Stomach cancer or gastric cancer is one of the challenging diseases with challenges and complexity in the millions of the world population. There have been tremendous improvements in its diagnosis and treatment over the last few decades, and results for patients have improved. This blog discusses some of the latest developments in stomach cancer treatments, particularly innovative therapies and targeted approaches, and emerging research.
Understanding Stomach Cancer
Over the pages that follow, the aetiology of stomach cancer will be discussed. It very commonly presents insidiously over many years and quite often does not have very subtle symptoms at the early stages. Some common presentations include persistent pain in the abdomen, bloating, difficulty swallowing food, and unexplained loss of weight. Because of its nonspecific characteristics, most patients do not seek medical attention until at very advanced stages of the disease, which clearly underscores the importance of early detection and effective treatment.
Conventional Treatment
Traditionally, stomach cancer treatment involved surgery, chemotherapy, and radiation therapy. These remain the bases but new approaches and technologies improve the effectiveness of these classic methods.
1. Surgery
Surgery often is the treatment for localized stomach cancer. Procedures can include:
Gastrectomy: Partial or total stomach removal
Lymph Node Dissection: Removal of nearby lymph nodes for examination for possible spread.
Recent advances in surgery, minimally invasive laparoscopic surgeries, result in much faster recovery times with less post-operative pain for patients.
2. Chemotherapy
Chemotherapy is one treatment in which drugs can kill cancerous cells or at least slow the speed at which they are growing. Often, within this approach, chemotherapy is administered prior to surgery to reduce the size of a tumor (neoadjuvant chemotherapy) or subsequent to surgery to assure all cancerous cells have been removed (adjuvant chemotherapy).
New research also emerged in recent years reporting some chemotherapy regimens that offer better outcomes for patients with stomach cancer. Another approach being considered as a treatment is combination chemotherapy with targeted therapies.
3. Radiation Therapy
Radiation therapy is the use of high-energy rays to kill cancer cells. It is often used as adjuvant therapy after surgery or with chemotherapy. Or, it can be used as a standalone therapy. In the past decade, radiologists developed exquisite techniques such as Intensity-Modulated Radiation Therapy (IMRT). It allows them the irradiation of tumors with maximum accuracy while damage to healthy surrounding tissues is avoided.
Developing Treatments and New Innovations
1. Targeted Therapy
Targeted therapy targets a specific genetic mutation or molecular alteration in the cancer cells. During the last decade, tremendous knowledge has been gained about the genetic makeup of stomach tumors. This knowledge paved the way for targeted treatments, which are usually much more effective and much safer than the conventional chemotherapy.
HER2-Targeted Therapies: HER2 is a protein that can activate the growth of cancer cells. In about 20% of stomach cancers, this protein is overexpressed. Drugs including trastuzumab (Herceptin) have shown activity against HER2-positive stomach cancers.
Molecular Profiling: Genomic evaluation by cutting-edge technology can detect the very mutations present in a tumor and lead to a customized treatment plan. This approach is useful for making decisions on therapies which are likely to be efficacious for the individual patient.
2. Immunotherapy
Immunotherapy is one of the most innovative treatments that would assist the body's immune system in identifying cancer cells and attacking them. This has already revolutionized treatment for many cancers and is now part of many stomach cancer treatments.
Checkpoints: Drugs like pembrolizumab (Keytruda) and nivolumab (Opdivo) block proteins that may otherwise shield cancer from the immune system. They have proven promising so far in treatment, especially for late-stage gastric cancer or those who carry genetic features such as MSI.
Combination Therapies: The combinations of immunotherapy with traditional chemotherapy and targeted therapies to make the former more effective and to enhance survival.
3. New Agents and Clinical Trials
Many clinical trials are now looking at new drugs and new combinations of drugs as a treatment for stomach cancer. Participants in a clinical trial may be among the first to benefit from an innovative approach that is still under study.
Adjuvant and Neoadjuvant Trials: New drug combinations that are given before or after surgery are being tested to see if they improve survival.
Exploratory Drug Development: New drugs, such as new chemotherapy, targeted therapy, and immunotherapy are explored in combination for efficacy in stomach cancer.
Role of Personalized Medicine
Personalized medicine refers to the treatment of a patient on the basis of different characteristics of each patient's cancer. It is possible to choose the most optimal therapy with minimum side effects, by the study of genetic profiles and the respective characteristics of a tumor, against which effective oncology strategies are to be used.
Genomic Testing
Individualized approaches can be detected with specific genetic markers like PD-L1 expression or HER2 overexpression. This could then make the intervention more effective and patients' outcomes shall improve as a result.
Liquid Biopsy
Liquid biopsies analyze cancer-related material through blood. This is an increasingly promising method of monitoring response to treatment and detecting recurrence early. Non-invasive methods of this kind may soon play a very important role in the management of stomach cancer.
Nutritional Support and Quality of Life
Advances in recognising the role of nutrition in treatment have also been made. Nutritional counselling has dramatically improved for patients receiving treatment and outcomes from treatment. Recognition of the need to preserve weight and nutritional status during treatment has led oncologists to bring dietitians into treatment as an integral part of integrated care models.
Advances in supportive care innovations include
Supportive Care Innovations
Apart from the fundamental therapies, the subsequent steps of establishing supportive care as an integral aspect of quality of life in patients with cancer are:
Palliative Care: From the management of symptoms and the betterment of quality of life established by the teams in palliative care, it can become an indistinguishable feature between the patient and his family during his treatment cycle.
Psychosocial Support : Psychologically, there exists counseling and support groups, as cases have clearly shown the influence of cancer on the psychological aspects of the affected people.
Conclusion
The landscape of stomach cancer treatment rapidly evolves with great developments in surgery, chemotherapy, target therapies, immunotherapy, and personalized medicine. Such developments bring new hope to patients and improve quality of life in the process of and after treatment. So long as such developments are further embedded in research and become more available to the patients, the future may seem bright for the stomach cancer treatment.
Encouragement is given to the patients to talk about the latest information regarding stomach cancer and the way towards the latest drugs. Better outcome of stomach cancer and life are expected with support from innovation.
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