From the Guidelines
Gastric cancer symptoms include abdominal pain, weight loss, and difficulty swallowing, and treatment options depend on the stage of the disease, with surgery, chemotherapy, and targeted therapies being potential treatments.
Symptoms of Gastric Cancer
- Abdominal pain
- Weight loss
- Difficulty swallowing
- Nausea and vomiting
- Bloating and discomfort in the upper abdomen
Treatment Options for Gastric Cancer
- Surgery: The primary treatment option for medically fit patients with resectable gastric cancer 1
- Chemotherapy: May be used as perioperative treatment for medically fit patients with resectable locoregional distal esophageal, gastroesophageal junction, and gastric adenocarcinoma 1
- Targeted therapies: Such as trastuzumab, nivolumab, and pembrolizumab, have produced encouraging results in clinical trials for the treatment of patients with locally advanced or metastatic disease 1
- Palliative management: Includes systemic therapy, chemoradiation, and/or best supportive care, and is recommended for all patients with unresectable or metastatic cancer 1
- Multidisciplinary team management: Essential for the management of patients with gastric cancer, especially those with localized disease 1 The treatment of metastatic gastric cancer is challenging, and comprehensive treatment based on systemic antitumor therapy is recommended, with other therapeutics such as palliative surgery, radiotherapy, and arterial embolization may help to prolong survival and improve quality of life 1. Best supportive care is an integral part of treatment, especially in patients with unresectable locally advanced, recurrent, or metastatic disease, and includes assessment of disease severity and related symptoms to initiate appropriate palliative interventions 1.
From the Research
Symptoms of Gastric Cancer
- Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis 2
- Early gastric cancer is often asymptomatic, leading to frequent delays in diagnosis 2
Treatment Options for Gastric Cancer
- Surgical resection of the tumor at an early stage is the only effective treatment method 3
- Minimally invasive techniques can be used for treatment of early gastric cancers 4
- Endoscopic resection techniques are emerging as successful treatment options for early gastric cancer 2
- Treatment options for advanced gastric cancer include surgery and chemotherapy 2
- Perioperative chemotherapy has become the standard treatment for resectable gastric cancer 5
- Systemic therapies, including chemotherapy, targeted therapy, and immunotherapy, have evolved significantly in recent years 5
- Triplet chemotherapy for resectable gastric cancer is now accepted and could represent a plateau of standard cytotoxic chemotherapy for localized disease 6
Prevention Strategies
- Helicobacter pylori eradication is an effective measure in the prevention of gastric cancer 3
- Adoption of a healthy diet consisting of fruits and vegetables can help prevent gastric cancer 2
- Prevention strategies should be based on specific risk profiles, including Helicobacter pylori genotype, host gene polymorphisms, presence of precursor lesions, and environmental factors 4
Diagnosis
- The diagnosis of gastric cancer typically involves a combination of endoscopy, biopsy, and imaging studies 2
- Classification based on molecular biomarkers, such as programmed cell death ligand 1 (PD-L1), microsatellite instability (MSI), and human epidermal growth factor receptor 2 (HER2), provides an opportunity to differentiate patients who may benefit from immunotherapy or targeted therapy 5, 6