Redefining Gastric Cancer Treatment: An Interdisciplinary Approach

by Columbia Surgery on February 25, 2014

This Blog Talk Radio program has already occurred. Please view the on-demand copy at the bottom of this post.

134110705Gastric cancer is a curable disease with effective treatment options.  When discovered in its early stages, gastric cancer can be eliminated with complete resection of the tumor alone.  The treatment of advanced gastric cancer requires a more comprehensive strategy to achieve long-term survival and maintain a good quality of life.  In the United States gastric cancer often carries a poor prognosis for two main reasons:

    1. Frequently, the tumor is not detected until it has reached an advanced stage, limiting curative therapy
    2. Only about 35% of the treatment facilities have a multidisciplinary approach where a coordinated team of specialists can offer a comprehensive treatment plan

On average the long-term survival rate in the United States is 25% with approximately half of all gastric cancer patients dying within a year of diagnosis. At The Center for Global Excellence in Gastric Cancer Care, we are committed to changing those statistics through the promotion of early detection initiatives and providing the highest quality of care through our multidisciplinary team of experts.

To learn more about how gastric cancer is diagnosed, please visit our other blog article: How is Gastric Cancer Diagnosed?

How is gastric cancer treated?

The three main treatment options for gastric cancer are surgery, chemotherapy, and radiation. Hormonal therapy may be an option for a small percent of patients with a certain type of tumor biology. Surgery, however, remains the primary option for curative therapy.

Small early gastric cancers (less than 2cm) involving only the first two layers of the stomach wall can be cured with endoscopic removal of the abnormal tissue. Since some early cancers have minimal chance of spreading to other areas, a trained endoscopist can perform either an Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD), two procedures that remove the cancerous tissues in a non-surgical, minimally invasive way. The procedures offer a curative removal of the tumor without the need for open surgery.

Advanced gastric cancers are most commonly treated by surgery. Surgery involves removing part or all of the stomach as well as the lymph nodes, which aid in the body’s clearing of infections, toxins, and more.  Subtotal distal gastrectomy, the removal of two-thirds of your distal stomach, is performed for tumors in the lower portions of the stomach.  A total gastrectomy, removal of the entire stomach, is performed for tumors, which are in the upper portion of the stomach. The extent of lymph node removal during the operation depends on the depth of tumor invasion of the stomach wall. In many cases, this can be performed using minimally invasive approaches and robotic assistance.

To learn more about the use of robotic surgery in gastric cancer, please visit our other blog article: Advancements in Gastric Cancer Treatment: Robotic Surgery

Why is it important to have a multidisciplinary team to treat gastric cancer?

When gastric cancer is diagnosed in more advanced stages, patients will require a combination of treatments including surgery, chemotherapy and possibly radiation therapy.

    • Chemotherapy either prior to surgery or after surgery will be recommended depending the tumor characteristics and patient factors.
    • Patients with large tumors, enlarged lymph nodes, or tumors near the esophagus will most likely benefit from chemotherapy before surgical resection.  The goal of chemotherapy prior to surgery, also known as neoadjuvant treatment, is to shrink the tumor so that it can be removed entirely at the time of surgery and to decrease the chance that the tumor will come back.
    • Chemotherapy, radiation, or a combination of both may be needed after surgery to prevent recurrence of disease.
    • There are several kinds of chemotherapy, both oral and intravenous, and the exact chemotherapy regimen is determined based on the characteristics of each individual patient.

In some circumstances the tumor will be too extensive to be removed through surgery, especially when the cancer has already spread beyond the stomach to distant organs.  In these cases, the patient’s medical team will evaluate options of chemotherapy and sometimes radiation in order to shrink the tumor and alleviate his or her symptoms such as pain or bleeding.

Yanghee Woo, MD

Yanghee Woo, MD

“Through cutting-edge scientific research and the most advanced individualized medical and surgical care, we are dedicated to the cure and care of our patients with gastric cancer,” says Yanghee Woo, MD, Director of the Center for Global Excellence in Gastric Cancer Care. “We aim to provide our gastric cancer patients with the highest quality of care through the expertise of our multidisplinary team.  We are committed to promoting early detection, improved survival, and elimination of this deadly disease world-wide.  This is what makes NewYork-Presbyterian/Columbia University Medical Center a leader in the fight against gastric cancer.”

Paul Oberstein, MD

Paul Oberstein, MD

How can I find out more about gastric cancer treatment?

Learn more about gastric cancer treatment by tuning into our Blog Talk Radio program, “Redefining Gastric Cancer Treatment: An Interdisciplinary Approach,” on Friday, March 28th at 3:30 PM/ET. Dr. Woo, Paul Oberstein, MD, medical oncologist, and Tamas A. Gonda, MD, gastroenterologist, will be hosting a panel discussion about the current state of gastric cancer treatment and their vision for the future of gastric cancer management. They will discuss how interdisciplinary approaches can more effectively treat and monitor patients, and why the medical community should achieve this new standard in treatment.

Tamas A. Gonda, MD

Tamas A. Gonda, MD

How do I participate in this program? What will be discussed?

Topics to be discussed in the Blog Talk Radio include:

      - Early detection initiatives
      - Gastric cancer risk factors
      - Traditional gastric cancer treatment
      - Multidisciplinary approach to gastric cancer
      - Ongoing research in gastric cancer

For the full program, listen to the entire podcast below or visit our Blog Talk Radio Station:

Check Out Health Podcasts at Blog Talk Radio with ColumbiaSurgery on BlogTalkRadio

For more information about the Center for Global Excellence in Gastric Cancer Care or to request an appointment, please visit call 212.305.0374.

{ 1 comment… read it below or add one }

Nelson R. February 28, 2014 at 10:19 am

I’ll try to be plug in to this time. In my neck of the wood probably radiation and chemotheraphy is not available for every patient. Surgery is the only way to go.

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