关于老年人胃癌的治疗
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  发布时间：2007-08-25 12:01:43

>>>>>>>>提问

请问老年人胃癌如何治疗？现术后两个月！
年龄78岁，胃癌病灶3＋cm，侵犯粘膜下层，手术切除边缘无癌栓，淋巴结无转移，但脉管见癌栓。

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>>>>>>>>休闲养生网回答：

Treatment for stomach cancer depends on the size, location, and extent of the tumour; the stage of the disease; and the patient's age and overall health. The goal of treatment for early-stage stomach cancer is to cure the disease.
Surgical removal (resection) is the only curative treatment. Chemotherapy and radiation therapy may be used in addition to surgery.
Surgery
The extent of surgery depends on the extent of the disease. Endoscopic mucosal resection may be used to treat early stomach cancer (i.e., tumour smaller than 3 cm that has not invaded beyond the innermost layer of the stomach lining [submucosa]). This procedure involves removing only the tumour and surrounding tissue.

Gastrectomy is the most common treatment for stomach cancer. In this surgery, the entire stomach (total gastrectomy) or part of the stomach (partial or subtotal gastrectomy) is removed. Parts of nearby tissues or organs (e.g., the spleen) may also be removed. In most cases, surrounding lymph nodes also are removed (lymph node dissection). Surgery for cancer of the upper stomach (cardia) may require removal of the stomach and part of the esophagus (called esophagogastrectomy).

Following total gastrectomy, the esophagus is attached directly to the small intestine. When a large section of the stomach is removed during partial gastrectomy, the surgeon reattaches the stomach to the esophagus or small intestine.
Gastrectomy requires a large incision. Most patients experience postsurgical pain, weakness, fatigue, and loss of appetite. Recovery from the procedure varies depending on the patient’s age and overall health, the type of surgery, and the stage of the disease.

Removal of a large part or all of the stomach usually requires permanent alterations in diet. Patients often must eat more frequently, eat smaller meals, reduce their sugar intake, and increase their intake of fat and protein. In most cases, drinking with meals must be avoided. If a small section is removed, patients may be able to gradually return to previous eating habits.

Chemotherapy
Chemotherapy involves using drugs to destroy cancer cells. This treatment may be used after surgery to destroy remaining cancer cells and prevent recurrence (adjuvant treatment). Chemotherapy drugs may be administered orally or through an IV (i.e., through a vein).

Chemotherapy drugs target rapidly dividing cells and travel throughout the body via the bloodstream (called systemic treatment). Side effects may be severe and include the following:

Diarrhea
Fatigue
Hair loss
Increased risk for infection (suppressed immune system)
Loss of appetite
Nausea and vomiting
Reduced red blood cell count (anemia)

Radiation Therapy
Radiation involves using high-energy x-rays to destroy cancer cells. This treatment may be used after surgery to destroy remaining cancer cells. In some cases, radiation is administered during surgery for stomach cancer (called intraoperative radiotherapy). Side effects of radiation include fatigue, inflammation, and skin irritation.

Follow-up Treatment
Follow-up care is necessary for stomach cancer patients. Regular physical examination and tests (e.g., CT scan, MRI scan) are used to detect recurrent or advanced disease. In addition, patients' dietary intake must be monitored regularly to promote health.