How Bad Is Stage 4 Stomach Cancer

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

When Is The Right Time To Use Hospice Care

Many people believe that hospice care is only appropriate in the last days or weeks of life. Yet Medicare states that it can be used as much as 6 months before death is anticipated. And those who have lost loved ones say that they wish they had called in hospice care sooner.

Research has shown that patients and families who use hospice services report a higher quality of life than those who dont. Hospice care offers many helpful services, including medical care, counseling, and respite care. People usually qualify for hospice when their doctor signs a statement saying that patients with their type and stage of disease, on average, arent likely to survive beyond 6 months. More information about hospice can be found below in the Related Resources section of this fact sheet.

Selecting Preoperative Drug Therapeutic Strategies To Achieve Conversion

In conclusion, conversion surgery for unresectable stage IV gastric cancer was associated with longer survival over chemotherapy alone. GC patients with a single incurable factor who experienced a favorable response to combination chemotherapy achieved better survival outcomes than those with multiple metastatic organs. Additionally, patients undergoing R0 resection had better prognosis than those with R1 or R2 resection. Common definitions remain to be clarified regarding the selection of initial combination chemotherapy, the timing of conversion surgery, and indications for postoperative chemotherapy. Additional trials are imperative to address these important issues and to confirm their feasibility and validity to further improve the prognosis of unresectable stage IV GC patients.

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Certain Factors Affect Prognosis And Treatment Options

The prognosis and treatment options depend on the following:

• The stage of the cancer .
• The patients general health.

When gastric cancer is found very early, there is a better chance of recovery. Gastric cancer is often in an advanced stage when it is diagnosed. At later stages, gastric cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.

Stage 4 Peritoneal Mesothelioma

There is no official stage 4 for peritoneal mesothelioma. This type of the cancer accounts for roughly 20% of all mesothelioma cases. It is generally accepted that peritoneal patients with extensive tumor spreading are classified as stage 4.

For people who can try surgery, heated intraperitoneal chemotherapy is the most promising option. It combines surgery and heated chemotherapy circulated throughout the abdomen.

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Factors That Affect The Outlook Of The Disease

If youve received a diagnosis of stage 4 lung cancer, many factors will affect your outlook, including:

• Overall health. Commonly, if youre healthy when you receive your diagnosis, its an indication that you might have a better ability to tolerate life-extending treatments.
• Age. Although data regarding the outcomes of older people with lung cancer is limited, a small

Often at this stage, your healthcare team is focused on palliative care as opposed to curative care.

Late stage 4a lung cancer can cause symptoms such as:

Late stage 4b lung cancer that has spread to other organs may also cause the following symptoms:

• bone pain or fractures if its spread to your bones
• headaches, vision issues, or seizures if its spread to your brain
• nausea, bloating, or jaundice if its spread to your liver

As a caregiver, you can expect to see your loved one experiencing many of the symptoms and changes listed above, from reduced appetite to difficulty breathing to emotional changes.

Your loved one might also experience spiritual changes, whether theyre religious or not. The NCI recommends that caregivers support and respect loved ones who depend on spirituality to help them cope with cancer.

The goal is to deliver person-centered, compassionate care that delivers improved quality of life along with the best possible health outcomes.

Physical signs and symptoms of burnout can include:

• body aches and pains

• irritability
• lack of energy

Having Another Type Of Cancer

Your risk of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma .

For men, the risk of getting stomach cancer is increased after having prostate cancer, bladder cancer, breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer, breast cancer or cervical cancer.

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Stage 4 Small Cell Lung Cancer

The second most-common type of lung cancer after NSCLC is small cell lung cancer . SCLC is not typically grouped into numbered stages. Instead, its identified as limited stage or extensive stage.

• With limited-stage SCLC, the cancer is present in one lung and may have spread to lymph nodes near that lung, but its contained to one side of the chest. If the lung has multiple tumors, the cancer may not be in the limited stage.
• Extensive-stage SCLC is similar to stage 4 NSCLC in that it is metastatic. SCLC is considered extensive if it has spread throughout the original lung, into the other lung or faraway lymph nodes, or to any other areas of the body.

How Stomach Cancer Spreads

There are 3 ways stomach cancer can spread:

• directly the cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum
• through the lymphatic system the lymphatic system is a series of glands located throughout your body, similar to the blood circulatory system the glands produce specialised cells needed by your immune system to fight infection
• through the blood which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver

Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer.

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Location And Type Of Lung Cancer

There are many different types and subtypes of NSCLC, some of which are more aggressive than others. The three most common types are:

• Lung adenocarcinoma, the most common form of the disease that mainly develops in the outer edges of the lungs
• Squamous cell lung carcinoma, which accounts for 25% to 30% of lung cancer cases and develops mainly in the airways
• Large cell lung carcinoma, an uncommon type of NSCLC that can develop anywhere in the lungs and tends to be more aggressive than other types

These characteristics can influence survival times in people with stage 4 NSCLC. Moreover, the location of the tumorwhether in the airways or in lung tissues themselvescan make a big difference in how long a person survives.

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 Are The Different Stages Of Stomach Cancer

Stomach cancer is staged based on the severity of cancerous cell growth and spread. Adenocarcinoma is initially evaluated by the tumor, node metastasis system.

• T: How deeply has the tumor spread into the stomach wall?
• N: Has the stomach cancer spread to the lymph nodes?
• M: Has the stomach cancer spread to other parts of the body?

After the TNM staging information has been taken into account, the cancer is staged at 0 or 1 to 4. Tumor classifications for staging are as follows:

• Stage 0 is early cancer on the surface of the stomach lining.
• Stage 1A or 1B
• Stage 2A or 2B, commonly with deeper stomach wall involved
• Stage 3A or 3B or 3C, commonly with lymph node involvement
• Stage 4 means cancer has metastasized elsewhere in the body outside of the stomach.

Improve Quality Of Life With Palliative Care

Palliative or supportive care can relieve symptoms and improve quality of life. At stage 4, doctors may recommend pain medication, oxygen therapy and respiratory therapies. These treatments control pain and improve lung function.

Many long-term mesothelioma survivors have incorporated complementary and alternative medicine into their stage 4 mesothelioma treatment plan. Certain complementary therapies may improve survival, ease symptoms, reduce treatment side effects and enhance quality of life.

Examples include mind-body therapies, nutritional support, acupuncture, massage and herbal treatments.

Find a Top Mesothelioma Doctor

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What Are The Survival Rates For Stage 4 Lung Cancer

Stage 4 lung cancer survival rates measure how many people are living a certain number of years after they were diagnosed with stage 4 lung cancer.

For example, a 5-year survival rate of 6 percent means that people with stage 4 lung cancer are, on average, about 6 percent as likely to survive for at least 5 years as people who dont have lung cancer.

Cancer survival rates are based on statistics from the NCIs Surveillance, Epidemiology, and End Results Program database.

Keep in mind that survival rates are only estimates. Everyones body responds to the disease and its treatment differently.

Relative survival rates also dont take into account recent improvements in treatment. Theyre based on diagnosis and treatment from at least 5 years earlier. New treatments are being researched and improved on every day.

The following provided by the ACS are based on people who were diagnosed with stage 4 lung cancer between 2010 and 2016.

The treatment options for late stage 4a or 4b lung cancer vary depending on several factors, such as:

• how far the cancer has spread
• whether any gene mutations have occurred
• your health in general

Before treatment for stage 4 lung cancer starts, your tumor may be tested for genetic mutations. According to a 2015 research review , one of these mutations is in the EGFR gene. If the gene is mutated in your cancer cells, you may receive a targeted therapy drug.

Treating Metastatic Lung Cancer

Treating metastatic lung cancer is challenging. This stage of cancer may continue to spread, and small bits of the disease may linger in the body and cause a recurrence, even if the treatment appears successful. Therefore, treatment will typically focus on extending and bettering life by relieving symptoms and controlling the cancer’s growth. A few things to consider:

• If you have advanced lung cancer, ask your doctor what to expect from treatment.
• You may even want to seek a second opinion from another doctor to ensure youre satisfied with your treatment plan.
• Your care team will weigh the benefits of treatment with the potential side effects and how these may impact your health and well-being.

• Radiation therapy

If the cancer has metastasized to one other siteparticularly the braina typical course of treatment may begin with surgery and radiation therapy to target the area where the cancer spread. Then, the focus shifts to the lung, where treatment may include some combination of surgery, chemotherapy and radiation .

More often, though, cancers at this stage may be too widespread and require systemic treatments that attack the cancer throughout the body.

The first consideration in choosing a systemic treatment is whether there are specific genetic changes in the primary lung tumor that may be targeted. If so, targeted therapy drugs designed to act on these gene changes would likely be the first choice. Chemotherapy, immunotherapy, or both, also may be options.

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How Can You Detect Stomach Cancer Early

Be sure to contact your medical provider if you feel like something is not right. There are screening tests for stomach cancer when people are at risk for or are experiencing signs and symptoms. Diagnostic evaluations for gastric cancer include:

• Complete medical history and physical exam
• Upper gastrointestinal endoscopy to view the esophagus, stomach and small intestine after sedation. A small, flexible tube is inserted into the mouth with a tiny camera on the end that allows the doctor to see inside your stomach.
• Biopsy of stomach tissue to be evaluated under a microscope
• CT scan to visualize organs during X-ray
• Endoscopic ultrasound to diagnose and treat stomach cancer at the same time by visualizing organs and nearby blood vessels
• Positron emission tomography scan to illuminate cancer cells. A radioactive sugar tracer is used because cancer cells use more sugar than healthy cells and the tracer illuminates the cancer cells.

How Can You Treat Stomach Cancer

The treatments for stomach cancer vary depending on the type of cancer you have, its location in the body, if it is advanced and your personalized care plan. At The University of Kansas Cancer Center, we offer clinical trials that may provide new treatment options for stomach cancer.

Possible options include:

• Radiation: High-energy X-rays to destroy cancer cells, typically done using a machine outside the body.
• Chemotherapy: Using one or more drugs to destroy cancer cells by preventing cancer cell growth.
• Surgery: GI surgery is typically a minimally invasive procedure. The surgeon removes the tumor, as well as some surrounding healthy tissue to determine the extent of disease.
• Targeted therapy: Treatment that targets the genes, proteins or tissue that supports the cancerous cell growth and survival. Targeted therapy blocks the growth and spread of cancer cells and minimizes damage to healthy cells.

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Metastatic Gastric Adenocarcinoma: Its Association With Stage Iv Stomach Cancer

When stomach cancer spreads to the areas located near the stomach, it is referred to as regional metastasis and when it spreads to organs or parts that are far away from the stomach, it is known as distant metastasis. Sometimes, recurrent stomach cancer may also be counted as metastatic stomach cancer because distant metastasis might be observed when cancer has reoccurred after a few years.

According to the stages of stomach cancer defined by the American Cancer Society, metastatic gastric cancer occurs at stage 4 because stomach cancer, at this stage, spreads to the distant organs such as the liver, lungs, brain, or the peritoneum .

Stage IV stomach cancer is the most advanced form of stomach cancer and it cannot be cured. This type of cancer is very hard to treat but the treatment helps to keep the cancer under control, improves quality of life of patients and also helps to minimize the symptoms of stomach cancer.

Which Chemo Drugs Are Used For Stomach Cancer

Many different chemo drugs can be used to treat stomach cancer, including:

• 5-FU , often given along with leucovorin
• Capecitabine
• Paclitaxel
• Trifluridine and tipiracil , a combination drug in pill form

Most often, 2 or 3 of these drugs are combined . But this depends on factors such as the stage of the cancer, the persons overall health, and whether chemo is combined with radiation therapy. Three-drug combinations can have more side effects, so they are usually reserved for people who are in very good health and who can be followed closely by their doctor.

For earlier stage cancers, some common drug combinations used before and/or after surgery include:

• Oxaliplatin plus 5-FU/leucovorin , or oxaliplatin plus capecitabine
• FLOT
• Docetaxel or paclitaxel plus either 5-FU or capecitabine
• Cisplatin plus either 5-FU or capecitabine
• Paclitaxel and carboplatin

When chemo is given with radiation after surgery, a single drug such as 5-FU or capecitabine may be used.

For advanced stomach cancer, many of the same combinations of drugs can be used, although doctors often prefer combinations of 2 drugs rather than 3 to try to reduce side effects. Some of the most commonly used combinations include:

• Oxaliplatin plus 5-FU/leucovorin , or oxaliplatin plus capecitabine
• Cisplatin plus either 5-FU or capecitabine
• Irinotecan plus 5-FU/leucovorin
• Epirubicin, either cisplatin or oxaliplatin, and either 5-FU or capecitabine
• Docetaxel, 5-FU, and either cisplatin, carboplatin, or oxaliplatin

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Side Effects Of Chemo

Chemo drugs attack cells in the body that are dividing quickly, which can lead to side effects. These depend on the type and dose of drugs, and the length of treatment. Side effects from chemo can include:

• Nausea and vomiting
• Increased chance of infection
• Easy bleeding or bruising
• Fatigue and shortness of breath

These side effects usually go away once treatment is finished. For example, hair will usually grow back after treatment ends. Be sure to tell your cancer care team about any side effects you have because there are often ways to help with them. For example, you can be given drugs to prevent or reduce nausea and vomiting.

Some chemo drugs have specific side effects. Your treatment team can help you know which of these you might need to look out for.

Nerve damage : Cisplatin, oxaliplatin, docetaxel, and paclitaxel can damage nerves. This can sometimes lead to symptoms such as pain, burning or tingling sensations, sensitivity to cold or heat, or weakness. In most cases this goes away once treatment is stopped, but it may be long-lasting in some people. Oxaliplatin can also affect nerves in the throat, causing throat pain that is worse when trying to eat or drink cold liquids or foods.

Some chemo drugs can cause other side effects. Talk with your treatment team about what types of side effects you should watch for.