Stomach cancer (Gastric Cancer) develops primarily from genetic mutations in the cells lining the stomach. Early symptoms are often subtle, such as persistent bloating, indigestion, or mild stomach discomfort, and can easily be mistaken for gastritis or gastric ulcers. As a result, many patients are diagnosed at a middle or advanced stage.

• Helicobacter pylori (H. pylori) infection: Recognised by the World Health Organization (WHO) as a Group 1 carcinogen, long-term infection can cause chronic gastritis and significantly increase the risk of stomach cancer.
• Unhealthy dietary habits: Long-term consumption of high-salt foods, preserved foods containing nitrites, and insufficient intake of fresh fruits and vegetables.
• Medical history and genetic factors: Individuals with pernicious anaemia, gastric polyps, or a family history of stomach cancer have a higher risk.

With advances in modern medicine, stomach cancer treatment has become increasingly personalised. At OncoCare, our multidisciplinary clinical team develops integrated treatment plans based on tumour size, location, and your overall health condition. These plans may include surgery, chemotherapy, targeted therapy, and immunotherapy, with the goal of improving cure rates while maintaining post-treatment quality of life.

Depending on the stage and genetic characteristics of the cancer, the clinical oncology and surgical teams may recommend one or a combination of the following treatment approaches:

1. Surgery

If the tumour has not spread to distant organs, surgery remains the only potentially curative treatment for stomach cancer.

• Subtotal Gastrectomy: Suitable for tumours located in the lower part of the stomach. The portion of the stomach containing the tumour is removed, and the remaining stomach is reconnected to the small intestine.
• Total Gastrectomy: Suitable for tumours located in the middle or upper stomach, or for more extensive disease. After the entire stomach is removed, the surgeon connects the oesophagus directly to the small intestine.
• Lymph Node Dissection: Removal of surrounding lymph nodes is routinely performed during surgery to enable accurate pathological staging and reduce the risk of recurrence.

2. Systemic Drug Therapy

• Chemotherapy: Can be administered before surgery (neoadjuvant chemotherapy) to shrink the tumour and improve surgical success rates, or after surgery (adjuvant chemotherapy) to eliminate potential microscopic metastatic cancer cells. For advanced stomach cancer, chemotherapy remains a key treatment approach.
• Targeted Therapy: Approximately one-fifth of stomach cancer patients have HER2-positive tumours. Following confirmation through genetic testing, anti-HER2 targeted therapy may be used to block cancer cell growth.
• Immunotherapy: For advanced stomach cancers with specific biomarkers (such as high PD-L1 expression), immunotherapy can reactivate the patient's immune system to attack cancer cells, providing new hope for long-term survival.

3. Radiotherapy

Radiotherapy uses high-energy radiation to target stomach tumours. It is commonly combined with chemotherapy (concurrent chemoradiotherapy) to improve local disease control or relieve symptoms such as bleeding or obstruction caused by advanced tumours.

As the stomach plays a crucial role in digestion, thorough pre-treatment assessment and post-treatment adaptation are essential for successful recovery.

• Pre-treatment staging and physical assessment: Before treatment, endoscopic ultrasound (EUS) or PET-CT scans may be arranged to determine the depth of tumour invasion. A registered dietitian will also assess your nutritional status to ensure you have sufficient physical reserves for surgery or chemotherapy.
• Preventing Dumping Syndrome: After stomach removal surgery, food may pass too quickly into the small intestine, causing symptoms such as palpitations, dizziness, abdominal cramps, or sweating after meals. This common physiological change can usually be effectively managed through eating small, frequent meals (5–6 meals per day); chewing food thoroughly and eating slowly; separating solids and liquids during meals (drinking fluids 30 minutes before or after meals rather than during meals).

The above describes general circumstances. For further details regarding dietary care following a gastrectomy, taking into account your individual needs, food sensitivities or medical condition, please consult your doctor.

Whether undergoing major surgery or systemic therapy, the body requires time to adapt. Patients may experience the following treatment-related effects.

Part 1: Common Expected Transitional Reactions

• Post-operative digestive changes: Early feelings of fullness, significantly reduced appetite, mild weight loss, and symptoms of dumping syndrome.
• Chemotherapy-related effects: Expected fatigue, mild nausea, or temporary reductions in blood cell counts.

Part 2: Medical Intervention for High-Risk Symptoms

The medical team will closely monitor your recovery and provide necessary nutritional support, such as regular Vitamin B12 injections for patients who have undergone total gastrectomy. However, if you experience any of the following high-risk symptoms at home, you should seek medical attention promptly:

• Possible gastrointestinal bleeding: Vomiting fresh blood, vomiting coffee-ground-like material, or passing black stools.
• Possible serious infection or anastomotic leakage (early post-operative period): Persistent high fever, severe abdominal pain that cannot be relieved, or an abnormally rigid abdomen.
• Severe dehydration or malnutrition: Persistent inability to eat, frequent vomiting, significantly reduced urine output, severe weakness, or confusion.

When facing stomach cancer, OncoCare adopts a Multidisciplinary Team (MDT) approach, bringing together experienced surgeons and oncologists, etc.. We ensure comprehensive support and care throughout every stage of treatment and post-operative recovery.