Questions To Ask Your Doctor
After receiving a terminal cancer diagnosis, your doctor might be the last person you want to talk to. But these questions can help start a dialogue about the next steps:
- What can I expect in the coming days, weeks, months, or years? This can help give you an idea of whats to come down the road, allowing you to better prepare yourself to face these new challenges.
- Whats my life expectancy? This may sound like a daunting question, but having a timeline can help you make choices you can control, whether thats taking a trip, catching up with friends and family, or attempting life-prolonging treatments.
- Are there any tests that can give a better idea of my life expectancy? Once a terminal cancer diagnosis is made, some doctors may want to conduct additional tests to get a better idea of the extent of the cancer. This will help you and your doctor have a better understanding of life expectancy. It can also help your doctor prepare you for proper palliative care.
What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of stomach cancer is 70%, it means that people who have that cancer are, on average, about 70% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
Could I Get A Second Cancer After Treatment
People whove had stomach cancer can still get other cancers. They do not get second cancers at an increased rate overall, but they do seem to have an increased risk of cancers of the thyroid and small intestine.
Experts do not recommend any additional testing to look for second cancers in people whove had stomach cancer. Still, its important to let your doctor know about any new symptoms or problems you have, because they could be caused by the stomach cancer coming back, or by a new disease or second cancer.
Like other people, survivors of stomach cancer should follow the American Cancer Society guidelines for the early detection of cancer and stay away from tobacco products, which increase the risk of many types of cancers.
To help maintain good health, survivors should also:
- Get to and stay at a healthy weight.
- Stay physically active and limit time spent sitting or lying down.
- Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and that limits or avoids red and processed meats, sugary drinks, and highly processed foods.
- Avoid or limit alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men.
These steps may also lower the risk of some other health problems.
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Stomach Cancer Survival Rate
The most recent numbers for stomach cancer use data from the years 2004 through 2008. Experts looked at people with stomach cancer who had surgery as part of their treatment. Surgery is the main treatment for all but the most advanced stages. People who are not candidates for surgery will likely have a poorer prognosis than these estimates.
The five-year survival rates for stomach cancer by stage are as follows:
- Stage IA: 94%
Tests For Stomach Cancer
Your doctor may do some tests to check for stomach cancer:
- Endoscopy a doctor passes a long, flexible tube with a light and small camera on the end into your mouth, down your throat and oesophagus, and into your stomach and small bowel. This allows the doctor to look inside your digestive tract to examine the lining.
- Biopsy during an endoscopy if the doctor sees any suspicious-looking areas they may remove a small amount of tissue from the stomach lining, known as a biopsy, a pathologist will then examine the tissue under a microscope to check for signs of disease.
- Endoscopic ultrasound a doctor passes an endoscope with an ultrasound probe on the end into your mouth, down your throat and oesophagus, and into your stomach and small bowel. The ultrasound probe then uses sound waves to create a picture of your stomach.
If these tests show you have stomach cancer you will then have some of the following tests to check your general health and to find out if the cancer has spread to other parts of your body:
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What Are Some Topics Patients And Family Members Can Talk About
For many people, its hard to know what to say to someone at the end of life. Its normal to want to be upbeat and positive, rather than talk about death. And yet, its important to be realistic about how sick the person may be. Caregivers can encourage their loved one without giving false hope. Although it can be a time for grieving and accepting loss, the end of life can also be a time for looking for meaning and rethinking whats important.
During this period, many people tend to look back and reflect on life, legacies created, and loved ones who will be left behind. Some questions to explore with a patient at the end of life are the following:
- What are the happiest and saddest times we have shared together?
- What are the defining or most important moments of our life together?
- What are we most proud of?
- What have we taught each other?
Patients with serious, life-threatening illness have stated that being positive or adding humor remains an important outlet for them. Even at this challenging moment, laughter may still be the best medicine.
Factors That Can Influence Survival Times
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Questions about life expectancy are often the first ones asked when someone is diagnosed with stage 4 non-small cell lung cancer , the most advanced stage of the disease in which cancer has spread from the primary tumor to distant organs. The median survival time for those with stage 4 lung cancer is around four months, which means that 50% of patients will still be alive four months after their diagnosis.
As distressing as this statistic may be, it is important to remember that stage 4 lung cancer has no set course. Many will live for months and even years longer than this.
Multiple factors can influence survival times, some of which are modifiable. Newer targeted therapies and immunotherapies are also helping people with stage 4 cancer live longer with fewer side effects and a better quality of life.
Verywell / Jessica Olah
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Types Of Stomach Cancer
The most common type of stomach cancer is adenocarcinoma of the stomach . This cancer starts in the glandular tissue found on the stomachs inner surface.
Other less common types of cancer can affect the stomach including small cell carcinomas, lymphomas, neuroendocrine tumours and gastrointestinal stromal tumours. Your doctor will be able to explain more about these types of stomach cancer.
Survival Rates By Disease Extent
A second method estimates survival rates based on the extent of cancer in the body. This is the approach used by the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. The SEER system classifies cancer in one of three broader categories:
- Localized: Cancer limited to the lungs
- Regional: Cancer that has spread to nearby lymph nodes or structures
- Distant: Metastatic cancer
Under the SEER classification system, distant disease and stage 4 cancer are synonymous.
The one drawback to the SEER approach is that stage 4a and 4b lung cancer are melded into one category. This generalized approach not only returns a much lower five-year survival estimate but fails to reflect the wide variability in stage 4 survival rates, particularly in people with limited metastases.
|SEER Stage at Diagnosis|
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How Is Stomach Cancer Treated
There are several approaches to treating stomach cancer. In many cases, surgery can be avoided.
In the early stages when the cancer is limited to the superficial layers of the stomach, the cancer can be removed through an upper endoscopy performed by a gastroenterologist. In this procedure , the tumor is dissected from the rest of the gastric wall and removed through the mouth.
Once the tumor invades beyond the superficial layers of the stomach, surgery will be required to remove the stomach and connect the esophagus to the small intestines to allow for digestion.
Radiation therapy uses high-powered beams of energy to kill cancer cells. Chemotherapy uses chemicals to kill the cancer cells. These treatments are generally combined.
There are also several drugs to treat stomach cancer. Treatment depends on how severe the cancer is and is decided upon by a doctor after diagnosis.
Stage Iiia Iiib And Iiic
Stage IIIA tumors have four possible conditions.
They may have:
- Spread to the muscle wall and seven to 15 nearby lymph nodes, or
- Spread to the subserosa and three to six lymph nodes, or
- Spread to the serosa and one to six nearby lymph nodes, or
- Spread to nearby organs including liver, colon, spleen, pancreas abdominal wall, adrenal glands, small intestine, back of the abdomen or kidney.
Stage IIIB tumors have three possible conditions.
They may have:
- Spread to the submucosa or muscle layer and to 16 or more nearby lymph nodes, or
- Spread to the subserosa or serosa and seven to 15 lymph nodes, or
- Spread out of the stomach to nearby organs and to one to six nearby lymph nodes.
Stage IIIC tumors have two possible conditions.
They may have:
- Spread to the subserosa or serosa and 16 or more nearby lymph nodes, or
- Spread from the stomach to nearby organs and seven or more nearby lymph nodes.
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What Causes Stomach Cancer
Scientists donât know exactly what makes cancer cells start growing in the stomach. But they do know a few things that can raise your risk for the disease. One of them is infection with a common bacteria, H. pylori, which causes ulcers. Inflammation in your gut called gastritis, a certain type of long-lasting anemia called pernicious anemia, and growths in your stomach called polyps also can make you more likely to get cancer.
Other things that seem to play a role in raising the risk include:
Risk Factors And Symptoms
Multiple risk factors have been identified that increase a persons probability of developing stomach cancer. These include a diet high in salted, smoked, or pickled foods, tobacco and alcohol use, obesity, or a family history of stomach cancer. Infection by the bacterium Helicobacter pylori, which can cause significant damage to gastric tissues and is a cause of peptic ulcers, can also lead to stomach cancer. Other factors that may increase the risk of stomach cancer to varying degrees are previous stomach surgery, blood type A, advanced age , or chronic stomach inflammation. Males develop stomach cancer at approximately twice the rate of females. Rare disorders such as pernicious anemia, Menetrier disease, or common variable immunodeficiency and congenital disorders that lead to increased risk for colorectal cancer may also increase stomach cancer risk.
The symptoms of stomach cancer are prevalent in many other illnesses and may include abdominal pain or discomfort, unexplained weight loss, vomiting, poor digestion, or visible swelling in the abdomen.
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What Is The Survival Rate For Someone With Stage 4 Stomach Cancer
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The Ultimate Upset Stomach
There are relatively few reasons why a person would ever want to have their stomach removed, and most disorders of the stomach can be fixed with medication or more minor procedures. Even partial removals of the stomach are chosen before a complete removal, but when it comes to cancer, doctors dont like to mess around. There is a particularly tricky form, called hereditary diffuse gastric cancer, which is often signified by a mutation of the CDH1 gene.
What makes this such a dangerous form of cancer is that the early cancer cells are diffusely spread throughout the stomach, making it very difficult to catch early on, and also making it nearly impossible to guarantee a complete elimination of the cancer cells. As a result of this, one of the preferred methods for treatment is actually a preventative measure the complete removal of the stomach.
The cancer cells may be scattered throughout the stomach, but if it isnt present in other organs, why not simply take the entire stomach out? The procedure is called a total gastrectomy , and as you might expect, you leave the OR without a stomach. However, your internal organs are also repurposed, for lack of a better word, during the same surgery.
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Surgery To Ease Your Symptoms
If your stomach cancer has spread beyond your stomach, it may not be possible to remove it using surgery.
However, if your stomach has been significantly affected by cancer it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and feeling very full after eating.
If your stomach is blocked, there are a few options:
- stenting a stent is a plastic or wire mesh tube inserted through the oesophagus using an endoscope under local anaesthetic after being inserted, the stent will be expanded and open up the stomach
- partial or total gastrectomy to remove the blockage and improve your symptoms
There Are Three Ways That Cancer Spreads In The Body
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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Laser Therapy Or Stent
Laser therapy can be used to destroy tumors, stop bleeding, or alleviate a blockage in the stomach.
This can sometimes be accomplished without surgery.
The doctor inserts a long, flexible tube called an endoscope down the throat and into the stomach to deliver the laser beam. This is also called endoscopic tumor ablation.
Hollow tubes called stents can sometimes help. By placing a stent between the stomach and esophagus or between the stomach and small intestine, food will be able to pass through unobstructed.
Diagnosis Of Stomach Cancer
If your doctor thinks you may have stomach cancer, you will be referred for further tests. The main test is an endoscopy . The doctor will use a thin, flexible tube with a camera , which passes into the mouth, down the throat and oesophagus into the stomach in order to look at the digestive tract.
If any suspicious-looking areas are detected, a small amount of tissue from the stomach lining may be removed and examined under a microscope. Less commonly used is an endoscopic ultrasound where the endoscope has an ultrasound probe at the end.
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Targeted Drug Therapy Or Immunotherapy
Targeted drug therapy can be used to treat advanced stomach cancer. These drugs attack specific characteristics of the cancer. Some of these are:
- imatinib , for stromal tumors
- ramucirumab , for advanced stomach cancer when other treatments arent effective
- regorafenib , for stromal tumors
- sunitinib , for stromal tumors
- trastuzumab , for HER2-positive tumors
Immunotherapy drugs boost your immune system to help attack cancer.
Pembrolizumab is an immunotherapy drug used to treat stomach cancer that has returned or spread in people who have tried but didnt respond to or stopped responding to two or more types of chemotherapy.
Living With Advanced Cancer
Advanced cancer usually means cancer that is unlikely to be cured. Some people can live for many months or years with advanced cancer. During this time palliative care services can help.
Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and other people who specialise in palliative care.
Treatment may include chemotherapy, radiation therapy or another type of treatment. It can help in these ways:
- Slow down how fast the cancer is growing.
- Shrink the cancer.
- Help you to live more comfortably by managing symptoms, like pain.
Treatment depends on:
- How far it has spread.
- Your general health.
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Causes And Risk Factors
Abnormal cell growth in the stomach lining causes stomach cancer to grow. But each person has different risk factors that increase individual risk for developing the disease.
The most significant risk factor for developing stomach cancer is having a Helicobacter pylori bacterial infection, according to Moffitt Cancer Center. Long-term infections can cause pre-cancerous changes in the stomach lining.
Some factors, such as age and sex, cant be controlled. Others, such as lifestyle and diet, can be controlled.
Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Factors that may increase stomach cancer risk include: