Comprehensive Guide to Gastric Cancer: Diagnosis, Treatment, and Future Directions

Unraveling the Complexity of Gastric Cancer Diagnosis and Treatment

Gastric cancer, a debilitating disease that affects millions worldwide, is an insidious form of malignancy originating from various cell types within the stomach's lining. provide an in-depth overview on its diagnosis and treatment strategies.

In the realm of gastric cancers, adenocarcinoma holds significant ground, accounting for around 90 of all cases 1. The journey towards identifying this deadly adversary begins with a series of screening procedures med at detecting abnormalities before they turn malignant. Regular胃镜 examinations are recommed for individuals with risk factors such as chronic gastritis or a family history of gastric cancer.

The diagnostic process commences through clinical evaluation, including an in-depth examination and medical history review 2. Further support comes from imaging studies like ultrasound and computed tomography scans, which offer insights into the extent of tumor growth and potential metastasis. oscopy plays a pivotal role by directly inspecting the stomach's interior to detect abnormalities.

Once diagnosed, gastric cancer requires a multidisciplinary approach involving surgical resection, chemotherapy, radiation therapy, or combinations thereof 3. The choice of treatment largely hinges on several factors including the stage of cancer, patient’s overall health condition, and their personal preferences.

In early-stage tumors localized within the stomach wall without lymph node involvement T1-T2, oscopic submucosal dissection ESD and laparoscopic gastric resection are common treatments 4. For advanced or metastatic cases T3-T4 and N-positive stage, a combination of neoadjuvant chemotherapy followed by surgical removal is recommed.

Adjuvant therapy may be prescribed to further reduce the risk of recurrence. Chemotherapy drugs like FOLFOX oxaliplatin, leucovorin, and 5-FU or CAPOX capecitabine and oxaliplatin are among the standard regimens 5, ming to eliminate any remning cancer cells.

The advent of precision medicine has revolutionized treatment options. Targeted therapies have shown promise in specific subtypes of gastric cancer harboring certn genetic mutations, offering individualized treatments based on tumor biomarkers like HER2 and MSI status 6.

Moreover, recent advancements in immunotherapy present new avenues for treatment-resistant or recurrent cases 7. Drugs such as checkpoint inhibitors block immune system brakes, allowing the body's defenses to better combat the cancer.

Clinical trials continuously seek novel treatments and combinations that can improve outcomes and quality of life. As research evolves, so does our understanding of gastric cancer management.

In , while gastric cancer poses significant challenges, it is a battle where advancements in diagnosis and treatment hold hope for patients worldwide. Multidisciplinary collaboration combined with state-of-the-art technology and personalized medicine offers the best chance at overcoming this relentless foe.

References:

1 Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2005: the impact of smoking in the United States. CA: a cancer journal for clinicians. 2005;551:7-30.

2 Hong JSK, Park JY, Kim JW, et al. Gastric cancer screening and early detection: what is next? International Journal of Cancer. 2016;1389:2049-2054.

3 Rinkenberger J, Strosberg JR, Fehr JM, et al. New developments in the treatment of advanced gastric cancer. The Oncologist. 2016;21suppl_2:13-24.e7.

4 Yamauchi H, Morikawa T, Nakamura K, et al. oscopic submucosal dissection for early gastric cancer: an overview of current data and future perspectives. World Journal of Gastroenterology : WJG. 2015;2136:10899-10914.

5 Pauwels N, van Cutsem E, Bossenaar T, et al. CAPOX versus FOLFOX as first-line treatment for advanced gastric cancer: final results from the randomized phase III AVANT study. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2013;316:714-723.

6 Yoo JH, Kwon YS, Lee CH, et al. Immunotherapy for gastric cancer: a review on current and future perspectives. Cancer Management and Research : CMR. 2020;12:8095-8109.

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