The stage of the stomach cancer (whether it is localised or has spread to other parts of the body), the patient’s age and general health will affect the success of the treatment.

SURGERY

Surgery typically offers the best chance to cure stomach cancer.

The surgeon may remove the entire stomach if the cancer is located in the middle of the stomach. This is called total gastrectomy. Only part of the stomach may need to be removed if the cancer is confined to the lower end of the stomach (partial gastrectomy). The lymph nodes will be removed and sometimes the spleen may need to be removed as well.

Patients with precancerous lesions and very early-stage gastric cancer may be suitable for less invasive procedures such as endoscopic mucosal resection (EMR) or submucosal dissection (ESD). This involves passing an endoscope fitted with a video camera and special blades to remove the cancerous growths.

CHEMOTHERAPY

Doctors may recommend chemotherapy prior to surgery to shrink large tumours as well as after surgery to kill off any remaining cancer cells and improve the chance of cure.

Recent research carried out at Duke-NUS identified three subtypes of gastric adenocarcinomas - the most common type of stomach cancer. Each subtype had different genetic abnormalities and was found to respond differently to treatments in the laboratory.

Published in Gastroenterology, this study showed that the metabolic subtype was the most sensitive to 5-fluorouracil (5-FU) which is commonly used to treat gastric cancers.

The proliferative subtype of adenocarcinoma was less sensitive to 5-FU treatment.

The mesenchymal subtype seemed to be more sensitive to drugs targeting the PI3K-AKT-mTOR process which is commonly abnormal in cancers.

RADIOTHERAPY

Doctors may include radiotherapy to shrink an advanced tumour or prevent gastric cancer from returning after surgery.

CLINICAL TRIALS

Clinical trials enable patients to gain access to the latest cancer treatments. Your doctor will discuss with you if you are suitable for a trial. Go through the information on the trial before making a decision.

• Eat a healthy diet that includes plenty of fruit and vegetables.
• Consume less salted and pickled foods such as salted fish and meats.
• Consume less smoked, preserved and cured meats like bacon, ham and bak kua.
• Lose weight if you are obese (Asians should target a BMI between 18.5 and 22.9).
• Stop smoking.​

​Ref: S13