Unfortunately, the endoscopist said that if you have something bad in your stomach, it is useless to run away, only to face it positively.
Because of the lack of medical knowledge, things on the Internet are scary and untrustworthy. So my thoughts were chaotic, and I rushed to the doctor when I was sick. Today I will explain a few of the most relevant questions, I hope it helps.
1) Is it stomach cancer?
The diagnosis of gastric cancer depends on biopsy pathology, and it cannot be said that it looks like gastric cancer. Large stomach ulcers can also be benign. I did an enhanced CT of the abdomen, saying that the thickening of the stomach wall was accompanied by enhancement, and the tumor should be considered, please combine it with endoscopy, and it could not confirm the stomach cancer at this time. This is the qualitative diagnosis in the diagnosis of stomach cancer.
2) Is it early?Is it late?
Gastroscopy alone cannot give an answer. It can be guessed according to the description of gastroscopy and **, such as superficial erosion of gastric mucosa, IIA+IIC lesions, most of which belong to the early stage. For example, there are descriptions of large deep ulcers, hardness, filth, etc., most of which are advanced or advanced.
At this time, imaging (chest CT + abdominal contrast CT) should be used to make a localized diagnosis and stratified diagnosis: look at the size and location of the tumor, whether there is invasion of adjacent organs, whether there is lymph node metastasis, whether there is distant metastasis - this is called clinical stage (CTNM stage), and roughly know which stage of the disease is (gastric cancer is divided into stages I-IV).
If surgery is done and the tumor is removed, it will be used for pathology, and there will be a pathological stage (PTNM stage), which is more accurate than the previous clinical stage, and it will ultimately determine which stage of the disease it is in.
3) How long will you live?
The prognosis of gastric cancer depends on the stage (PTNM stage), and the prognosis for early-stage gastric cancer (stage I) is very good, with a 5-year survival rate of 95%. Advanced gastric cancer (stage IV) 6-18 months. The difference is huge.
4) Do I need chemotherapy after surgery?
Depends on the stage (PTNM stage). Chemotherapy is not required for stage I gastric cancer (not absolutely, if there are many high-risk factors, it should also be done). Advanced gastric cancer (stage II-III) should be treated with intravenous chemotherapy. Stage IV gastric cancer, not only chemotherapy, but also targeted immunity**.
5) Traditional open or laparoscopic surgery?
If it can be done laparoscopically, it can be done laparoscopically, after all, the trauma is small and the recovery is fast, and the tumor resection and lymphatic dissection are the same. Laparoscopic gastric cancer surgery is recommended for early or locally advanced surgery. More advanced is recommended to be done openly.
6) How much does the surgery cost?Number of days in hospital?
In Shanghai, a smooth gastric cancer surgery cost 6-70,000 yuan.
Number of days of hospitalization: 1-2 days before surgery + day of surgery + 7-9 days after surgery.
If there are complications, it is not the above data.
7) Is it necessary to do genetic testing?
HER2 testing is routinely done in immunohistochemistry.
For stage I-III gastric cancer, there is no need for genetic testing. I can't use it even if I do it.
Stage IV gastric cancer is recommended. (In fact, doing immunohistochemical MMR protein testing, you can roughly know the results of genetic testing, which can save a lot of money, I have written in many articles: DMMR is equivalent to MSI-H).
8) How can I eat after my stomach is removed?
The stomach is removed, the esophagus is attached directly to the small intestine, and food goes directly into the small intestine. Nutrients are mainly absorbed by the small intestine. So the stomach was removed and I could live normally.
9) What's the best?
Early stage gastric cancer (stage I): endoscopic resection or surgery.
Advanced gastric cancer (stage II-III): Immediate surgery** + postoperative chemotherapy if resectable. If the tumor is severe, neoadjuvant chemotherapy (3-6 cycles of preoperative chemotherapy) can be done, and surgery can be performed after the tumor has been downstaged.
Advanced gastric cancer (stage IV): Drugs** are preferred over surgery. Surgery unless there is (1) tumor bleeding, (2) tumor perforation, (3) tumor obstruction, etc. Medications** (called conversions**) are performed first, and if they are effective, they are evaluated before surgery is considered.
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