Stomach cancer is changing: An expert explains surgical approaches
Sometimes innovation in cancer care means developing something entirely new. Other times, it means returning to an old idea with the knowledge and tools to make it work better. Both are happening in stomach cancer surgery, says Travis Grotz, M.D., a Mayo Clinic surgical oncologist who specializes in treating stomach cancer.
Stomach cancer treatment is evolving, according to Travis Grotz, M.D., a Mayo Clinic surgical oncologist. Innovations are being made by adapting old surgical techniques and revisiting abandoned procedures while focusing on patient well-being post-surgery.
Grotz explains that upper stomach cancers were once treated through proximal gastrectomy, but this procedure often led to severe bile reflux, negatively impacting patients' quality of life. Now, surgeons are using a technique called double-tract reconstruction, which helps preserve part of the stomach and reduces reflux. The incidence of reflux with this reconstruction is around 5%, compared to the entire stomach removal which eliminates the body's food reservoir, causing patients to eat smaller meals and experience dumping syndrome.
The stomach is being replaced with a J-pouch, which holds food for about 90 minutes and then slowly releases it. This can significantly improve patients' everyday life, as many can return to eating three normal-sized meals a day. This approach has seen success, with over 80% of patients being able to maintain a normal eating pattern.
In addition to surgical advancements, early detection of stomach cancer is also improving. Endoscopic treatment, requiring specialized expertise, allows physicians to remove cancer through an endoscope without removing the stomach. This option is especially beneficial for early-stage cancers. Minimally invasive and robotic approaches can also reduce the physical burden of treatment.
Treatment often involves a combination of surgery, chemotherapy, immunotherapy, and other therapies tailored to the individual patient. Even patients with metastatic stomach cancer may be considered for surgery if they have responded well to systemic treatment.
Interestingly, the profile of stomach cancer in the U.S. has also changed. Decades ago, stomach cancer more often occurred in the lower portion of the stomach and affected older patients. Today, physicians are seeing more proximal and diffuse stomach cancers, including in younger adults. Researchers are investigating potential links between increased consumption of ultraprocessed foods and the rise in early-onset stomach cancer.
Written by urgent.news from Medical Xpress's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
