What does it mean if my disease is “too advanced” for curative treatment?
When a gastric cancer diagnosis is caught early enough, doctors hope that the cancer cells are mostly found in one location so that they can all be cut out. This is called a curative gastrectomy – the stomach is removed and as long as there are no cancer cells left, the patient will hopefully enter remission.
Unfortunately, this is not always the case. That is, a lot of the time a patient will only find out about their cancer diagnosis when the disease has spread significantly. This could mean it has invaded multiple layers of the stomach (for example, a T3 or T4 tumor) and/or cancerous cells have moved to other areas of the body (M1, meaning metastasis has happened). So, a tumor would be considered advanced if some of its features make it impossible to remove with the intention of curing the disease completely.
What does this mean for my treatment?
Many advanced gastric cancer patients are treated with chemotherapy. However, it can be difficult to know which chemotherapy routine is best for each patient. Chemotherapy can be physically and emotionally difficult for patients, especially if it is not effective.
Surgery is usually only done in emergency situations or to reduce discomfort in cases of advanced gastric cancer. Some examples of surgical procedures which could be used are a palliative gastrectomy or bypass surgery. Palliative surgical procedures may be used for a few reasons. Firstly, they can cut out part of the cancerous area which is causing patients to feel pain. An example of this would be a partial gastrectomy. Otherwise, surgery might be used to partially redirect the GI tract. An example of this would be a gastric bypass operation. This might be helpful if the patient has a blockage near the stomach which makes it difficult to eat.
These two research articles hoped to learn better ways to treat advanced gastric cancer patients using surgery.