Scientists have found a higher incidence of gastric cancer in patients treated for H. pylori, a bacterium found in the stomach, if they took proton pump inhibitors (PPIs) over extended periods of time. The prolonged use of these antacids may worsen gastric atrophy and promote bacterial overgrowth. The results of the study conducted at the University of Hong Kong showed that the long-term use of PPIs doubled the risk of gastric cancer – even after eradication of H. pylori, whereas the use of a H2-receptor antagonist – a less potent acid suppressant drug – did not have any stomach cancer risk. Since this research is an observational study, no firm conclusions can be drawn considering PPIs are generally considered safe. It is important to use PPIs at their minimum effective dose, frequency and duration in order to prevent any complications.
Risk Factors
View Full Article
Related Videos
Today, Merck announced that the FDA has approved the anti-PD-1 therapy, Keytruda (pembrolizumab) for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma whose tumors express PD-L1. This makes Keytruda the first PD-1 checkpoint inhibitor approved in the United States for previously treated gastric or GEJ cancer.
Treatment Options
View Full Article
Related Videos
Scientists have suspected for some time that stomach cancer is mainly caused by a bacteria called Helicobacter pylori. Bacteria does not transfer DNA into infected cells, so it is still not well understood as to how H. pylori triggers cancer. While certain viruses are known to cause cancer, such as human papilloma virus (HPV), by transferring oncogenes into the host cell DNA – the same cannot be said for how bacteria triggers cancer. Researchers Michael Sigal, Thomas Meyer, and their teams believe that bacteria’s role in triggering cancer is through stem cells in the glands that line the inside of the stomach. The stems cells identified were two different types, one cell was pushed into overdrive by exposure to bacteria, while the other is quieted.
Risk Factors
View Full Article
Related Videos
The standard reconstruction method may affect postoperative bone mineral density (BMD) loss in gastric cancer according to a study published in the Journal of Gastroenterology and Hepatology. In multivariate analysis, researchers found that R-Y reconstruction was an independent risk factor for BMD loss after distal gastrectomy. B-I reconstruction was found to have superiority over R-Y reconstruction for preventing BMD loss in the first three years after distal gastrectomy. The authors of the study also mentioned that B-I reconstruction may be a preferred method of treatment in preventing BMD loss post-gastrectomy in gastric cancer patients.
Surgical Treatment Options
View Full Article
Related Videos
A new standard of treatment of care for resectable gastric or gastroesophageal (GEJ) adenocarcinoma is perioperative chemotherapy with docetaxel-based triplet. The MAGIC trial established perioperative epirubicin, cisplatin, and fluorouracil (ECF) as a standard of treatment for patients with operable esophagogastric cancer, but outcomes remain unsatisfactory. With the new method of treatment, docetaxel-based triplet FLOT, the median overall survival was higher and showed an increased rate of curative and prolonged progression-free survival when compared to ECF/ECX. With FLOT there was no increase in surgical morbidity and mortality, re-surgeries, and hospitalization time. Overall, FLOT improved outcome in patients with resectable gastric and GEJ cancer – making it the new standard of care in perioperative treatment of patients with such cancers.
Treatment Options
View Full Article
Related Videos
Researchers from the University of Quebec and University of Montreal conducted a study on how prolonged exposure to work-related stress can greatly impact an individual’s health and may increase their risks of developing certain kinds of cancers. The results showed that employment in at least one stressful job increase the odds of various cancers, including stomach cancer. Most of the common reasons for work related-stress included: high demand, time pressure, responsibilities, anxious temperament, financial insecurity, personal conflicts, difficult working conditions, and traffic.
Symptoms, Screening & Early Detection
View Full Article
Related Videos
Charles S. Fuchs, MD, MPH, director, Yale Cancer Center, physician-in-chief, Smillow Cancer Hospital, 2017 Giant of Cancer Care in Gastrointestinal Cancer, and a member of the Debbie’s Dream Foundation Medical Advisory Board discusses new strides in immunotherapy for treating gastric cancer. While therapies are common in the treatment of various cancers, Dr. Fuchs emphasizes the need for a greater variety of therapies by developing new drugs with the understanding of how gastric cancer works in the body. Sustained response shows promise for patients who have little to no other treatment options and may help other patients further down the road.
Treatment Options
View Full Article
Related Videos
Linitis Plastica (LP) is one of the most serious forms of gastric cancer. It is a subtype of gastric cancer that presents itself in about 20% of gastric adenocarcinoma cases and can be identified as a “signet ring” via biopsy. With LP, most patients have a 5-year survival of less than 10%, making an early diagnosis critical to the patient’s outcome. Patients with LP will have more intense symptoms presented with gastric cancer in addition to early satiety and how much stomach involvement there is since it may lead to limited distensibility.
Diagnosis & Staging
View Full Article
Related Videos
Perioperative chemotherapy is the standard method of care for patients with locally resectable gastric cancer. This is based on the results of the British MAGIC and the French FNCLCC/FDD trails, both of which showed a significant overall survival benefit for those who received perioperative chemotherapy compared to those who only had surgery. For those enrolled in the MAGIC trial, neoadjuvant chemotherapy aided in lowering tumor burden and tumor size, improved the likelihood of resection, and involved less lymph node involvement when compared to those who only received surgery. In the time frame between the completion of chemotherapy and surgery, Dr. Sunnie S.Kim and Dr. Waddah B. Al-Refaie recommend various measures for patients who would benefit from gastrectomy. In order to properly asses the progression of disease CT imaging or PET scans are recommended, sometimes diagnostic laproscopy with peritoneal cytology may also be considered. Nutritional education and counseling is also very important since there are major lifestyle changes that come after surgery, weight loss being one of the major issues. Increased nutritional treatment of weight loss has been associated with significant improvements in survival and complication rates.
Diagnosis & Staging
View Full Article
Related Videos
Today, the FDA approved Merck’s Keytruda for microsatellite instability-high (MSI-high) cancers, a tumor type identified by genetic testing. About 4-5% of stomach cancer patients are MSI-high and are now eligible for treatment after at least one prior therapy. This is the first time the FDA has approved a cancer treatment based on a common biomarker rather than the location in the body where the tumor originated.
Genome Profiling
View Full Article
Related Videos