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
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).
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