Stomach cancer, also known as gastric cancer, is a serious health condition that requires timely and appropriate medical intervention. While there are various treatment options, stomach cancer surgery is often the most common and effective approach, especially in cases where the cancer is localised to the stomach. However, for many patients and their families, the idea of undergoing stomach cancer surgery can be overwhelming.
This blog aims to provide a comprehensive understanding of stomach cancer surgery, from the initial diagnosis to post-surgical recovery, helping patients and their families prepare for the journey ahead.
What is Stomach Cancer?
Stomach cancer begins in the stomach’s lining and can spread to other parts of the body if not treated promptly. The most common type of stomach cancer is adenocarcinoma, which starts in the cells of the stomach lining that produce mucus. Other, less common forms include gastrointestinal stromal tumours (GISTs), neuroendocrine tumours, and lymphomas.
While stomach cancer is less common in Western countries, it remains a significant health concern in many parts of Asia, including India. Risk factors include:
- Chronic gastritis
- Infection with Helicobacter pylori (H. pylori) bacteria
- Smoking and excessive alcohol consumption
- Poor diet (especially diets high in salted or smoked foods)
- A family history of stomach cancer
Diagnosis: The first step of stomach cancer treatment
Diagnosing stomach cancer involves several tests to determine the type, stage, and location of the tumour. Early detection is crucial for effective treatment, as symptoms of stomach cancer can be vague and easily mistaken for other gastrointestinal issues. Common symptoms include indigestion, nausea, stomach pain, and unexplained weight loss.
Some diagnostic methods include:
Imaging Tests: CT scans, MRIs, and PET scans are used to determine the tumour’s size, location, and whether it has spread to other parts of the body.
Blood Tests: A stomach cancer blood test is done to test if there are any markers of stomach cancer present in the blood. Certain markers in the blood, such as elevated levels of carcinoembryonic antigen (CEA), may indicate the presence of stomach cancer.
Endoscopic Ultrasound: This test provides detailed images of the stomach and surrounding organs, helping doctors determine how deep the cancer has spread.
Once diagnosed, the cancer is staged to determine its progression. Stages range from Stage 0 (localised to the inner lining of the stomach) to Stage IV (spread to other organs). Treatment plans, including surgery, are based on the cancer’s stage and the patient’s overall health.
Does endoscopy detect cancer?
Yes, endoscopy can detect cancers. During the procedure, a thin, flexible tube with a camera is inserted into the body, allowing doctors to visualise internal organs and tissues. If abnormalities such as tumours or lesions are observed, biopsies can be taken for further analysis. An upper gastrointestinal endoscopy is usually performed to detect stomach cancer.
Types of Stomach Cancer Surgery
Surgery is the primary treatment for stomach cancer that has not spread beyond the stomach or nearby lymph nodes. The goal of surgery is to remove the cancerous part of the stomach and, in some cases, nearby tissues that may be affected.
The types of stomach cancer surgeries include:
Partial Gastrectomy
In a partial gastrectomy, the surgeon removes only the cancerous portion of the stomach tumour, leaving the remaining part intact. This procedure is commonly used for cancers located in the lower or middle parts of the stomach. The remaining portion of the stomach is then reconnected to the small intestine to allow digestion to continue.
A partial gastrectomy may involve the removal of nearby lymph nodes to ensure that any potential spread of cancer is addressed. The extent of the removal depends on the tumour’s location and size.
Total Gastrectomy
In cases where the cancer has spread throughout the stomach, a total gastrectomy may be necessary. This involves the complete removal of the stomach. The oesophagus is then directly connected to the small intestine, allowing food to pass through the digestive system, though in a modified manner.
While total gastrectomy is a more extensive procedure, it is sometimes the only option for patients with advanced stomach cancer. Patients who undergo this surgery need to make significant lifestyle and dietary adjustments to adapt to life without a stomach.
Lymphadenectomy
Lymphadenectomy, or lymph node dissection, is often performed in conjunction with a gastrectomy. Stomach cancer often spreads to nearby lymph nodes, so the surgeon removes these nodes to reduce the risk of recurrence.
Palliative Surgery
In cases where the cancer is too advanced to be completely removed, palliative surgery may be performed to relieve symptoms and improve the patient’s quality of life. This type of surgery is not curative but can help reduce pain, blockages, or bleeding caused by the tumour.
The Surgical Process
Before surgery, the patient will undergo preoperative testing to assess their fitness for the procedure. This typically includes blood tests, heart function tests, and imaging studies. Patients are advised to stop smoking and follow a special diet before surgery to reduce complications.
During the surgery, general anaesthesia is administered, and the procedure may take several hours, depending on the extent of the tumour and the type of surgery performed. Surgeons may opt for open surgery (traditional incision) or laparoscopic surgery (minimally invasive with smaller incisions), depending on the patient’s condition and the tumour’s location.
Post-Surgery Recovery
Recovery after stomach cancer surgery can be a long process, and it varies depending on the type of surgery performed. Here’s what to expect:
Hospital Stay
Most patients stay in the hospital for 7 to 10 days after surgery. During this time, the medical team monitors for any complications such as infection, bleeding, or leaks at the surgical site. Patients will initially receive nutrition through an intravenous (IV) line until their digestive system is ready to handle food again.
Pain Management
Pain is a normal part of the recovery process, but the healthcare team will provide pain relief through medications. Patients are encouraged to move around as soon as possible to prevent blood clots and improve circulation.
Dietary Adjustments
One of the most significant challenges after stomach cancer surgery is adjusting to a new diet. Patients who have undergone a partial or total gastrectomy will need to eat smaller, more frequent meals. The body’s ability to absorb certain nutrients, especially vitamin B12, calcium, and iron, may be reduced, so supplementation is often necessary.
Over time, most patients can adapt to their new dietary requirements, but it may take months of adjustment. Dietitians play a crucial role in helping patients navigate these changes and ensure proper nutrition during recovery.
Follow-Up Care
Regular follow-up visits with the surgical and oncology team are critical after surgery to monitor for any signs of recurrence. Imaging tests, blood work, and endoscopies may be required to assess the patient’s recovery and ensure that the cancer has not returned.
Patients are also encouraged to attend regular physical check-ups and maintain a healthy lifestyle, which includes avoiding smoking and maintaining a balanced diet. These factors can help improve the long-term prognosis.
Complications and Risks
As with any major surgery, stomach cancer surgery carries potential risks, including:
- Infection: This can occur at the surgical site or within the abdomen.
- Bleeding: Some patients may experience internal bleeding during or after surgery.
- Nutritional Deficiencies: Without a stomach or with a reduced stomach, nutrient absorption is affected, requiring lifelong dietary modifications.
- Dumping Syndrome: This condition occurs when food moves too quickly from the stomach to the small intestine, causing nausea, diarrhoea, and dizziness.
Most of these complications can be managed with appropriate medical care and lifestyle changes, but it’s important to discuss these risks with the surgical team before the procedure.
Stomach cancer surgery is a critical treatment option for patients diagnosed with gastric cancer, offering hope for recovery and improved quality of life. Understanding the types of surgeries, the recovery process, and potential complications can help patients and their families make informed decisions and prepare for the journey ahead.
If you suspect yourself or someone you know of experiencing symptoms related to stomach cancer and are looking for a reliable healthcare provider to get diagnosed and treated in Chennai, reach out to us at RPS Hospitals.