Cutting-edge solutions for advanced stomach cancer

Stomach cancer is a severe cancer, but modern treatment allows to increase the life expectancy even at the last stage. The main methods of treatment for stage 4 stomach cancer are considered to be chemotherapy, targeted and immunotherapy. Radiation therapy and endoscopic procedures are used for palliative care. If peritoneal carcinomatosis develops, pressurised intraperitoneal aerosol chemotherapy (PIPAC) is used.

Systemic treatment

Systemic treatment is the cornerstone of stomach cancer control. Drugs that affect the primary tumor and any metastases are injected intravenously.

Chemotherapy for advanced cancer usually consists of two drugs instead of three. This is because the goal is no longer to cure the cancer, and two drugs provide good control of the disease with fewer side effects.

Doctors may use FOLFOX, CAPOX, FOLFIRI, and other regimens. If some drugs do not work, other drugs are tried to get better results.

Patients with HER2-positive tumours receive targeted therapy with monoclonal antibodies that target HER2. In other countries, innovative drugs are also being used, such as antibody-drug conjugates. These also target HER2, but deliver chemopreparations to the cancer cells.

In the last stage of stomach cancer, anti-angiogenic therapy is used. VEGF inhibitors block the growth of new blood vessels that are needed to feed the tumour.

PD-1 inhibitors are used as first-line drugs, along with chemotherapy and targeted anti-HER2 therapy. These are immunotherapeutic agents that enhance the anti-tumour immune response.

Treatment of peritoneal carcinomatosis

In the final stage of stomach cancer, peritoneal carcinomatosis may be one of the scenarios of its progression. Metastases spread to the abdominal cavity, affecting internal organs.

In such a case, the stomach cancer treatment may be supplemented with PIPAC – intraperitoneal chemotherapy. A solution of cytostatics is sprayed into the abdominal cavity, destroying cancer cells and shrinking the tumors in size. It is a minimally invasive procedure that is performed through laparoscopic access.

Palliative treatment

In advanced stomach cancer, the passage from the esophagus to the stomach or from the stomach to the duodenum may become blocked, and there may also be symptoms due to the development of distant metastases, such as in the liver or bones.

In these situations, palliative care can help. Its main goal is to improve the patient’s quality of life, but it can also increase life expectancy.

Possible palliative treatment options:

• Endoscopic destruction of the part of the tumour blocking the digestive tract and placement of a stent
• Chemoembolisation of liver metastases, a minimally invasive procedure performed from within the blood vessels to block the arteries feeding the tumour with tiny beads of chemotherapy drugs
• Embolisation of gastric vessels to prevent bleeding
• Radiation therapy to suppress metastases in the brain and bones, and possibly to control a large primary tumor

If you want to undergo diagnostics and treatment abroad, visit Booking Health website. Here you can find out prices, compare the cost of treatment in different clinics, make an appointment for convenient dates and get travel organisation services. Our team will help you to choose the best stomach cancer hospital, where you will get good results even at the 4th stage of cancer.

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