Perspective is the chances of improving the patient's condition. The doctor may refer to this as the prognosis of treatment. As with many other cancers, the outcome of gastric cancer treatment depends on its prevalence at the time of diagnosis.
How reliable are statistics on malignant diseases?
No statistics will tell you what will happen next. Statistics are unable to provide information about the different treatments that have been given to other people and the impact of that treatment on their prognosis.
Each cancer case is unique. For example, in different people, a tumor of the same type can grow at different rates.
The statistics are not detailed enough to describe the different treatments that are being given to other patients. Certain treatments help people live longer by relieving cancer symptoms. Many individual factors can influence your own prognosis and treatment. If your physical condition allows you to withstand the treatment, then the prognosis may be better than average.
Statistics on malignant neoplasms in general
Remember, statistics are averages that have been collected from a huge number of patients. These indicators will not be able to tell what will happen next with you. No two people are exactly the same, and the response to treatment is different for all patients.
You are completely free to ask your doctor questions about the prognosis of your treatment, but even your doctor cannot predict what it will be like. You may have heard that the doctor used the term "five-year survival". This does not mean at all that you will live only 5 years. This concept refers to clinical trials and the number of patients in them who are still alive 5 years after diagnosis. In any study, scientists study the health status of patients 5 years after treatment. This allows you to accurately compare the results of different treatments.
Clinical researches
Evidence suggests that participation in clinical trials can improve the prognosis for life. Nobody knows exactly what this is connected with. This may be partly due to more careful monitoring of patients who participate in a clinical study. For example, blood tests and instrumental examinations are more often prescribed to a patient.
OUTCOME OF TREATMENT IN GASTRIC CANCER DEPENDING ON THE STAGE
As with many other cancers, the outcome of gastric cancer treatment depends on its prevalence at the time of diagnosis. In other words, from the stage of the disease.
Since at the time of diagnosis in most cases, cancer is already common, the overall 5-year survival rate is only 15% (that is, only 15 out of 100 people survive within 5 years after cancer diagnosis).
The 10-year survival rate is 11% (that is, within 10 years after cancer diagnosis, only 11 people out of 100 survive).
For young people, survival rates are usually higher than for older people. In patients under 50 years of age, the five-year survival rate is 16-22% (that is, from 16 to 22 people out of 100 survive after cancer detection), while among patients over 70 years old, this indicator is 5-12%.
Stage 1
In patients with stage 1 cancer, the five-year survival rate is 80% (that is, 8 out of 10 people survive after cancer is detected). Unfortunately, stomach cancer is detected so early too rarely: perhaps only in 1 case in 100.
Stage 2
At the time of diagnosis, six out of 100 cancers (6%) have stage II. In patients with stage 2 cancer, the five-year survival rate is 56% (that is, after the detection of cancer, just over 5 people out of 10 survive).
Stage 3
The detection of cancer in the third stage is quite common. At the time of diagnosis, cancer is stage 3 in every patient out of seven. As you might expect, survival rates for this more advanced stage of gastric cancer are decreasing. Patients with stage 3a gastric cancer have a five-year survival rate of 38%. Patients with stage 3b gastric cancer have a five-year survival rate of 15%.
Stage 4
Unfortunately, cancer is common in 80% of patients at the time of diagnosis. This means that the tumor has already spread to other organs. As a consequence, survival rates will be even lower than for stage 3 gastric cancer. Doctors consider the patient's condition to be very good if, 2 years after the diagnosis of advanced cancer, the patient is still alive. In patients with stage 4 stomach cancer, the five-year survival rate is usually less than 5%.
+7 495 66 44 315 - where and how to cure cancer
Breast cancer treatment in Israel
Today in Israel, breast cancer can be completely cured. According to the Israeli Ministry of Health, Israel currently has a 95% survival rate for this disease. This is the highest rate in the world. For comparison: according to the National Cancer Register, the incidence in Russia in 2000 compared to 1980 increased by 72%, and the survival rate is 50%.
This type of surgical treatment was developed by the American surgeon Frederick Mos and has been successfully used in Israel over the past 20 years. The definition and criteria for Mohs surgery were developed by the American College of Mohs Surgery (ACMS) in conjunction with the American Academy of Dermatology (AAD).
You should not refuse surgical treatment, since a timely operation significantly prolongs a person's life and reduces the overall recovery time.
Indications and contraindications
A direct indication for surgery on the stomach is a malignant lesion of this organ.
The postoperative diet and chemotherapy and radiation sessions before and after surgery are of great importance in complete recovery.
But not always surgery for stomach cancer can be prescribed, contraindications for its implementation are:
- Metastases detected in the liver, lungs, ovaries, Douglas space, supraclavicular lymph nodes.
- The defeat of the lymph nodes located at a distance from the stomach.
- Ascites.
- Cachexia.
- Cancer peritonitis.
- Severe damage to the cardiovascular system, kidneys.
- Hemophilia.
The operation is performed in the absence of contraindications, regardless of the patient's age. Sometimes chemotherapy is required beforehand, which leads to a shrinkage of the tumor and the possibility of its removal.
Diagnostics before resection
Before any type of surgery on the stomach, patients with a cancerous lesion of this organ are necessarily assigned a number of studies.
They are necessary to clarify the functioning of vital organs, to accurately determine the location of the tumor in the stomachs, to identify all secondary foci.
- Gastroscopy. This research method detects all changes on the walls of the stomach, during which a biopsy is done, that is, the affected tissues are separated for histological examination.
- Computed tomography. This study shows the size of the tumor, its prevalence in all layers of the walls of the organ, damage to nearby organs and lymph nodes.
- Ultrasound scanning is necessary to identify secondary foci. Examining the abdominal organs, pelvic organs, chest.
- General blood tests and biochemistry. According to the data of blood indicators, one can judge the activity of the inflammatory process; they are also necessary to assess the functioning of the liver, heart, and the blood coagulation system.
- An ECG examination is done to detect changes in the functioning of the heart. For certain disorders, appropriate treatment is required before the operation.
- Chest X-ray.
Preparation measures
Before surgery for removal of a malignant tumor in the stomach, preparation of the patient is necessary. Preoperative measures are carried out in order to improve the functioning of the most important organs, and in order to improve the general well-being of a person.
The patient needs to explain the advisability of adhering to a special diet. Food for a few weeks before surgery should be consumed mainly in a mashed, easily digestible form. Food should be fortified, it is better to eat in small portions.
The psychological preparation of the patient is also important. Not all doctors are inclined to report a malignant lesion to their patient right away. Usually, the patient is told about a stomach ulcer, which must be urgently operated to avoid complications.
The patient should be tuned in to a favorable outcome of the surgical intervention, and his relatives can also be of great help in this.
Medical preparation of patients with stomach cancer before surgical treatment consists of:
- In taking vitamin complexes and agents that improve the performance of the digestive system.
- In the use of sedatives to improve sleep and overall well-being.
- In the transfusion of protein preparations and plasma when a patient is diagnosed with severe anemia.
- In the appointment of funds that improve the functioning of the liver, kidneys, heart.
- In antibiotic treatment, when an increasing inflammatory reaction and fever are detected.
When signs of bleeding are detected, hemostatic drugs are prescribed. Patients with oncological operations before the operation are often prescribed a course of Methyluracil, this drug has anti-inflammatory properties, improves metabolic processes and liver function.
In case of stomach cancer, chemotherapy drugs are often prescribed before the operation, their use allows you to stop the spread of cancer cells throughout the body, leading to a halt in tumor growth.
Correctly conducted preoperative preparation of patients with gastric cancer should ensure a decrease in the negative effect of pathology on the functioning of all organs, an increase in the immune system and psychological preparation of a person.
Types of stomach surgery for cancer
In oncology, several types of operations are used in the surgical treatment of stomach cancer.
They are selected based on the location of the tumor, the degree of its spread, the age of the patient is also taken into account, the presence of nearby metastases.
- Resection, that is, the removal of one of the parts of the stomach with a tumor.
- Gastrectomy is a complete excision of an organ, in which parts of the intestine, esophagus and other structures are also removed.
- Lymphadenectomy - cutting off the lymph nodes and blood vessels along with the surrounding fatty tissue. Lymph node removal is essentially part of a complete gastrectomy or gastric resection.
- Palliative surgery. This type of surgery is prescribed to alleviate the course of the disease in patients with inoperable gastric cancer. Various surgical techniques are used.
The decision on the type of surgical intervention is made after the doctor receives all the results of the examination of his patient.
Complete resection
A complete resection or total gastrectomy is the cutting off of an entire organ during an operation. It is prescribed if the cancer grows from the middle part of the organ or affects all its departments. In addition to the stomach, it is also removed:
- The part of the omentum is the fold of the peritoneum that holds the stomach.
- The pancreas is completely or a part of the organ affected by metastases.
- Spleen.
- Lymph nodes located next to the stomach.
After the stomach is removed, the upper part of the intestine is connected to the esophagus. The distal part of the duodenum 12 is also supplied to the intestine, which is necessary for the reflux of enzymes that facilitate the digestion of food.
Total gastrectomy is a difficult operation, and after it, the patient must adhere to the nutritional guidelines recommended by the doctor. How the person will feel in the future, and how the recovery period will go, depends on adherence to the postoperative diet.
Laparoscopic gastrectomy
Laparoscopic surgery is a minimally invasive surgery. Currently, such treatment is also possible with gastric cancer.
First, the surgeon makes a small incision on the patient's abdominal wall through which the endoscope is inserted, with its help he examines the stomach itself and the structures next to it. After the examination, several more incisions are made, which are necessary for the introduction of surgical instruments.
Laparoscopic intervention can be performed for gastric cancer, both for partial removal of the organ and for its complete gastrectomy.
Removal of the stomach, its parts, lymph nodes, affected organs are cut off using a special surgical knife. Enlargement of the abdominal cavity and better visibility of all internal parts of the body provides the introduction of carbon dioxide during laparoscopic intervention.
Thanks to the camera on the endoscope, the image is displayed on a large screen, the surgeon chooses to enlarge the image, which allows him to see all the changes and carry out the operation with high accuracy.
Compared to conventional surgery, laparoscopic gastrectomy has fewer complications.
After such an intervention, the patient tolerates the rehabilitation period more easily. But laparoscopy can not always be prescribed, and in about three percent of cases, when it is carried out, it is necessary, according to a number of identified changes, to proceed to conventional surgical intervention.
Partial proximal
Partial proximal gastric resection is indicated when the neoplasm is located in the upper part of the organ.
It is rarely performed, since the detected tumor must meet certain conditions, these are:
- The size of the neoplasm should not exceed 4 cm.
- Tumor growth must be exophytic.
- There should be no germination of cancer into the serous membrane.
Proximal resection involves not only cutting off the upper part of the organ, but also removing about 5 cm of the esophagus and lymph nodes. The operation ends with the formation of an anastomosis connecting the remaining stomach stump with the cut off esophagus.
Partial distal
Partial distal resection is chosen when a malignant tumor is diagnosed in the lower stomach.
At the same time, the lymph nodes, tissue affected by the tumor and, if necessary, part of the duodenum are removed. The distal resection ends with the formation of a gastroenteroanastomosis, that is, the rest of the stomach is sewn to the loop of the jejunum.
Removal of lymph nodes
Regardless of what kind of operation is performed for stomach cancer, removal of the lymph nodes is also considered a prerequisite. Cancer cells accumulate and develop in the lymph nodes, from where they can enter distant organs and tissues.
Palliative care
The term palliative surgery refers to a surgical procedure undertaken to relieve the symptoms of cancer.
Some types of such operations are performed with the aim of reducing the size of the cancer, which also leads to a decrease in intoxication and allows great success to be achieved using chemotherapy and radiation.
Palliative surgery for stomach cancer is divided into two types:
- The first option of surgery involves creating a bypass path between the small intestine and the stomach. This improves the patient's nutrition, which has a positive effect on his well-being and makes it possible to better tolerate further treatment. With this type of operation, the stomach can be removed, but the lymph nodes and cancer-affected tissues of the nearby organs are not touched.
- The second option implies complete excision of the tumor, this is necessary to enhance the effect of radiotherapy and chemotherapy.
Palliative surgery is prescribed in advanced cases, and it can somewhat prolong the patient's life. There are also contraindications to palliative operations, this is the involvement of the bone system, mesentery, peritoneum, lungs, and brain in the oncological process.
What is lymphadenectomy?
Lymphadenectomy for gastric cancer is the cutting off of the lymph nodes and blood vessels adjacent to the organ, along with the surrounding fatty tissue.
Lymphadenectomy differs in the amount of removal, which depends on the stage of the malignant lesion.
There are such types of lymph node clipping:
- D0 - lymph nodes are not removed during surgery.
- D1 - cutting off nodes located along the near and large curvature, next to the greater and lesser omentum.
- D2 - removal of the above-mentioned lymph nodes and nodes belonging to the second level.
- D3 - lymph nodes along the celiac trunk are additionally cut off.
- D4 - in addition to those listed, para-aortic nodes are cut off.
- Dn - removal of not only the lymph nodes, but also the organs affected by cancer located near the stomach.
The above options for removing lymph nodes are usually designated as D1 lymph node dissection. There is also another option, denoted by the term D2 lymphadenectomy, it also means resection of groups of lymph nodes located next to the main blood vessels of the stomach.
This surgical intervention is considered more complex in terms of the technique, but relapses of the disease occur less often with it.
Rehabilitation
The minimum rehabilitation period after removal of a part of the stomach or organ with a cancerous tumor is at least three months. At this time, it is very important to strictly adhere to all the doctor's recommendations, the lifestyle of a person in the future depends on it.
During the recovery period in the first weeks, you cannot:
- Visit baths, saunas.
- Stay under the sun for a long time.
- To resort to physiotherapy.
- Eat as usual.
Nutrition is the most important issue for gastric cancer patients. Since after the operation the size of the organ is reduced or anastomoses are created, it is necessary to adhere to certain rules in the choice of dishes.
For the first two to three postoperative weeks, a person should eat baby food - adapted formulas and purees. In the future, ordinary food is used, but it must be mashed, and the volume of the dish at a time should not exceed 300 grams.
Chemical irritants in the form of spicy, smoked pickled dishes, too salty food, alcohol are excluded. They switch to the usual diet gradually after about a year, but under the condition of normal restoration of the digestive function. But the operated person should always know what is forbidden for him and completely exclude it from his diet.
During the rehabilitation period, control examinations are periodically carried out, allowing time to detect a relapse of the disease.
Reviews after surgery for stomach cancer
My husband was diagnosed with stomach cancer a year and a half ago. At first there was a shock, because my husband is only 47 years old. But then we immediately began to consult several oncologists at once, all of them unanimously argued that the operation was necessary. Operated almost immediately, the upper part of the stomach was removed. The husband went through the recovery period very hard, lost weight, became irritable. But now everything is gradually returning to normal. I began to eat a little of the usual dishes, naturally not fatty and not too salty. There are no pains, as well as no metastases - he was examined a month ago. So far on disability, but hopes to get a working group. The doctor recommended that you periodically receive courses of vitamins and drink iron, because food is not absorbed as it should. I hope the worst is over.
The removal of the stomach after the detected cancer was carried out by my mother almost immediately. For more than four months after the operation, we were adjusting food. Everything seemed to be returning to normal, but the next examination showed the presence of metastases in the lungs. Now my mother is on pain relievers, and every day she is getting weaker. I swear at myself that I did not insist on a full examination three years ago, when problems with digestion appeared.
Survival prognosis and how long do patients live?
The survival rate of gastric cancer patients after surgery depends on the stage at which the surgical removal was performed.
Life is significantly reduced with the appearance of distant metastases, palliative operations only somewhat facilitate a person's well-being.
Video of Laparoscopic D2 Lymphadenectomy for Stomach Cancer:
Recurrent stomach cancer
Recurrence of gastric cancer is the re-development of a malignant tumor in the remainder (stump) of the stomach after radical surgery. The clinical picture is similar to that of primary gastric cancer. There is a deterioration in the general condition, dyspepsia and impaired patency of the gastrointestinal tract. Distinctive features of gastric cancer recurrence are higher aggressiveness, a tendency to infiltrative growth and germination of nearby organs. The diagnosis is made on the basis of anamnesis, complaints, results of gastroscopy with biopsy, ultrasound and CT of the abdominal organs. Treatment is surgical, drug or radiation.
Recurrent stomach cancer
Recurrence of gastric cancer is a malignant neoplasm that occurs some time after the removal of the primary tumor of the stomach. According to various sources, it is diagnosed in 20-60% of patients who underwent gastric resection due to cancer. It can develop from several months to several decades after surgery. Cases are described when recurrent cancer was diagnosed 30 or more years after the excision of the primary neoplasm. With early recurrence, the tumor is usually localized in the area of the anastomosis, with late - in the area of the lesser curvature, the cardiac section or the wall of the stomach stump. With late relapses of gastric cancer, the prognosis is more favorable. The treatment is carried out by specialists in the field of oncology and gastroenterology.
Reasons for the development of relapse of stomach cancer
In clinical practice, oncologists usually use the M.D. Laptin, according to which there are three groups of relapse of stomach cancer:
- Left (residual) cancer or early recurrence. It occurs up to 3 years after removal of the primary cancer. It accounts for 63% of the total number of relapses.
- Recurrent cancer or late relapse. It develops after 3 years after removal of the primary malignant neoplasm. It accounts for 23% of the total number of relapses.
- Primary (initial) cancer. It occurs 3 or more years after the removal of a benign stomach tumor. It accounts for 15% of the total number of relapses.
The reason for the development of a relapse of stomach cancer is the renewal of the tumor process, not removed malignant cells in the rest of the organ or regional lymph nodes. The likelihood of recurrence depends on the stage and degree of tumor differentiation. Stage I-II cancer recurs in 19%, with primary neoplasms of stage III, the risk of gastric cancer recurrence increases to 45%. The greatest number of recurrent tumors is detected in poorly differentiated forms of primary cancer.
Symptoms of recurrent stomach cancer
Recurrence of gastric cancer develops against the background of already existing post-resection disorders, so the initial stages of the disease can go unnoticed for the patient. A characteristic sign indicating the onset of a recurrent oncological process is the aggravation of symptoms after a light interval, the duration of which can range from several months to several decades.
The clinical picture resembles the symptoms of primary gastric cancer. Patients complain of weakness, unreasonable fatigue, apathy, loss of interest in activities that previously brought joy and satisfaction, as well as decreased ability to work for several weeks or months. Patients with recurrent stomach cancer have a persistent deterioration in appetite, weight loss, "gastric discomfort" (lack of satisfaction after eating, feeling full stomach when eating a small amount of food, pain, feeling of fullness or heaviness in the epigastric region), nausea, vomiting and pallor skin.
With early relapses of gastric cancer, predominantly localized in the area of the anastomosis, frequent vomiting, dehydration and severe exhaustion can be detected due to stenosis of the gastrointestinal anastomosis. With late relapses of gastric cancer, more often located in the cardiac region, dysphagia usually becomes the leading symptom. Often, the oncological process spreads to the rest of the stomach, which entails a rapid progression of symptoms.
Diagnostics of the recurrence of stomach cancer
The diagnosis is made taking into account the history, complaints, objective examination data, the results of instrumental and laboratory studies. During the survey, attention is paid to the progression of post-resection complaints in dynamics, lack of appetite, weight loss and the appearance of "gastric discomfort". The most informative research method that allows reliably diagnosing a relapse of stomach cancer is gastroscopy with endoscopic biopsy. To identify ascitic fluid and metastases in the liver, an ultrasound of the abdominal organs is prescribed. In some cases, using this technique, it is also possible to detect enlarged retroperitoneal lymph nodes.
More detailed information about the condition of nearby organs and lymph nodes in relapse of stomach cancer is obtained using CT of the abdominal cavity organs. Sometimes for the same purpose, laparoscopy is performed, which makes it possible to assess the condition of the anterior surface of the stomach, the lower and anterior surface of the liver, ovaries and spleen, to detect ascites and carcinomatosis of the peritoneum. To determine the level of anemia, patients with recurrent stomach cancer are prescribed a general blood test, and a biochemical blood test is performed to assess the functions of the liver and kidneys. The final diagnosis is made after morphological examination of the material taken during gastroscopy.
Treatment of relapse of stomach cancer
Treatment is predominantly surgical. In most cases, the most promising option for surgical intervention is the extirpation of the gastric stump. With a large stomach stump and a small neoplasm located in the anastomotic zone, gastric resection is sometimes performed. The possibility of reoperation depends not only on the size, location and prevalence of gastric cancer recurrence, but also on the type of primary surgery. After reconstruction of the stomach according to Billroth-II, repeated operations can be performed more often than after surgery according to Billroth-I.
Due to previous lymph node dissection, lymphogenous metastasis in recurrent gastric cancer differs from that in the primary tumor. Lymphogenous metastases can be found in the area of the hilum of the spleen, left paracardial lymph nodes, lymph nodes along the inferior diaphragmatic artery and lymph nodes in the mesentery of the small intestine. Features of lymphogenous spread of cancer cells necessitate extended lymph node dissection, spleen removal and mesentery resection.
With a widespread relapse of stomach cancer, complicated by gross strictures, palliative operations are performed. Chemotherapy provides temporary tumor regression in some patients, but does not affect the average life expectancy. This method of treatment can be used if it is impossible to radically remove the neoplasm. In some cases, it allows you to postpone palliative surgery or do without such an intervention. Radiation therapy for recurrent tumors is rarely used due to problems with effective irradiation of deeply located organs and the high resistance of stomach cancer to radiation therapy.
Prognosis of relapse of stomach cancer
The prognosis for recurrent gastric cancer is poor in most cases. The median five-year survival rate is 26%. With early relapses, up to 5 years from the moment of surgery, 23% of patients survive, with late relapses - 27% of patients. The average life expectancy with a relapse of signet ring cell carcinoma is 18 months, with a relapse of a poorly differentiated tumor - 25 months, with a relapse of gastric adenocarcinoma - 33 months. In the presence of lymphogenous metastases, the life expectancy of patients with recurrent gastric cancer is reduced to 17 months. With the germination of the liver, colon and pancreas, 23.8% of patients manage to step over the three-year boundary, 19% of patients survive up to 5 years from the moment of the second operation. The most unfavorable localization of gastric cancer recurrence is the area of the anastomosis; only 13% of patients manage to survive 5 years from the date of surgery.
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Consequences and treatment of stomach cancer after surgery
After surgery for stomach cancer, removal of a part of the digestive organ, or its complete resection, many people think that no treatment carried out now is capable of giving good prognosis and there will never be an opportunity to return to a previous, active and high-quality life. That the consequence of this surgical intervention will always be dependence on a strict diet and multiple deprivations that await in the usual way of life.
This opinion is completely wrong. If, in the very first months after an operation to remove cancer on the stomach, behave appropriately and follow some simple rules, as well as follow all the recommendations of a specialist on the prescribed preventive treatment and avoid disturbances in the diet, in the near future it will be possible to return to a full-fledged existence ... Many patients are interested in what behavior will be the most correct in life after stomach cancer surgery, and whether it is possible to participate in household chores, or is it worth staying in bed?
Postoperative period of stomach cancer
After the operation has been performed to remove the entire digestive organ, or part of it, the patient needs to make every effort to start a full life as soon as possible, although at first it seems an impossible task. The most basic thing that he needs to tune in is to be as attentive as possible to his health:
- Regular follow-up with an oncologist;
- Timely referrals to specialists regarding the exacerbation of any disease that is completely unrelated to the performed gastric resection;
- After this operation to remove a cancerous tumor, it is advisable to be examined by a therapist;
- A prerequisite is also adherence to a special strict diet.
This will prevent the development of any consequences that may arise in other systems and organs of his body. The postoperative period for stomach cancer is considered by many experts to be as important as the surgery itself. Also, for the most favorable prognosis after gastric cancer surgery, the patient's own aspiration is needed not only to overcome a serious illness, but to start a full life without fear of any consequences of the disease.
Most likely, in the postoperative period, the help of a specialist - a nutritionist will be needed, who will help you choose the necessary nutrition and constantly advise on all the nuances that arise. This is necessary for the reason that after surgery for stomach cancer, the patient completely changes all his eating habits.
In addition, the selection of a special diet is very individual, and is carried out for the most part according to a person's feelings, and according to the susceptibility of his body to certain foods. Also, after the operation of stomach cancer has been performed, its consequences for a long period can be such specific symptoms as:
- Frequent abdominal pain and indigestion;
- Morning vomiting and frequent diarrhea;
- Feeling of constant fullness of the stomach.
In their treatment after surgery to remove a cancer of the stomach, especially in the case when the digestive organ was resected, in order that the above consequences do not disturb the patient's quality of life, the support and advice of a nutritionist is also needed on the selection of appropriate nutrition.
What is the cancer survival rate after gastric resection?
After a patient is diagnosed with cancer of the main digestive organ and an operation is prescribed to partially or completely remove it, the main question for him becomes how much time he has left. It is no secret that in every person the inevitable surgical intervention in this regard causes real horror, which does not even allow one to think about the fact that if the forecasts for the removal of both the whole stomach, affected by a cancerous tumor, and its parts were as disappointing as it seems, then oncologists did not offer this method of treatment.
As with many other types of malignant neoplasms, the survival rate after surgery on the main digestive organ is currently completely dependent on the stage in which the disease is. The best prognosis for patients with stage I, in which the probability of death is only 20%, and 70% of patients expect a full recovery after surgery.
Since stomach cancer at the very beginning of its development does not show any signs, those people who are at risk due to inflammatory pathologies of the gastrointestinal tract should not neglect regular diagnostic tests and specialist advice. The sooner the development of a malignant tumor is detected and the appropriate treatment is started, the more the patient has the chances for a further full life without any consequences.
Chronic gastritis is diagnosed today in eighty percent of the population. One of the most dangerous of it.
Proctitis is one of the most common diseases of the rectal cavity, the development of which is caused.
The processes of inflammation in the area of the rectal mucosa bring a large number of unpleasant sensations. A.
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Surgery to remove the stomach completely (gastrectomy): indications, course, life after
Removal of the stomach is considered a very traumatic operation, it is performed according to special indications, but at the same time it is the most effective way to get rid of some diseases. The risks of the operation are high, and the intervention itself requires good preparation and a stable condition of the patient.
Before deciding whether to completely remove the stomach, the doctor will always weigh the pros and cons, assess the consequences and benefits for the patient, who may permanently lose a very important organ.
The stomach is not just a muscle "bag" into which food enters for digestion. It prepares the contents for further advancement into the intestines, breaks down some food components, produces important biologically active substances, and regulates hematopoiesis. When such an important organ is removed, not only digestion in general is disturbed, but also many metabolic processes.
The indications for surgery are limited, and almost always, if possible, the surgeon will try to choose more gentle methods of treatment, implying the abandonment of the part of the organ in which the secretory activity is concentrated. According to statistics, every tenth patient is at risk of dying after undergoing an intervention, but modern technologies and high qualifications of a doctor help to reduce this probability.
Who needs surgery?
Indications for removal of the stomach:
- Malignant tumor;
- Diffuse polyposis;
- Chronic bleeding ulcer;
- Perforation of the organ wall;
- Extreme obesity.
The main reason for resorting to stomach removal is malignant tumors. Stomach cancer is one of the most common types of neoplasms affecting humans, most common in Japan and Asia, but its frequency continues to rise in other regions. The presence of a tumor, especially in the middle third, cardiac or pyloric region, is considered a direct indication for gastrectomy, which is complemented by the removal of lymph nodes and other formations of the abdominal cavity.
Much less often, doctors perform an operation to remove the stomach due to other reasons. For example, stomach ulcers are usually treated conservatively by gastroenterologists, but complications such as perforation or unstoppable bleeding may require radical surgery.
Diffuse polyposis, when polyps are multiple and scattered over the entire area of the gastric mucosa, is also an indication for gastrectomy, because each polyp is not possible to remove, and their presence is fraught with malignant transformation. Perforation of the stomach wall, not only of ulcerative origin, but also against the background of trauma, requires emergency intervention, which may result in gastrectomy.
A special group of patients is overweight, when the only way to limit the amount of food eaten is to remove the fundus and body of the stomach.
In very rare cases, gastrectomy can be prophylactic, in particular, when the CDH1 gene is carried, in which a mutation has occurred, which predetermines the hereditary form of diffuse gastric cancer. For such individuals, the doctor may recommend preventive removal of the organ while the cancer has not yet formed.
Given the large volume of intervention, possible blood loss during surgery, prolonged anesthesia, there are contraindications to this type of surgical treatment:
- Cancer with metastases to internal organs and lymph nodes (inoperable tumor);
- Severe general condition of the patient;
- Decompensated pathology from the cardiovascular system, lungs and other organs;
- Blood clotting disorders (hemophilia, severe thrombocytopenia).
Preparing for a gastrectomy
Such a complex operation as gastric removal requires a thorough preoperative examination of the patient and treatment of concomitant diseases.
Before the planned operation, you will need:
- General and biochemical blood tests;
- Analysis of urine;
- Fecal occult blood test;
- Fluorography or chest x-ray;
- Ultrasound examination of the abdominal organs;
- CT, MRI of the affected area;
- Fibrogastroscopy for examining the inner lining of the stomach, determining the nature of tumor growth, etc., which is usually supplemented by a biopsy.
Before the operation, if it is carried out in a planned manner, it is necessary to undergo consultations of a number of specialists, starting with a therapist. In the presence of diseases of the heart and blood vessels (hypertension, ischemic disease), diabetes mellitus, chronic bronchopulmonary pathology, their treatment should be adjusted so that the patient can safely undergo anesthesia and the operation itself.
Patients taking any medications need to notify their doctor about this, and a week before gastrectomy, you should stop taking blood-thinning and anti-thrombotic drugs (anticoagulants), non-steroidal anti-inflammatory drugs, aspirin. At a high risk of infectious complications in the preoperative period, antibiotics are prescribed.
Diet and lifestyle also need to be reviewed. Patients preparing for the complete removal of the stomach need a gentle diet that excludes spicy, salty, fried, alcohol. Smokers should think about how to get rid of the addiction that increases the risk of dangerous postoperative complications.
When all the necessary examinations have been completed, the patient's condition is stable and does not interfere with the operation, he is admitted to a hospital. The day before gastrectomy, food should be especially light, and from midnight it is forbidden to consume food and water, not only because of the possible overcrowding of the stomach, but also in connection with possible vomiting during the introduction of anesthesia.
Types of surgery to remove the stomach
Gastrectomy usually involves the complete removal of the stomach, but it is also possible to leave small parts of the organ. Removal of the stomach includes several types of operations:
- Distal subtotal gastrectomy, when most of the stomach is removed and passed into the intestines.
- Proximal subtotal gastrectomy, used for tumors of the upper third of the organ, when the proximal fragment of the stomach with a lesser curvature is to be removed, both omentum, lymphatic apparatus.
- Total gastrectomy - the entire stomach is removed completely and the esophagus is connected to the small intestine.
- Sleeve gastrectomy.
The main stages of gastrectomy
Introduction of the patient into anesthesia (endotracheal plus muscle laxatives).
- Opening of the abdominal cavity is transabdominal (through the anterior abdominal wall), transthoracic (through the pleural cavity), thoracoabdominal (combination of both approaches).
- Examination of the abdominal cavity.
- Mobilization of the stomach.
- Imposition of a junction between the esophagus and intestines.
Mobilization of the stomach is a very important part of the operation, in which the surgeon provides access to the organ by dissecting the ligaments, the omentum, cutting and suturing the small intestine. The intersection of the gastro-pancreatic ligament simultaneously with the vessels located there is the most significant stage, requiring extreme caution and attention. As the ligament is dissected, the surgeon also performs vascular ligation.
The gastrectomy is completed with the imposition of a junction between the esophagus and the small intestine, most often end-to-side. Anastomosis "end-to-end" is rarely applied, with long esophagus or a section of the small intestine to be connected.
Cancer surgery
Since the main indication for gastrectomy is a malignant tumor, most often doctors are forced to remove the entire organ and some surrounding structures at once. The operation to remove the stomach for cancer has its own characteristics associated with the prevalence of the tumor process and damage to adjacent tissues.
A gastrectomy is performed under general anesthesia and can take up to five hours. The patient is placed with a urinary catheter and a nasogastric tube. In oncology, open types of operations are most expedient, an abdominal approach is preferable, implying a sufficiently large incision in the abdominal cavity. Of course, this is more traumatic, but it gives the surgeon the opportunity to examine the affected area well and remove all the affected tissue.
After opening the abdominal cavity, the doctor revises the organs, and then proceeds to gastrectomy, removing the stomach, both omentum, stomach ligaments, fatty tissue, and lymph nodes in a single block, according to the stage of the disease. With a significant spread of the tumor, resection of the pancreas, esophagus, liver, spleen may also be required.
The final stage of total gastrectomy for cancer is the reunification of the small intestine with the esophagus. All stages of the operation are carried out with strict adherence to the principles of ablastic surgery to prevent the spread of cancer cells (early vascular ligation, change of linen and gloves, etc.). The oncologist surgeon should be very careful, because even the most modern diagnostic methods do not always provide accurate information about the spread of the tumor, and upon direct examination, the doctor may find additional foci of cancer that require expansion of the operation.
In some cases of oncopathology, a laparoscopic approach is possible, when the stomach is removed through a small incision in the abdominal wall. Laparoscopy is much less traumatic than opening an operation, modern equipment allows it to be carried out safely and efficiently, but it can be difficult to remove lymph nodes, so the possibility of such an operation is decided individually with each patient.
Gastrectomy for ulcers and other non-neoplastic lesions
In chronic peptic ulcer disease that cannot be treated with conservative methods, or in case of its complications, gastrectomy is also performed, trying to limit itself to subtotal options for the operation or to remove part of the stomach (resection). In addition, with non-oncological processes (diffuse polyposis, Zollinger-Ellison syndrome), there is no need to remove the omentum, lymph nodes and parts of other organs, therefore, the intervention is generally more gentle and less traumatic for the patient.
If the operation is performed on an emergency basis due to massive bleeding, then there is simply no time for examination, so the surgeon has to determine the required amount of intervention right during the operation.
Sleeve gastrectomy
A special type of surgery to remove the stomach is the so-called sleeve gastrectomy, which is indicated for patients with severe obesity. To reduce the amount of food that the patient can eat, the surgeon removes the body and the fundus of the stomach, leaving only a narrow channel at the lesser curvature of the organ. When eating even a small amount of food, the remaining fragment of the stomach quickly fills up, and a feeling of fullness sets in, and the patient stops eating.
Sleeve gastrectomy is widely practiced all over the world and shows good results. Sustained weight loss is seen in most patients, but further dietary restrictions cannot be avoided.
Complications of gastrectomy and possible consequences
Removal of an entire organ, in this case the stomach, cannot go unnoticed by the patient. The risk of complications is quite high, and the consequences are not limited to impaired food digestion. Most likely:
- Reflux esophagitis;
- Anemia;
- Weight loss;
- Dumping syndrome;
- Recurrence of a tumor in the stomach stump;
- Bleeding and peritonitis.
Bleeding and peritonitis is an acute surgical pathology that requires urgent treatment. Usually, such complications are caused by the failure of the sutures imposed on the vessels and intestinal walls during the removal of the stomach.
With a favorable course of the operation itself and the early postoperative period, after being discharged home, the patient may face a number of other consequences of treatment. So, reflux esophagitis consists in inflammation of the esophagus when the contents of the intestine are thrown into it with bile acids and enzymes, which is manifested by pain, heartburn, and nausea.
Dumping syndrome is caused by an inadequate amount of food consumed and is manifested by tachycardia, sweating, dizziness, and vomiting immediately after eating.
The vast majority of patients who underwent gastrectomy, regardless of the reason for the operation, suffer from a lack of vitamins, trace elements, nutrients, which is manifested by weight loss, weakness, drowsiness, etc. Anemia is associated with a lack of factors produced by the gastric mucosa and enhancing the formation of red blood cells.
Postoperative lifestyle and prevention of complications
In the postoperative period, the patient may require care and assistance, consisting in the administration of pain relievers, nutritional mixtures through a tube, and intravenous fluids. Until such time as it becomes possible to take food by mouth, special solutions are prescribed intravenously or through a tube inserted into the small intestine. To replenish the missing fluid, infusion therapy is performed.
Approximately 2-3 days after the operation, the patient is offered to drink liquid and taste liquid food. If all is well, the intestines began to function, then the diet gradually expands from liquids to cereals, mashed dishes and then to the intake of regular food.
Nutrition after gastrectomy is of particular importance. Patients who have undergone surgery are advised to eat small meals up to 6-8 times a day to prevent the likelihood of dumping syndrome and digestive disorders. Large amounts of food should be discarded.
The diet after removal of the stomach should be gentle, it is better to steam or boil dishes, preferably a sufficient amount of protein, a decrease in the proportion of fat and rejection of easily digestible carbohydrates (sugar, sweets, honey). After removing the stomach from the diet, you will have to exclude spices, alcohol, spicy and fried foods, smoked meats, pickles, and reduce salt intake. Food should be well chewed, not cold, but not hot either.
In case of intestinal dysfunction in the form of diarrhea, dishes with rice, buckwheat are recommended, and in case of constipation - prunes, fermented milk products, boiled beets. It is allowed to drink tea, compotes, but the amount should not exceed 200 ml at one time, and it is better to divide it into 2-3 parts.
The deficiency of vitamins and microelements, which inevitably arises after the removal of the stomach, is compensated by taking them in the form of medications. Vitamin B12 is necessarily prescribed, since in the absence of the stomach its absorption does not occur, which is fraught with the development of pernicious anemia.
You can switch to the described diet after a month and a half after removal of the stomach, but rehabilitation usually takes about a year. The psychological status and mood of the patient is of particular importance. So, excessive anxiety and suspiciousness can lead to long-term unjustified restrictions in the diet, as a result - weight loss, anemia, vitamin deficiency. There is another extreme: the patient does not stand the regimen, reduces food to three or four meals a day, begins to eat prohibited types of foods, which entails indigestion and the development of complications.
Good physical activity is essential for early activation and stimulation of bowel function. The sooner the patient gets up after surgery (within reason, of course), the lower the risk of thromboembolic complications and the faster recovery will come.
With the correct and timely operation, adequate rehabilitation and adherence to all the doctor's recommendations, patients after gastrectomy live as long as everyone else. Many adapt to new digestive conditions and lead a very active lifestyle. The situation is worse in patients who underwent surgery for cancer. If a tumor is detected in a timely manner at an early stage, then the survival rate reaches 80-90%, in other cases this percentage is much lower.
The prognosis after removal of the stomach, like life expectancy, depends on the reason for the operation, the general condition of the patient, the presence or absence of complications. If the technique of removing the organ was not violated, complications were avoided, the malignant tumor did not recur, then the prognosis is good, but the patient will have to make every effort so that the body receives the substances it needs in full, and the digestive system, deprived of the stomach, does not suffer from an unbalanced nutrition.
Sunday, 19 July 2015Survival prognosis and in case of stomach cancer, every patient and his relatives are interested. In this article, we will tell you how many people live with stomach cancer.
But remember that statistics are averages based on a large number of patients. They cannot tell exactly what will happen to you. Just as no two people are alike, the treatment of different people varies.
Don't be scared - ask your doctor about your life expectancy prognosis.
Your doctor may use the term five-year survival. This does not mean that you will only live for five years. This refers to studies (statistics) that are calculated five years after diagnosis.
How many people live with stomach cancer
42 out of 100 people diagnosed with stomach cancer (i.e. 42%) will be alive one year after the diagnosis. About 19 out of 100 people (19%) pass the five-year survival rate. And about 15 out of every 100 people (15%) will live at least ten years.
The prognosis for survival depends on how sooner or later the cancer is diagnosed (the stage of your cancer).
Most often, stomach cancer is diagnosed at a late stage. Only 20 out of 100 people (20%) can have surgery to treat stomach cancer, which means they will completely cope with the disease.
Survival prognosis depending on the stage of stomach cancer
First stage
The five-year survival rate is 80%. Unfortunately, very few people diagnose stomach cancer so early. Probably only one in 100 cases of cancer is stage 1.
Second stage
56% of people diagnosed with stage 2 stomach cancer will live at least 5 years. In the second stage, only 6% of stomach cancers are found.
Third stage
In the third stage, stomach cancer is detected more often. Usually about 14% of patients are in the third stage. According to statistics, a third of patients with stomach cancer (38%) live at least 5 years - at stage 3A. In stage 3B, approximately 15% of patients live for more than 5 years.
Fourth stage
Unfortunately, 8 out of 10 people with stomach cancer develop stage 4 cancer. It is clear that the survival statistics are also lower than for the third stage. Typically, doctors are optimistic if a patient is alive two years after being diagnosed with stomach cancer that has already spread. Typically 5% of people will live in 5 years.
How reliable is this data?
No statistic can tell what will happen to you. Each cancer is unique. That is, it can spread at different speeds for different people.
The statistics are not detailed enough to tell about the course of the disease depending on the different treatments. There are many individual factors that will determine treatment and prognosis for survival.
If you were in good general health prior to the illness, your result will be better than average.
Clinical trials
Research results show that participation in clinical trials can improve prognosis. Nobody knows why this is happening. Perhaps this makes doctors and nurses more attentive. For example, you may have more screening and blood tests.
How stomach cancer will affect you physically
Stomach cancer and its treatments can cause physical changes in your body. During treatment, you may lose weight, appetite, and may find it difficult to eat.
You may feel tired and weak over time. There may also be problems with your personal relationships, as cancer can affect your sex life.
How to deal with the diagnosis
It can be challenging to cope with a stomach cancer diagnosis, both practically and emotionally.
You may feel upset, frightened. It is very important for you to get all the information about your type of cancer in order to better treat it. Patients who are well informed about their illness cope better with what is happening.
You may have to deal with more than just fear and anxiety, but also money issues. In this case, you will need information about financial support.
How do you tell people you have cancer? What should I say to the children?
You shouldn't decide everything at once. This may take some time.
Your doctor or nurse should know who to contact if you need help. Do not give up the support of loved ones. And also remember about social service.
Please contact us if you have a desire.
Bladder cancer
At stage I, the survival rate is 60 - 70%, at stage II - 40 - 80%. (At stage III 15 - 50%).
Cancer of the body of the uterus
At stage I, the survival rate is 70 - 73%, at stage II - 50 - 57%. (At stage III 31.5%).
Cervical cancer
At stage I, the survival rate is 89 - 92%, at stage II - 74%. (At stage III 51.4%).
Ovarian cancer
At stage I, the survival rate is 80 - 95%, at stage II, 65 - 87%. (At stage III 22.7%).
Mammary cancer
In breast cancer, 5-year survival is not considered a criterion for lasting recovery. About 1/3 of patients die 5 years or more after the end of treatment.
At stage I, the 5-year survival rate is 77.9% - 94.7%, at stage IIA - 65 - 83.6%, at stage IIB - 44.7 - 75.7%, at stage III - 35.2 - 43.7%. The overall 10-year survival rate is 48.5% (stages I-III).
The facts are in front of you. The prospect of survival is generally good, from 40 to 95% - depending on the type of tumor. On average, 70% of patients with stage I cancer will live for 5 years (although such averaging cannot be done - it turns out, as it were, "the average temperature in the hospital"). But this is in general. And if you take it from the patient's point of view? Rank 10 women treated with cancer, such as stage I breast cancer. Two of them, alas, will not live for 5 years. How not to be in their place? The only answer is to use medicinal anticancer herbs. Even after courses of the most modern and successful treatment, individual tumor cells, as a rule, remain in the patient's body. You can destroy them or keep them dormant by long-term intake of herbal poisons in small non-toxic doses.
Why, then, oncologists, knowing perfectly well that even at stage I of cancer it is impossible to speak to a patient about 100% cure rate, nevertheless they do not advise him to use poisonous medicinal herbs ?!
Because they are well aware of the side effects of drug chemotherapy used in oncology, and they think that herbal chemotherapy has the same severe side effects, and therefore seek to protect the patient from yet another "fatal" treatment. After all, the main problem with cancer chemotherapy is toxicity. The drugs used in cancer chemotherapy have a narrow therapeutic range. The doses required to achieve the antitumor effect do not differ much from the doses that can cause a toxic effect with a fatal outcome (unfortunately, this sometimes happens - the patient dies not from the disease, but from the treatment itself, or rather, from the side effects of chemotherapy). The main side effects of chemotherapy are suppression of hematopoiesis in the bone marrow, damage to the liver, kidneys, lungs, nervous system, gastrointestinal tract, heart with all the ensuing consequences. Those who have been to "chemistry" do not need to explain what the consequences are, they are shivering for the rest of their lives from this word.
And when you tell a patient that herbal chemotherapy is a comfortable chemotherapy, it is not at all difficult to take drops, there are no side toxic effects - this is perceived with distrust, especially if the attending oncologist is also against herbal poisons.
For suspicious patients and for vigilant oncologists who are worried that their patients are not poisoned by herbal poisons, I give a detailed calculation of the poison based on the medicinal tincture of one of the most commonly used poisonous plants - spotted hemlock.
Treatment of inoperable stomach cancer
Oncology in the stomach is dangerous for its prevalence and late detection due to latent symptoms of the early stages. Inoperable stomach cancer is diagnosed when people seek help, but it's too late. At the terminal stage, surgery is considered impractical, and the 5-year survival rate is 5%. To alleviate the suffering of a cancer patient, palliative therapy is prescribed, which includes treatment with chemistry, radiation, after which an operation is performed.
General information
The diagnosis rate of gastric cancer inoperability is 60%. The reason for the poor statistics is a late visit to doctors, when the cancer has reached the 3rd or 4th stage, that is, it has sprouted into neighboring organs, gave distant metastases. Due to the vastness of the process, it becomes impossible to remove the tumor and be cured, and then the diagnosis of inoperable cancer is made. In this case, palliative treatment is prescribed, which prolongs life for a period of 3 to 5 months, but does not improve the prognosis.
Inoperable stomach cancer is the stage when:
Inoperability is largely due to deep metastasis against the background of the difficulty of identifying the entire number of secondary foci, severe damage to the tissues of the stomach and other organs. Excision of metastases is considered objective only in the early stages, when the process has just begun. Depending on the nature of growth, several types of secondary foci are distinguished, according to which the type of palliative treatment is determined:
The symptoms of inoperable gastric cancer are as follows:
Treatment methods
The use of chemotherapy
Taking anticancer drugs is a medication type of treatment. A cancer patient is prescribed cytostatic drugs that destroy cancer DNA, thereby slowing down the rate of abnormal growth. As the DNA strand breaks down, abnormal cells stop dividing and begin to die. For maximum effectiveness, several cycles of such treatment are required, but more than 6. This is necessary for the drugs to work during the division phase, when cancer cells are most sensitive to chemotherapy.
The number of cases of oncological ailment of the gastrointestinal tract increases every year, in fact, because the questions: "How long do they live with stomach cancer?", Become quite vital.
Reasons and influencing factors
Stomach cancer symptoms and treatment
Estimated survival rates for gastric cancer after surgery reach 20% of the total number of patients. Such small data foresee, first of all, the difficulty of early detection of the disease, which, as a rule, is asymptomatic, or disguises itself as other ailments. But it should be noted that all episodes are personal, precisely because any particular patient can live for a long time.
It should be noted that a number of nuances affect the 5-year survival rate:
A positive result in cancer patients is determined, as a rule, by the parability of the neoplasm with the help of removal. Otherwise, the life span of sick people does not exceed the 5-year limit. If metastasis has progressed to individual organs, in this case it is difficult to give an answer for how long the patients live. Since such episodes are ranked as more complex, and do not provide for deletion.
The four periods of cancer and life expectancy
Stages of stomach cancer
Stage one carcinoma can sometimes have a number of symptoms:
But such a clinical picture also appears with other ailments. If the symptoms do not disappear for a long period, therefore, it is necessary to visit the clinic for a complete examination.
The first stage of stomach cancer
Successful treatment of oncology at stage 1 depends on what age group the person is and, of course, what state of immunity they have. If therapeutic manipulations are performed, then it is likely that the patient can, quite a lot, live without relapse.
Stomach cancer, stage 2, how long do patients live, depending on the general picture? It is customary to make a direct assessment of the results of treatment in relation to the data of 5-year survival, which includes the general group of patients who survived to this milestone.
Life expectancy in the second stage of gastric cancer
Existing types of operation:
After removal of the stomach for cancer, how many years a patient can live - this is of interest to every patient with such a diagnosis. Experts cannot give an unambiguous answer to this question. Because, the predictions about how long the patient has left to live are rather ambiguous. Equally, there may be a positive effect, or vice versa, the spread of the disease and the aggravation of the patient's condition. Survival fully depends on cancer neglect. How many sick people live after removal of the stomach depends on the scrupulous implementation of the doctor's recommendations.
Life expectancy at 3 and 4 stages of gastric cancer
Grade 3 esophageal cancer is characterized by the fact that cancer cells are actively dividing, and aggressive tumor growth significantly reduces the patient's chances of living a painless life. As a rule, stage 3 is inoperable stomach cancer, therefore, auxiliary therapy is prescribed, thanks to which the patient lives longer.
Life expectancy for metastases and ovarian cancer
How exactly the ovaries pass the onset of the tumor process has not been identified. As a rule, an ailment with an early stage of development is asymptomatic. After the enlargement of the overall neoplasm, pain and symptoms of bloating begin. The treatment is aimed at decisive elimination of the tumor. The survival line is about 80%.
Most cancer patients are interested in the question - how long can a person live with lung cancer? As a rule, metastases in the lungs occur in the 2nd period of the disease. But, which is typical at this stage, cancer manifests itself as a common cold. Lung cancer occurs in most cases in smokers.
At the 2nd stage of cancer development, metastases occur in the lungs and other organs. Experts with such a development of the disease do not undertake to make any predictions. If there are metastases in the lungs, then in this case, patients do not live more than 2 years. Consequently, most of the patients are expected to die. But it should be noted that if the forecasts are as good as possible, then it is possible to live with such a disease for a long time.
How long do you live after stomach cancer surgery?
Causes and influencing factors
The average survival rate for gastric cancer after surgery is 20% of the total number of cancer patients. This indicator is due to the difficulty of early diagnosis of the disease, which often proceeds without symptoms or is mild, disguising itself as other pathologies and disorders. However, all cases are individual, so each individual person can live a long time after medical intervention, not obeying general statistics.
The reason is that during treatment in countries with a high level of medicine and service, oncological diseases in the bulk are detected at the first stages, therefore, the statistics on death rates among patients and cases of a positive prognosis are very optimistic. For example, the 5-year milestone is passing, 85-90% of patients live with it after the cure of stomach cancer in clinics in Japan.
On the territory of Russia, the statistics on the detection and survival of cancer patients are as follows:
Along with the degree of neglect of oncology, the following reasons affect the 5-year survival rate:
A positive outcome in cancer patients is determined by the operability of the tumor in the stomach through radical excision. Otherwise, only a small number of cancer patients live for more than 5 years. If metastasis has progressed to distant organs, life expectancy is greatly reduced. Such cases are complex, since they do not involve resection. On average, the disease ends fatally earlier than 2 years.
How long do they live with early diagnosis of stomach cancer?
The survival rate of cancer patients within 5 years indicates that, provided that the course of treatment is carried out after this period, a recurrence of the pathology is not detected during repeated diagnostics. Therefore, if the total indicator of all cancer patients is 20%, then 5 cancer patients with previously diagnosed stomach cancer will live during the specified period.
The statistics can be improved by early diagnosis of oncopathology at the zero or first stage of development, when cancer cells are localized only in the mucous and muscle layer of the gastric wall. With timely medical measures taken, the five-year survival rate is from 80%.
The second stage of gastric cancer refers to early, but the positive outcome of treatment is lower than with zero and first. This is due to the fact that the tumor grows significantly and grows into the serous layer, which covers the outer walls of the stomach. If cancer cells are not found in regional tissues and lymph nodes, in 50% of cases, after a successful radical operation with complete excision of the neoplasm, patients recover.
If complete removal of the malignant tumor is difficult, in the remaining 50% of cases, patients do not survive the two-year line after resection. This is due to the rapid progression of the tumor against the background of relapse and metastasis to other organs.
Exodus at stages 3 and 4
The shortest duration of further existence is characteristic of the last stages of gastric cancer. The insidiousness of tumors at this stage of development consists in the spread of a malignant process throughout the body with damage to distant organs by secondary foci of abnormal growth.
For the 3rd stage of development of oncology in the stomach, metastasis is characteristic of neighboring lymph nodes. With this diagnosis, people live for more than 5 years in 40% of cases. It is even worse to know how long patients with stage 4 cancer have to live, when the entire lymphatic system is affected, secondary foci are found in the liver, kidneys, bones, lungs and even the brain. Such patients do not survive in 96% of cases. Therefore, the forecast will be positive only for 4%. Often, death overtakes patients with stages 3 and 4 within six months from the moment of diagnosis. Often such patients are considered inoperable.
Gastric resection and survival
Gastric resection - before and after surgery.
Life expectancy after removal of the tumor along with the stomach depends on three factors:
In clinics with world renown and the use of advanced technologies, the number of deaths after radical interventions does not exceed 5%. The remaining 95% of patients do not complain of symptoms of a relapse of the disease for at least a decade. If the surgery was performed according to the subtotal principle, that is, there was a complete excision of the affected organ, the survival rate for more than 5 years is 60-70%. But if such a resection was performed at the last stages of the oncological process, the rate drops to 30-35% of survivors during the first five years.
Ways to prolong survival
Palliative techniques are used in relation to inoperable patients with the 4th stage of cancer. For this, the following methods are used:
How many people live with stomach cancer of different stages and after its removal
No specialist will give an objective answer to this question. Since there are different periods of cancer with different rates of formation. The prognosis for a 5-year survival depends on the direct method of treatment, the stage of oncology, and whether or not there are metastases.
On the territory of Russia, regarding statistics, the survival rate at various stages of oncology shows:
What are the forms of stomach cancer?
For cancer in the 1st period, the location of the neoplasm is characteristic only in the mucous layer of the organ, without damage to healthy tissues. This degree of development of oncology is often asymptomatic, therefore, the patient sees no reason to consult a specialist.
Important! It should be remembered that if cancer is detected at an early stage of development, in this case, it is possible to cure the ailment even without serious surgical intervention.
Staged classification of stomach cancer
Treatment for stage 1 cancer is performed:
Life expectancy at stage 2 stomach cancer
In the formation of a cancerous neoplasm, a special role is played by the presence of the Helicobacter bacteria in the body, heredity and an ulcer, which can turn into a cancer. As a rule, the second stage of the course of an oncological disease for a long time may not manifest itself at all. But sometimes patients may experience the following symptoms:
At the current stage of the development of the disease, experts advise making a radical intervention, which has a positive effect. It is rather difficult to answer how long people with stomach cancer live. Because even at the initial stages, the diagnosis of stomach cancer does not exceed 50%. The doctors' comments indicate that with metastatic gastric cancer, only 15% of patients can survive.
Life expectancy at stage 3 stomach cancer
The disease penetrates through the lining of the organ and affects the nearby tissues, while affecting about 15 nodes. Tellingly, the neoplasm is growing rapidly. The third stage has the following symptoms:
The fourth stage of the course of the disease is the most difficult. Since grade 4 stomach cancer has many metastases that affect the entire body. Symptoms of grade 4 cancer with metastases, as a rule, combine all previous ones. But it should be noted that with stage 4 stomach cancer, unbearable pain is added to all the symptoms, which cannot be overcome by most drugs.
Ovarian cancer symptoms and treatment
Stomach cancer metastases
Metastases in stomach cancer spread through the lymphatic tract or through the blood vessels. Cancer cells can invade other organs (liver, pancreas, transverse colon, abdominal wall).
Doctors pay special attention to metastases spreading through the lymphatic tract. There are three lymph flows through which lymph is removed from the stomach:
How many live with metastases in stomach cancer
The prognosis of doctors for cancer in the stomach and metastases will be associated with the stage of the disease, the presence of distant metastases, the chosen method of treatment and the patient's health. At the beginning of the development of cancer, cancer cells are located only in the stomach - they affect the walls and mucous membranes. If you start treatment on time and choose a technique, then the survival rate is high.
In the second stage, malignant cells invade the serous membrane that covers the outside of the stomach. For 50% of patients, surgery is recommended, after which it is possible to get rid of the tumor.
If there is a contraindication to remove stomach cancer, metastases will be fatal within two years. As the tumor grows, it metastases to other organs. At 3 stages of gastric cancer, metastases spread to the lymph nodes; 40% of patients have a 5-year survival rate.
When the disease progresses to stage 4, the entire lymphatic system is affected, metastasis of stomach cancer spreads to the liver, kidneys, and other organs. Patients with stage 4 stomach cancer live 6 months.
Diagnosis of gastric cancer metastases
Doctors use different types of equipment and methods to diagnose cancer and metastases. This:
Metastases can spread not only through the lymphatic vessels, but by hematogenous, contact and implantation routes. First, metastases affect the regional lymph nodes associated with the stomach, then the malignant cells spread to organs and lymph nodes in the abdominal cavity.
Distant-type metastases in gastric cancer are called metastases of Virchow (above the collarbones, in the navel), Krukenberg (in the ovaries), Schnitzler (in the bottom of the pelvis). Cancer affects the liver, lungs, and adrenal glands with metastases.
Metastases to the lungs, brain in gastric cancer
In gastric cancer, metastases can be hematogenous in the lungs, brain, liver, navel. The most dangerous are metastases in the ovaries, navel, Douglas space, supraclavicular fossa.
Metastases in gastric cancer spread without symptoms, only with large tumors, patients complain of pain on the right side of the ribs. Even in difficult situations, timely diagnosis and treatment play an important role.
Thanks to modern diagnostic measures, cancer can be detected in its early stages. If the patient is being examined, he is not threatened with a dangerous form of cancer. At the slightest suspicion, the doctor directs the patient for CT, MRI, ultrasound.
In the lungs, metastases are determined in parallel with alveolitis. Malignant cells affect the bronchial and subpleural lymph nodes. Metastases will cause symptoms: hemoptysis, shortness of breath, cough. Metastases are detected using X-ray, CT. Treat with radiation and chemotherapy.
Bone and spine metastases
In about 20% of cases, gastric cancer metastases to the spine and skeletal bones. Most often, the bones are affected by cancer of the breast, lungs, bladder, and kidneys. Metastases penetrate the bones by the hematogenous route or during the growth of the tumor into the nearby bones.
The presence of metastases can be asymptomatic, there and against the background of pain due to pinched nerves in the spine, pathological fractures, etc. Secondary foci can be diagnosed in the skull, ribs, shoulders, but more often - near the vertebrae. Bone metastases are diagnosed using X-ray, scintigraphy.
The tumor rarely affects the spine. After surgery on the primary tumor without radiation and chemotherapy, particles of malignant cells can enter the spine. Spinal metastases are manifested by neurological pain, akin to radiculitis, and with the growth of neoplasms, they lead to paralysis of the limbs.
How are breast cancer metastases treated?
The doctor selects the method of treatment depending on the extent of the lesion, the state of health and age of the patient, the chosen method of treating the primary tumor. With damage to other organs, as a rule, the disease is in the 4th, incurable, stage of stomach cancer.
In this case, the treatment will be aimed at relieving symptoms, stopping the process of tumor growth, and prolonging the patient's life.
Surgery for stomach cancer is rarely used to remove metastases, since they are scattered throughout the body. The operation is performed when it is necessary to eliminate intestinal obstruction, artificially connect the intestines and a healthy part of the stomach to each other for the passage of food. In the presence of a large number of metastases, a microsurgical gastroma is indicated - a gastric fistula is removed to the anterior peritoneum under a food probe.
Chemotherapy is carried out to stabilize the pathological condition. Cytostatics of the latest generation are used, often against the background of radiation therapy. If the patient's immune system is weakened, then radiation is contraindicated.
During treatment, the patient is prescribed a set of medications. These will be pain relievers and anticonvulsants, as well as medications for the prevention of cerebral edema. Additionally, gastric lavage is performed with a solution of hydrochloric acid and potassium permanganate, since the neoplasm disintegrates, the body is poisoned with decay products.
Radiation therapy is aimed at stopping the growth and reproduction of malignant cells. For stomach cancer, radiation therapy is prescribed for brain metastases. How long a person lives after irradiation depends on the affected organ and other factors.
The forecast is as follows:
Poor prognosis accompanies any stage of metastasis.
The cause of metastases is a neglected disease; in case of stomach cancer, metastases spread no earlier than the disease progresses to stage 3. You need to listen to the body's signals, monitor your health, and undergo examinations.
Stomach cancer in its development goes through 4 stages, as, indeed, any other oncological disease. Unfortunately, the disease is often diagnosed at the last, fourth stage, when it is almost impossible to achieve the patient's recovery, but this does not mean that modern medicine is unable to help the patient, alleviate his condition and prolong life for years.
What is the disease
A malignant tumor of the stomach in most cases is formed by epithelial tissues, which are lined with its mucous membrane. This type of tumor is called adenocarcinoma. In addition, other types of cancer are registered, which, in accordance with the WHO classification, are divided into the following:
- cricoid cancer, consisting of vesicular cricoid cells and having a hormonal nature - in women and men, in this case, there is an increase in the level of the corresponding sex hormones;
- papillary cancer, formed by papillary structures with the inclusion of a cystic component;
- tubular cancer growing from cells of columnar epithelium;
- mucinous cancer with a mucous structure.
There are also more detailed classifications that, in addition to the above types of stomach cancer, are also considered:
- ulcerative and pseudo-ulcerative, simulating a traditional gastric ulcer in shape and course;
- infiltrative, not having a well-defined border and growing deep into the gastric wall;
- polypoid, i.e. shaped like polyps;
- skirra - invasive tumors of an aggressive nature, capturing large areas of the organ both in breadth and in depth;
- adenosquamous and squamous - squamous cell neoplasms with signs of keratinization and without, respectively.
Depending on the histology, gastric cancer can be highly differentiated, moderately differentiated and poorly differentiated. What does this mean? The level of differentiation of a cell reflects the degree of its ability to perform its functional tasks. Cancer cells, to one degree or another, lose the ability to such differentiation, and the deeper this process, the more aggressive the tumor behaves. In highly differentiated cancer, abnormal cells differ from healthy ones only to a small extent, and such tumors are considered the least "harmful".
In accordance with the international TNM system, where T - tumour (tumor), N - nodes (lymph nodes), M - metastasis (metastases), stage 4 stomach cancer is indicated by the formula: T any, N any, M1, which means any size of the neoplasm, any variants of the spread of the tumor in the lymphatic system and the presence of distant metastases in other organs.
At the 4th stage of stomach cancer, the invasion (spread) of cancer cells occurs through the blood and lymphatic vessels, as a result of which vital distant organs are affected - the liver, lungs, kidneys, skeleton.
Causes and factors for the development of pathology
First of all, it should be noted that malignant tumors do not arise in a healthy stomach - they must be preceded by certain pathological processes. Some of these precancerous conditions include:
- chronic gastritis;
- polyposis and other benign neoplasms of the gastric mucosa;
- peptic ulcer caused by the bacterium Helicobacter pylori;
- dysplasia of the gastric walls.
In addition, there are a number of factors that contribute to the development of stomach cancer. These include:
- the consequences of gastric surgery;
- hereditary predisposition;
- unhealthy diet (excessive use of salt, carcinogenic food additives and preservatives, alcohol abuse, marinades, spicy and smoked foods);
- uncontrolled intake of medicines - aspirin, steroid drugs, etc.;
- deficiency of vitamins C and E, which affect the state of the mucous membrane;
- the presence of infections in the body - staphylococcal, fungal, herpes.
Symptoms of the disease
If at the initial stages of oncology development there are practically no manifestations, then by the 4th stage stomach cancer manifests itself quite clearly. Symptoms can vary significantly depending on the location of the tumor. The location of the neoplasm in the cardiac part of the stomach (closest to the esophagus) most often simulates cardiovascular diseases, for example, ischemic heart disease, and a tumor localized in the antrum (at the exit from the stomach) - pathologies of the gastrointestinal tract, such as gastritis, pancreatitis, etc.
The main symptoms of gastric cancer can be considered as follows:
- feeling of constant discomfort in the epigastric zone;
- pain in the stomach that does not go away after eating and is not relieved by conventional analgesics;
- lack of effect from standard treatment of gastrointestinal disorders;
- difficulty swallowing food;
- nausea after eating, possibly with vomiting;
- lack of appetite, aversion to meat products;
- significant weight loss;
- increased fatigue, weakness, anemia;
When the tumor begins to decay, perforation of the gastric wall occurs, in which the contents of the organ enter the abdominal space, causing the development of peritonitis. In this case, acute symptoms develop, requiring immediate surgical care:
- a sharp drop in blood pressure, weak, rapid pulse;
- vomiting of "coffee grounds", meaning internal bleeding;
- fainting, loss of consciousness;
- febrile temperature (38 0 and above);
- pale skin and mucous membranes.
Basic diagnostic methods
The main task of diagnosis in this case is differentiation with diseases that have similar symptoms - atrophic gastritis, peptic ulcer disease, polyposis, angina pectoris and a number of infectious diseases (syphilis, tuberculosis, amyloidosis).
Differential Diagnostic Methods Table
| Diagnostic method | The content of the diagnostic method |
| Physical | analysis of patient complaints |
| assessment of its appearance and condition | |
| examination of the condition of the lymph nodes localized in the areas of possible metastasis | |
| percussion of the heart area to exclude ischemic heart disease | |
| Instrumental | esophagogastroduodenoscopy - an internal examination of the esophagus, stomach and pancreas using a fiber optic probe to detect a tumor and take tissue samples |
| Ultrasound - performed in several versions: through the abdominal wall without filling the stomach with liquid and with filling, as well as using an endoscopic probe (not to be confused with fiber optic). The method allows you to examine the state of organs and adjacent lymph nodes | |
| X-ray of the stomach with a contrast agent - gives an idea of the exact localization of the neoplasm and defects of the stomach wall | |
| CT and MRI - the main task of diagnostics is not so much the detection of a tumor, but the presence of distant metastases in other organs | |
| laparoscopy - a study that allows you to assess the degree of operability of the neoplasm | |
| Morphological | cytological examination of the material taken, which establishes the nature of cancer cells and the degree of their differentiation, and therefore malignancy |
| Laboratory | blood test (including tumor markers for CA and CEA), lymph, gastric juice |
Treatment
In most cases, stage 4 stomach cancer is recognized as inoperable and the treatment of the disease is aimed at ensuring the patient's quality of life, i.e. is palliative in nature.
The use of traditional medicine for stage 4 stomach cancer, unfortunately, is not able to help in alleviating the patient's condition, and even more so to influence his cure.
When is surgery performed?
Surgical removal of the neoplasm at the 4th stage of the disease is performed for health reasons. For example, endoluminal stenting is performed to restore the lumen of the stomach so that the patient has the opportunity to eat, or the imposition of an anastomosis - an artificial fistula through which food can enter the patient's body.
In addition, palliative removal of at least part of the tumor makes it possible to reduce its size and thus reduce the toxic effect on the patient's body, which will undoubtedly alleviate his condition.
Palliative surgery increases the effect of subsequent chemotherapy and radiation, thereby stabilizing the disease and extending the patient's life expectancy.
Chemotherapy, radiation
In the case of inoperable stomach cancer, palliative treatment is performed - radiation therapy and treatment with cytostatics - Doxorubicin, Cisplatin, Mitomycin, Cyclophosphamide and other chemotherapy drugs. Both chemotherapy and radiation give serious complications to the patient's body, but at the same time suppress the development of a malignant process in the body. The physician prescribing such treatment, of course, must correlate the possible benefits from it with the harm caused.
Immunotherapy
Immunotherapy used in the treatment of stage 4 gastric cancer can be carried out in three ways:
- The use of vaccines prepared on the basis of the biomaterial of a specific tumor;
- General immunotherapy aimed at activating the immune system of the patient's body;
- The use of monoclonal antibodies, i.e. clones created on the basis of a human cell (in the case of stomach cancer, these are antibodies designated by the code SU11248).
The last innovative method is relatively new and has a number of significant advantages, including the absence of a negative effect on the patient's body, already weakened by a serious illness. Unfortunately, some patients do not respond to such treatment, because they develop resistance (resistance) to this type of therapy, but scientists do not stop looking for a solution to this problem and already have some success.
Companion diet
The main objectives of the diet during the treatment of stage 4 stomach cancer are as follows:
- compensation for weight loss;
- mitigation of the aggressive effects of therapy on the patient's body;
- support and enhancement of immunity;
- normalization of metabolism;
- activation of recovery processes in the body.
Food for a patient with stomach cancer should be organized according to certain rules:
- food should only be boiled, baked, stewed, steamed;
- fractional meals are necessary - small portions 5-6 times a day;
- the menu needs to be adjusted depending on the patient's well-being and the period of treatment.
- pureed soups (vegetable, dairy);
- soft-boiled chicken and quail eggs;
- dietary meats - chicken, rabbit, veal;
- lean fish;
- boiled porridge;
- dried white bread;
- vegetable fats;
- limited amount of butter;
- fruit and berry jelly.
Fatty, fried, spicy, salty, smoked foods, strong tea, coffee, alcoholic and carbonated drinks should be excluded from the diet. In addition, any hot food is contraindicated for the patient.
Diet lean meats 
Cottage cheese, preferably low-fat 
Chicken eggs - a source of protein and micronutrients 
Astringent fruit and berry jelly is very useful for the gastric mucosa
Foods to Avoid (Gallery)
Black coffee 
Strong tea 
Alcoholic drinks are strictly prohibited 
Smoked products and spices irritate the gastrointestinal mucosa
Pleasant remedies: juice therapy
If the patient does not have edema, the use of juices is indicated for him, since with stomach cancer the body constantly loses a lot of fluid due to frequent vomiting and stomach bleeding, and juices, among other things, in addition to restoring fluid balance, help to solve a number of problems:
- saturation of the body with natural vitamins and minerals;
- increased acidity of gastric juice;
- decreased gag reflex;
- improvement of intestinal peristalsis;
- increased appetite.
It is better to use freshly squeezed juices with pulp. The following vegetables, fruits and berries are most suitable for making fresh juices:
- beets, carrots, tomato, cabbage, paprika, celery;
- pears, apples, quince, pomegranate, apricot;
- black and red currants, cherries, cranberries.
Disease prognosis
Not so long ago, the five-year survival rate of patients with stage 4 stomach cancer did not exceed 5%. Today, thanks to new methods of therapy, this figure has grown significantly and is 18–20%. Speaking about the prognosis of the disease, it is necessary to take into account the age of the patient, the state of his body, the nature of the malignant neoplasm and the place of its localization, the prevalence of distant metastasis. In addition, the psychological attitude of the patient towards a positive result plays a huge role.
Doctors talk about stomach cancer (video)
Stomach cancer of the 4th stage is a difficult diagnosis, and the treatment process is also not an easy exhausting work, but even after learning the whole truth about your illness, do not rush to give up on yourself. Innovative technologies introduced into the practice of treatment in recent years, cooperation with a doctor and belief in the result will help prolong life for years, and for this it is worth fighting and winning!
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