Types of treatment and drug options for stomach cancer (stomach)

Gastric cancer, also known as stomach cancer, must be treated immediately. WHO (World Health Organization) records stomach cancer as a type of cancer that is ranked third in the world causing the most deaths. So, how do you treat stomach cancer? Is it enough to take medication, can stomach (stomach) cancer be cured? Come on, find out the answer below.

Gastric cancer drugs and common types of treatment

Cancer treatment can use drugs as well as other medical procedures that can kill or eliminate cancer cells in the digestive system. For more details, let's discuss one by one the following treatments.

1. Chemotherapy

Chemotherapy is a cancer treatment using drugs that are injected into a vein or taken in pill form. This drug works by killing cancer cells because it can mix with the bloodstream so that it reaches all areas of the body.

Chemotherapy can be done before surgery to shrink the tumor, making surgery easier. This treatment can also be carried out after the surgical removal of cancer cells. The goal is to kill cancer cells that may not be completely removed during surgery.

A number of drugs used to treat stomach (stomach) cancer include:

• 5-FU (fluorouracil), often given together with leucovorin (folinic acid).
• Capecitabine (Xeloda).
• Carboplatin.
• Cisplatin.
• Docetaxel (Taxotere).
• Epirubicin (Ellence).
• Irinotecan (Camptosar).
• Oxaliplatin (Eloxatin).
• Paclitaxel (Taxol).
• Trifluridine and tipiracil (Lonsurf).

The drugs above can be used singly, or in combination to be more effective in fighting cancer. Examples of combination drugs that oncologists often recommend for gastric (stomach) cancer are:

• ECF (epirubicin, cisplatin, and 5-FU), which can be given before and after surgery.
• Docetaxel or paclitaxel plus 5-FU or capecitabine, combined with radiotherapy as a preoperative treatment.
• Cisplatin plus 5-FU or capecitabine, combined with radiotherapy as a preoperative treatment.
• Paclitaxel and carboplatin, combined with radiotherapy as a preoperative treatment.

Many doctors recommend a combination of 2 chemotherapy drugs to treat advanced stomach (stomach) cancer. The reason is that a combination of more than two drugs, for example three drugs, can cause more side effects. Generally this combination is only intended for people who are in very good health.

Although effective, chemotherapy for stomach cancer can cause side effects, such as nausea and vomiting, worsening appetite, hair loss, and diarrhea. In the long term, certain medications can also cause heart and nerve damage.

2. Cancer surgery

Cancer of the stomach (stomach) causes tumors to form. That is why surgery for gastric (stomach) cancer is sometimes the main treatment option with a high chance of recovery.

The type of surgery will depend on the part of the stomach that is affected by cancer and how much tissue or other organs are affected. The types of surgery that doctors usually recommend are:

Endoscopic resection (endoscopy resection)

This procedure is performed when the stage of the cancer is very early, or the chances of the cancer spreading to the lymph nodes are very low. The surgeon does not make an incision wound, but instead inserts an endoscope down the throat and into the stomach. With this tool, doctors can remove tumors that are in the lining of the stomach.

Partial gastrectomy (subtotal gastrectomy)

This type of surgery is performed when the cancer cells are in the upper part of the stomach. Sometimes only part of the stomach is removed, sometimes along with part of the esophagus or the first part of the small intestine. The remaining part of the stomach will be reconnected.

In some cases, the fat-like tissue covering the stomach (omentum) is removed along with the nearby affected organs, such as the lymph nodes or spleen.

Total gastrectomy

How to treat cancer is done when the cancer cells have spread throughout the stomach and upper stomach lining near the esophagus. In this case, the lymph nodes, spleen, and pancreas will be removed. The end of the esophagus will be attached directly to the small intestine.

After surgery for stomach (stomach) cancer is performed, the patient will be given pain relievers. Patients who have difficulty eating will be helped by a tube that is placed into the intestine when the operation is being performed. This tube, called a jejunostomy, ends outside the skin of the stomach. In that section, liquid nutritious food will be inserted directly so that it can reach the intestine.

According to the American Cancer Society, surgery for stomach (stomach) cancer can cause side effects, ranging from bleeding, infection, to blood clots. In fact, it can cause death in about 1-2 percent of complex operations.

3. Radiotherapy

Apart from taking chemotherapy drugs, cancer patients can also undergo radiotherapy. This medical procedure uses high-energy rays to kill cancer cells in the body. Sometimes radiotherapy is done in conjunction with chemotherapy before surgery is performed.

After surgery, radiotherapy can also be done to kill any remaining cancer cells. In advanced cancer, this cancer therapy is used to slow growth and relieve symptoms of stomach cancer, such as pain, bleeding, and eating disorders.

This radiation therapy is usually given 5 days a week for a few weeks or months. The side effects of radiotherapy for stomach (stomach) cancer that may occur are skin problems, body fatigue, and low red blood cell counts.

4. Targeted therapy

When chemotherapy drugs are not effective in curing stomach (stomach) cancer, targeted therapy will be recommended by the doctor. In this therapy, the drugs used can target abnormal cells more specifically so that they are quite effective against cancer cells. Some of the drugs used in targeted therapy include:

• Trastuzumab (Herceptin) can suppress the HER2 protein so that the tumor does not increase in size. This medicine is given every 2 or 3 weeks along with chemo by injection into a vein.
• Ramucirumab can block VEGF protein signaling from creating new blood vessels for tumors. This drug is injected into a vein once every 2 weeks.

5. Immunotherapy

The next cancer treatment for stomach (stomach) cancer is immunotherapy. This treatment helps patients to boost their immune system so that it is stronger in destroying cancer cells. The drug used in this therapy is Pembrolizumab.

Pembrolizumab can block the protein PD-1 and stimulate an immune response to be more sensitive to cancer cells. With this drug, the tumor will shrink and its growth will also become slower. Usually the drug is given every 3 weeks by injection in a vein.

Can stomach (stomach) cancer be cured?

Cancer of the stomach (stomach) does cause quite high mortality, but can someone recover from this disease? This depends on the stage of stomach cancer being experienced.

In stage 1 or early stages, stomach (stomach) cancer can be cured by surgical removal of cancer cells. Then, in stages 2 and 3, the disease can also be cured with a combination of treatments such as chemotherapy, radiotherapy, targeted therapy, or immunotherapy.

However, some patients with stage 3 stomach cancer who are already severe may not be cured. Likewise with stage 4 cancer patients. Although it cannot be cured, patients still have to undergo treatment. The goal is to relieve cancer symptoms and slow the spread of cancer cells so as to improve the patient's quality of life.