa chuyên ngành các bệnh lý gan mạn, Pizza, Italia 2009
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Phó giáo sư, Chuyên ngành Tiêu hoá, Trường Đại học Y Hà nội
Đào tạo và Nghiên cứu khoa học:
Đã công bố hơn 200 bài báo trên các tạp chí chuyên ngành trong nước và quốc tế
Chủ biên nhiều sách chuyên khảo và tham gia biên soạn 2 sách giáo khoa.
Hướng dẫn nhiều sinh viên và học viên sau đại học của Trường Đại học Y Hà Nội
Chủ nhiệm nhiều đề tài nghiên cứu cấp cơ sở
Chứng chỉ Y khoa:
Chứng chỉ thực hành lâm sàng tốt (GCP: 2012, 2015), Bộ Y tế
Chứng chỉ chuyên ngành: Nội soi tiêu hoá thông thường, Nội soi tiêu hoá can thiệp, Siêu âm tiêu hoá thông thường, Siêu âm tiêu hoá can thiệp (BV Bạch Mai), Bệnh lý gan mạn.