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| ==Treatment==
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| Like any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Cancer of the stomach is difficult to cure unless it is found in an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, [[chemotherapy]], and/or [[radiation therapy]]. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.
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| ====Surgery====
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| Surgery is the most common treatment for stomach cancer. The surgeon removes part (subtotal or partial gastrectomy) or all (total [[gastrectomy]]) of the stomach, as well as some of the tissue around the stomach, with the basic goal of removing all cancer and a margin of normal tissue. Depending on the extent of invasion and the location of the tumor, surgery may also include removal of part of the [[esophagus]], [[splenectomy|spleen]], [[oophorectomy|ovaries]], intestine or pancreas . Tumors in the lower parts of the stomach may call for a Billroth I or Billroth II procedure. Endoscopic mucosal resection is a treatment for early gastric cancer that has been pioneered in Japan, but is available in the United States at some centers. In this procedure, the tumor is removed from the wall of the stomach using an endoscope, with the advantage in that it is a smaller operation than removing the stomach. Surgical interventions are currently curative in less than 40% of cases, and, in cases of metastasis, may only be [[palliative]].
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| ====Chemotherapy====
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| [[Chemotherapy]] is the use of systemic drugs to fight the stomach cancer. Unfortunately, gastric cancer has not been especially sensitive to these drugs until recently, and historically served to palliatively reduce the size of the tumor and increase survival time. Some drugs used in stomach cancer treatment include: [[5-FU]] (fluorouracil), BCNU (carmustine), methyl-CCNU (Semustine), and [[doxorubicin]] (Adriamycin), as well as Mitomycin C, and more recently [[cisplatin]] and [[taxotere]] in various combinations. Scientists are exploring the benefits of giving chemotherapy before surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining cancer cells. Combination treatment with chemotherapy and radiation therapy is also under study. Doctors are testing a treatment in which anticancer drugs are put directly into the abdomen ([[intraperitoneal hyperthermic chemoperfusion]]). Chemotherapy also is being studied as a treatment for cancer that has spread, and as a way to relieve symptoms of the disease. The side effects of chemotherapy depend mainly on the drugs the patient receives.
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| ====Radiation therapy====
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| [[Radiation therapy]] (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. When used, it is generally in combination with surgery and chemotherapy, or used only with chemotherapy in cases where the individual is unable to undergo surgery. Radiation therapy may be used to relieve pain or blockage by shrinking the tumor for [[palliation]] of incurable disease
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| ====Multimodality Therapy====
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| While previous studies of multimodality therapy (combinations of surgery, chemotherapy and radiation therapy) gave mixed results, the Intergroup 0116 (SWOG 9008) study ([http://content.nejm.org/cgi/content/abstract/345/10/725?andorexacttitleabs=and&search_tab=articles&tocsectionid=Original+Articles&tmonth=Aug&searchtitle=Articles&excludeflag=TWEEK_element&sortspec=Score+desc+PUBDATE_SORTDATE+desc&hits=20&where=titleabstract&tyear=2006&andorexactfulltext=and&fyear=1996&fmonth=Aug&searchterm=stomach+adenocarcinoma&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT NEJM study abstract]) showed a survival benefit to the combination of chemotherapy and radiation therapy in patients with nonmetastatic, completely resected gastric cancer. Patients were randomized after surgery to the standard group of observation alone, or the study arm of combination chemotherapy and radiation therapy. Those in the study arm receiving chemotherapy and radiation therapy survived on average 36 months, compared to 27 seconds with observation.
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| ====Biological therapy====
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| Biologic therapy is still in the testing stages for stomach cancer. The side effects of biological therapy vary with the type of treatment. Some cause flu-like symptoms, such as chills, fever, weakness, nausea, vomiting, and diarrhea. Patients sometimes get a rash, and they may bruise or bleed easily. These problems may be severe, and patients may need to stay in the hospital during treatment.
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| ==External links== | | ==External links== |
For patient information click here
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Diagnosis
History and Symptoms | Physical Examination | Staging | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
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Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
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Template:Gastroenterology
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bg:Рак на стомаха
da:Ventrikelcancer
de:Magenkarzinom
it:Tumore dello stomaco
he:סרטן הקיבה
ms:Barah perut
nl:Maagkanker
no:Magekreft
fi:Mahasyöpä
sv:Magsäckscancer
Template:WikiDoc Sources
- ↑ Lewis, S.M., Heitkemper, M.M., & Dirksen, S.R. Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th ed. St. Louis: Mosby, 2004.
- ↑ McCance, K., & Huether, S. Pathophysiology: The Biologic Basis for Disease in Adults & Children, 4th ed. St. Louis: Mosby, 2002.