Treatment Of Stomach Cancer
Treatment has to be individualized according to the stage the patient is in as I shall mention below. With this approach, these are the cancer cure rates that can be achieved (table below simplified from Ref.1 and 2).
5-year cure rates for stomach cancer
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The stomach cancer survival rate is impressive in stage I, but less so in stage IV. Conventional surgery consists of a partial or total gastrectomy. Stomach reconstruction is done using a section of small bowel. Stage II to IV needs to be combined with radiotherapy to achieve the survival rates shown here. This is based on the Japanese experience where intraoperative radiotherapy has been used extensively in large trials that showed conclusively that the cure rates are about 5% to 10% better than without this combination.
Chemotherapy has been investigated extensively in the US, but apart from impressive response rates in the 20% to 30% range following the first few months of treatment, there is a sudden resurgence of more aggressive cancer cells that have become chemoresistant and kill the patient about 9 to 18 months from the beginning of the chemotherapy. Further research is needed and will likely be developed in the next decade with new genetic approaches designed to overcome the weaknesses of the immune system while turning off the cancer gene (demonstrated in an animal model).
References:
1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Cancer of the stomach.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the stomach.
3. J Sun et al. Eur J Cancer Prev 2001 Feb;10(1):61-67.
4. SS Mirvish et al. Nutr Cancer 1998;31(2):106-110.
5. JM van Maanen et al. Cancer Detect Prev 1998;22(3):204-212.
6. JM van Maanen et al. Environ Health Perspect 1996 May;104(5):522-528.
7. B. Sears: “The age-free zone”.Regan Books, Harper Collins, 2000.
8. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
9. K Murakami et al. Am J Clin Pathol 2001 Feb;115(2):224-34.
10. Y Tsubono et al. N Engl J Med 2001 Mar 1;344(9):632-636.
11. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
12. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc
13. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
