Surgery for gastric cancer - what is the success rate and what should a patient expect following the procedure?

In response to a question on healthshare.com.au

The cure rate of gastric cancer depends on the tissue type of the cancer, the stage of the cancer, and the fitness and symptoms of the person affected by the cancer.

The common tissue type of gastric cancer is called an adenocarcinoma. This is a cancer that arises from the glands in the lining of the stomach.

The stage of the cancer depends on 3 main factors;

  • The depth of invasion of the cancer into (or through) the somach, called the T-stage (T for tumour);
  • Whether the cancer has spread to the lymph nodes around the stomach, the N stage;
  • Whether the cancer has metastasised (spread) to other parts of the body, such as the other organs in the abdominal (belly) cavity, or the liver or lungs. This is the M stage.
The T, N and M scores are combined to give an overall stage, which goes from 1 to 4. Here's a link that describes these in more detail: http://www.cancer.gov/cancertopics/pdq/treatment/gastric/Patient/page2

Unfortunately it isn't possible to give a single cure rate for gastric cancer, but your surgeon or oncologist should be able to tell you where you stand based on the above factors.

Treatment for gastric cancer usually involves a combination of chemotherapy and surgery, and also radiotherapy in some cases. Often the process will involve chemotherapy, surgery, then further chemotherapy and possibly radiotherapy. Early stomach cancers can sometimes be treated with surgery alone.

Treatment should be discussed by a multidisciplinary team of surgeons, oncologists, radiation oncologists and other specialists to ensure that all options are considered, and that any relevant clinical trials are considered. Clinical trials compare different treatment options in the hope of improving treatments in the future; a list of currently open trials can be found here: http://agitg.org.au/clinical-trials/trials-open-to-recruitment/

Surgery can be laparoscopic (keyhole) or open (large incision). Not all surgeons perform laparoscopic stomach surgery.

The hospital stay following surgery can be from 5 days to two weeks, depending on the operation and how well recovery proceeds.

It is normal to lose weight following surgery - 10% of body weight is common - and to need to snack or graze on small, high-protein meals after surgery. Large meals are usually not tolerated, due to the smaller size of the stomach. Meals high in sugar should be avoided, they can cause headaches, dizzyness and diarrhoea after stomach surgery.

Most people will need vitamin B12 injections every 3 months, lifelong, following surgery for stomach cancer.

Modern methods of reconstruction (joining everything up again) after surgery, such as Roux-en-Y reconstruction, decrease symptoms such as reflux which can occur after stomach surgery.

Follow up after treatment is usually with CT scanning (CAT scan) and gastroscopy. This should continue for at least five years after treatment is completed.

Other places to ask for support include:

The Australian Cancer Council
http://www.cancer.org.au/ has resources and links to support groups in each state, they also have a Helpline, Tel. 13 11 20 which is open during business hours.

The Victorian Better Health Channel
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/stomach-cancer