How is the recovery of distal gastrectomy post-chemotherapy?

Question

Hello doctor,

My cousin is diagnosed with stomach cancer. He has taken chemotherapy and did not have surgery; rather, he been taking ayurvedic medicine for the last six months. He is getting frequent stomach pains. I am attaching his latest PET-CT report. Please check and tell me if he still has cancer, and if yes, what will be the course of treatment?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I have seen your PET-CT (positron emission tomography-computed tomography) scan report (attachment removed to protect the patient's identity), and based on that, it is cancer of the distal part of the stomach (food storage organ). A biopsy report is needed for confirmation (I hope it is already done before starting chemotherapy).

A recent PET scan is suggestive of non-metastatic disease (not spread to other sites). Now staging laparoscopy (to see inside the abdomen by scope with a small hole) is advisable to see that it is non-metastatic, because in 15 percent of cases even a PET scan can miss metastasis. After that, chemotherapy is advisable to reduce the disease burden. Based on evidence, four cycles of chemotherapy followed by surgery (distal radical gastrectomy) and again four cycles of chemotherapy to complete the full treatment. As you said, you already received four cycles of chemotherapy, and now you are getting alternative treatment.

Now there are two options -

1. Two more cycles of chemotherapy, followed by surgery, and again two more cycles of chemotherapy after surgery. 2. Surgery as of now, followed by 4 cycles of chemotherapy. As I can tell you, you are lucky enough that the disease is still nonmetastatic, and you still have a chance to complete the treatment.

I would suggest you complete the whole treatment. As per my knowledge, there is no alternative treatment for stomach cancer, and once the disease is metastatic, then there is no curative treatment. I would advise you to accept the thing as soon as you can and start the treatment.

Kindly revert for more queries.

Answer 2

Hello,

Welcome back to icliniq.com.

I can understand your concern.

It is a major surgery and will take approximately three to four hours. It will require removal of the whole stomach, followed by esophagojejunostomy (joint between esophagus and jejunum). Life will not be the same as compared to before surgery. Surgical morbidity is 15 to 20 percent, which includes bleeding, surgical site infection, and sometimes anastomosis leak.

Initial postoperative recovery will take five to seven days, and complete recovery will take approximately three weeks. After surgery patients have to take small, frequent meals (frequency five to six times in 24 hours). There are a lot of other things also. I hope this will help you.

I hope this helps.

Kindly revert if there are any queries.