<unk>  of the<unk>  is difficult to cure unless it is found at an early stage (before it has begun to spread). Unfortunately, because early<unk>  causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for<unk>  may include surgery, chemotherapy, or radiation therapy. New treatment approaches such as immunotherapy or gene therapy and improved ways of using current methods are being studied in clinical trials. Surgery Anatomy before Roux-en-y surgery to resect<unk>  Surgery remains the only curative therapy for<unk> . Of the different surgical techniques, endoscopic mucosal resection (EMR) is a treatment for early gastric<unk>  (tumor only involves the mucosa) that was pioneered in Japan and is available in the United States at some centers. In EMR, the tumor, together with the inner lining of<unk>  (mucosa), is removed from the wall of the<unk>  using an electrical wire loop through the endoscope. The advantage is that it is a much smaller operation than removing the<unk> . Endoscopic submucosal dissection is a similar technique pioneered in Japan, used to resect a large area of mucosa in one piece. If the pathologic examination of the resected specimen shows incomplete resection or deep invasion by tumor, the patient would need a formal<unk>  resection. A 2016 Cochrane review found low-quality evidence of no difference in short-term mortality between laparoscopic and open gastrectomy (removal of<unk> , and that benefits or harms of laparoscopic gastrectomy cannot be ruled out. Post-operatively, up to 70% of people undergoing total gastrectomy develop complications such as dumping syndrome and reflux esophagitis. Construction of a "pouch", which serves as a<unk>  substitute", reduced the incidence of dumping syndrome and reflux esophagitis by 73% and 63% respectively, and led to improvements in quality-of-life, nutritional outcomes, and body mass index. Those with metastatic disease at the time of presentation may receive palliative surgery, and while it remains controversial, due to the possibility of complications from the surgery itself and because it may delay chemotherapy, the data so far are mostly positive, with improved survival rates being seen in those treated with this approach. Chemotherapy The use of chemotherapy to treat<unk>  has no firmly established standard of care. Unfortunately,<unk>  has not been particularly sensitive to these drugs, and chemotherapy, if used, has usually served to palliatively reduce the size of the tumor, relieve symptoms of the disease, and increase survival time. Some drugs used in<unk>  treatment have included: fluorouracil or its analog capecitabine, BCNU (carmustine), methyl-CCNU (semustine) and doxorubicin (Adriamycin), as well as mitomycin C, and more recently cisplatin and taxotere, often using drugs in various combinations. The relative benefits of these different drugs, alone and in combination, are unclear. Clinical researchers are exploring the benefits of giving chemotherapy before surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining<unk>  cells. Targeted therapy Recently, treatment with human epidermal growth factor receptor 2 (HER2) inhibitor, trastuzumab, has been demonstrated to increase overall survival in inoperable locally advanced or metastatic gastric carcinoma over-expressing the HER2/neu gene. In particular, HER2 is overexpressed in 13–22% of patients with gastric<unk> . Of note, HER2 overexpression in gastric neoplasia is heterogeneous and comprises a minority of tumor cells (less than 10% of gastric<unk> s overexpress HER2 in more than 5% of tumor cells). Hence, this heterogeneous expression should be taken into account for HER2 testing, particularly in small samples such as biopsies, requiring the evaluation of more than one bioptic sample. Radiation Radiation therapy (also called radiotherapy) may be used to treat<unk> , often as an adjuvant to chemotherapy and/or surgery. Lymphoma Lymphoma of the MALT type can often be fully treated by treating an underlying H. pylori infection. This results in remission in about 80% of cases.
Stomach cancer
Appendix cancer
Stomach disease
Peptic ulcer disease
Small intestine cancer
Acid peptic diseases
Duodenal cancer
Oral cancer