Surgical intervention remains the primary method of treating gastric cancer. Whenever possible, abdominal exploration surgery should be pursued if the patient’s overall condition allows. Depending on the condition of the gastric cancer, curative resection surgery or palliative resection surgery can be performed to cure the disease or prolong life and improve quality of life.
1.Gastric cancer treatment-Curative Surgery
In China, the 5-year survival rate of gastric cancer patients after curative surgery was only 30.9% in 1976, which increased to 39.4% by 1986. Some hospitals even achieved rates exceeding 50%. The improvement can be attributed to the following factors:
- A lower proportion of early-stage gastric cancer cases.
- Insufficient radical cure in the initial treatment. Due to inadequate radical resection and lymph node dissection during the initial treatment, postoperative recurrence and treatment failure occurred.
Therefore, emphasizing standardized treatment is essential. For some early-stage gastric cancers, which rarely or never have lymph node metastasis, endoscopic mucosal resection or laparoscopic local resection can be performed for curative purposes, achieving favorable results. For advanced-stage gastric cancer, in order to increase the surgical resection rate, some hospitals attempt preoperative or intraoperative radiation therapy to improve the resection rate and postoperative survival. Some hospitals also use chemotherapy before or during surgery to reduce the activity of cancer cells and prevent their spread and metastasis. For patients with lymph node metastasis, postoperative adjuvant chemotherapy can yield good results.
2.Palliative Surgery
Due to local infiltration and distant metastasis of gastric cancer, the opportunity for curative surgery is lost, and only the primary lesion or partial metastatic lesions can be removed, which is known as palliative resection surgery. This surgery can effectively relieve obstruction, control bleeding, alleviate pain, prevent acute perforation, reduce toxic symptoms, improve quality of life, and prolong survival. The 3-year and 5-year survival rates after surgery are 13.2% and 7.1%, respectively.
In summary, based on the specific condition of the patient and the stage of gastric cancer, doctors will choose appropriate treatment methods for treatment and rehabilitation. During the treatment process, patients also need to actively participate in rehabilitation training and adopt a proper diet to improve quality of life and promote the recovery process.
3. Recent research of Gastric cancer
Gastric cancer remains a significant global health challenge, particularly in East Asia where it is more prevalent. Recent research has focused on improving early detection, advancing treatment modalities, and understanding the molecular basis of the disease to develop more targeted therapies. Here are some of the latest research developments in gastric cancer treatment:
- Immunotherapy: Immunotherapy, which harnesses the body’s immune system to fight cancer, has shown promising results in several types of cancer. In gastric cancer, drugs like PD-1 and PD-L1 inhibitors (such as pembrolizumab and nivolumab) have been approved for use in certain patients based on clinical trials demonstrating improved survival rates in those with advanced disease.
- Targeted Therapy: Targeted therapies that attack specific molecular abnormalities in cancer cells are being explored. For instance, HER2-positive gastric cancer, which accounts for about 15% of cases, can be treated with trastuzumab (Herceptin,developed by Genentech) in combination with chemotherapy, significantly improving outcomes.
- Precision Medicine: Advances in genomic profiling are enabling a more personalized approach to treatment. By analyzing the genetic makeup of a patient’s tumor, doctors can select therapies that are more likely to be effective against that specific cancer.
- Neoadjuvant and Adjuvant Therapies: Research is ongoing to determine the best use of chemotherapy and radiation therapy before (neoadjuvant) and after (adjuvant) surgery to improve survival rates. These approaches aim to eliminate any remaining cancer cells and reduce the risk of recurrence.
- Microbiome Research: There is growing evidence suggesting that the gut microbiome may play a role in gastric cancer development and response to treatment. Studies are exploring how manipulating the microbiome could potentially enhance treatment efficacy.
- Early Detection and Screening: Novel biomarkers and imaging techniques are being developed to improve early detection, which is critical for better treatment outcomes.
- Combination Therapies: Clinical trials are testing various combinations of chemotherapy, immunotherapy, and targeted therapies to find the most effective treatment regimens.
These research efforts reflect a multidisciplinary approach to tackling gastric cancer, with the goal of improving patient outcomes through more effective and individualized treatments. As research continues, it is hoped that these advancements will lead to better survival rates and quality of life for gastric cancer patients.
