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Subtotal Gastrectomy by Dr Majid Ahmed Talikoti | Cancer Surgery
Surgery applies to any stage of the stomach cancer.
When surgeon removes a part of the stomach, some lymph nodes, it is named subtotal gastrectomy (gaster=stomach, ectomy=resection or removal). Surgeon may also remove spleen as an organ that also has some immunological function as the lymph nodes. Spleen as well as lymph nodes may contain metastases. Connection of the rest of the digestive tract may be done by Billroth I, Billroth II, Roux -en- Y and some other surgical methods. When disease spreads wider, by removing the stomach as a whole, surgeon performs total gastrectomy. Lymph nodes, lower esophagus, part of small intestine (usually duodenum) and spleen may also go.
If the tumor can not be removed entirely, but the patient still needs to get some food, some palliative procedures are used. Palliative means that they relieve the patient's condition, but do not cure the cancer itself. The procedures include sent placement and electrocautery. Stent usually looks like metal mesh tube that keeps the gut open. It prevents compression form the tumor and allows the food to go below the obstruction. Electrocautery is the procedure with heated instrument. It allows cutting the tumor or stopping bleeding. Laser can also be used for the same purpose. Radiation therapy uses gamma-rays or x-rays to kill cancer cells or sensitize them to other type of treatments. External radiation requires a machine to target the radiation toward the tumor. Internal radiation means the use of radioactive substance that is placed directly into the tumor or nearby. The doctor, who performs this type of procedures, is named radiation oncologist.
Chemotherapy drugs kill the cancer cells or prevent dividing. Doctors perform chemotherapy by mouth by intravenous infusion, or by direct introduction into the spine, organs, abdominal cavity, etc. The procedures are usually done by oncologist.
Chemoradiation combines chemotherapy and radiation. It is also named adjuvant therapy when is done together with surgery.
Immunological therapy uses antibodies or immune cells instructed to kill the tumor.
Treatment of stage 0 gastric cancer is usually surgical Treatment of stage I, II and III of gastric cancer is surgery, chemotherapy and radiation Stage IV Gastric Cancer is surgery, chemotherapy and radiation or palliative therapy and palliative surgery, depending on several factors, that are evaluated by doctors.