Recurrent stomach cancer means cancer that has returned after primary treatment. Patients with refractory stomach cancer have cancer that has stopped responding to primary or secondary treatments
Treatment received depends on multiple factors like the potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment. The following is a general overview of the treatment of recurrent or refractory gastric cancer. Circumstances unique to the individual’s situation and prognostic factors of their cancer may ultimately influence how these general treatment principles are applied.
Most new treatments are developed in clinical trials. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. The pros of participating in a clinical trial is easier access to better treatments and advance the existing knowledge about treatment of this cancer. Clinical trials are available for most stages of cancer. Discussing the risks and benefits of clinical trials with their physician is important for patients who are contemplating a clinical trial. Staying informed and following the cancer news in order to learn about new treatments and the results of clinical trials can help one make educated decisions.
Patients experiencing progression of stomach cancer have been perceived to have few treatment options yet they may benefit from additional treatment. It is important for patients to be treated at a medical center that takes a multi-modality treatment approach involving medical oncologists, radiation oncologists, surgeons, gastroenterologists and nutritionists.
Read more on treatment for stomach cancer here.
Chemotherapy is the main treatment for patients who have residual cancer after surgery or experience a cancer recurrence after surgery. Chemotherapy can relieve symptoms and extend survival among patients with advanced gastric cancer. Several chemotherapy regimens are available, and the choice of which to use depends in part on the patient’s health and prior treatments. Chemotherapy may be used alone or in combination with other treatments such as targeted therapy, radiation therapy, and/or surgery.
Targeted therapies are drugs that interfere with specific pathways involved in the growth or spread of cancer. In the case of some gastric cancers, a protein known as HER2 (human epidermal growth factor receptor 2) contributes to cancer growth. Metastatic gastric cancers that test positive for HER2 may be treated with a HER2-targeting drug called Herceptin® (trastuzumab). Herceptin is often used in combination with chemotherapy, and can prolong survival with advanced, HER2-positive gastric cancer.
Radiation therapy involves the use of a particular type of energy, known as ionizing radiation, to kill cancer cells. Radiation can play a role in managing the symptoms of advanced gastric cancer, and can also help to control problems such as bleeding or blockages.
For patients with recurrent gastric cancer, surgery may be performed in order to reduce bleeding or to keep the cancer from obstructing the intestines or stomach.
Prior to any surgical procedure, adequate preparation of the patient is important to minimize complications. Many patients with gastric cancer are malnourished at the time of diagnosis. Aggressive nutritional support has not been shown to improve long-term survival, but it has been shown to improve survival in the immediate post-operative period. Feeding intravenously and/or through a nasogastric tube can enhance nutrition before surgery.
Strategies to Improve Treatment
The progress that has been made in the treatment of gastric cancer has resulted from the use of multi-modality treatment and improved patient and physician participation in clinical trials. Future progress in the treatment of gastric cancer will result from continued participation in appropriate trials. Currently, there are several areas of active exploration aimed at improving the treatment of gastric cancer.
Supportive Care: Supportive care refers to treatments designed to prevent and control the side effects of cancer and its treatment. Side effects not only cause patients discomfort, but also may prevent the optimal delivery of therapy at its planned dose and schedule. In order to achieve optimal outcomes from treatment and improve quality of life, it is imperative that side effects resulting from cancer and its treatment are appropriately managed.