Disorders of the Gastrointestinal System, 2nd Edition
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Because many other gastric problems can mimic gastric cancer, it is necessary to confirm the diagnosis via specific diag - nostic tests (ACS, 2022b): ● Esophagogastroduodenoscopy (EGD): This test allows visualization of the esophagus, stomach, and duodenum (the first section of the small intestine). It provides a color photographic record of any lesions or suspicious areas and is the primary way to obtain a tissue specimen for biopsy. But this method may not detect cancers related to hereditary diffuse gastric cancer syndrome. ● Barium x-rays: These are x-rays of the GI tract and are obtained to determine if issues are present, such as tumors, filling defects, loss of gastric flexibility, and abnormalities in the gastric mucosa. ● CT scan with or without needle- guided biopsy : These tests are conducted to view the chest, abdomen, and pelvis to assess local disease and identify possible areas of metastasis while allowing a biopsy of areas of concern. ● PET scan: This allows cancer to be visualized by injecting a slightly radioactive substance. This substance collects in cancer cells and can alert providers that a cancer is present or has spread. Although this is a helpful tool, some types of stomach cancer do not show up using this method, as they do not absorb the radioactive substance. ● Endoscopic ultrasound: An endoscope is fitted with a small ultrasound probe inserted into the stomach to visualize areas of concern or confirmed cancer. This can also be used to guide a needle for biopsy.
For gastric cancers, a combination of treatments is usually used. The most com- mon treatments are surgery, chemother- apy, radiation therapy, immunotherapy, and targeted therapy. Surgery usually in- cludes the removal of the malignant area. If the surgeon determines clear margins surrounding the cancerous area, some of the stomach may be left in place; howev- er, depending on the extent of the dis- ease, it may be necessary to perform a total gastrectomy. | NURSING CONSIDERATION A patient who has had a partial gastric resection may eventually be able to eat normally; however, a patient who has had a total gastrectomy may have a slow recovery and a limited ability to eat a normal diet. After a total gastrec- tomy, patients should eat six to eight small meals a day for the rest of their lives to avoid dumping syndrome, which can cause nausea, vomiting, excessive gas, and indigestion (Me - morial Sloan Kettering Cancer Center [MSKCC], 2022a). Even if surgery is successful, multiple treatment methods will likely be used to ensure the best chances of survival and the lowest chance of reoccurrence (ACS, 2022b). Various chemotherapy agents may be administered as part of the treat- ment regimen. Examples of such agents include paclitaxel (Nov-Onxol) and Cis- platin (Platinol-AQ). Radiation in combi- nation with chemotherapy may be bene- ficial (ACS, 2022b).
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