Several issues that family members of gastric cancer patients need to know

The diagnosis of gastric cancer is the doctor's job, but family members should pay attention to the following issues.

(1) The degree of differentiation of gastric cancer: The patient's family should ask the doctor for the pathological diagnosis report to determine whether it is well-differentiated, moderately differentiated or poorly differentiated, so as to determine the degree of malignancy. Because poorly differentiated gastric cancer is easy to metastasize and is sensitive to chemotherapy, it is best to receive one or several chemotherapy sessions before surgery, and consolidation chemotherapy is also required after surgery. If it is well-differentiated gastric cancer, preoperative chemotherapy is not necessary, but local treatment is emphasized. If the surgical resection is complete, you can follow the doctor's advice and not undergo chemotherapy or take Chinese medicine alone.

(2) About the staging of gastric cancer: The staging of gastric cancer can only be determined after surgery, because the staging is determined by the scope of invasion of the lesion: Gastroscopy can only see the situation inside the stomach. For the cancer lesion, the depth of invasion of the stomach wall can only be estimated from the size, and then the possibility or degree of metastasis or dissemination can be estimated. Although B-ultrasound can examine the surrounding lymph nodes, the understanding is too poor. So far, the relationship between the cancer lesion and the surrounding organs can only be seen clearly during surgery. Therefore, a considerable number of advanced patients are only opened for exploration and then closed, which is called "opening and closing surgery". The preoperative estimation of clinicians is often very rough, unless a large mass is felt in the upper abdomen and cannot be moved, then it is judged that the gastric cancer has adhered to the retroperitoneum, or it means that there is no value in surgery. However, Japanese scholars have proposed that 25% of gastric cancer patients with masses felt in the upper abdomen can still be resected: sometimes, the stomach and jejunum are anastomosed by opening the abdomen, just to temporarily solve the patient's eating problem, so as to improve the quality of life and prolong survival. After understanding these, you will also easily understand the doctor's treatment plan.

(3) Tumor marker test results: The main tumor markers for gastric cancer are: CA72-4 is currently one of the best tumor markers for diagnosing gastric cancer and has a high specificity for gastric cancer. Others such as CA19-9 and CEA are also good detection indicators. If blood can be drawn from the portal vein during surgery to detect CEAmRNA, it can be determined earlier whether there is potential liver metastasis: At the end of the operation, peritoneal lavage must be performed. If the peritoneal lavage fluid can be sent for CEAmRNA testing, it can also be prompted whether there is abdominal dissemination and appropriate treatment can be taken early. At present, some general surgeons have not paid more attention to the detection of tumor markers. Family members can make suggestions when they understand the situation, which may be an important step. The test results should also be kept together with other information for future reference and should not be lost.

(4) Pay attention to metastasis to the abdominal cavity and ovaries: The stomach is an organ in the upper abdomen. During gastric cancer surgery, cancer cells often fall off into the abdominal cavity, causing implantation and becoming one of the causes of recurrence. Under the influence of intestinal peristalsis and peritoneal fluid, the shed cancer cells can easily reach the pelvic cavity, or in advanced gastric cancer, the cancer cells break through the serosal layer and reach the abdominal cavity, so the pelvic cavity is a common site of metastasis. In women, the ovaries are not only located in the pelvic cavity, but the ovaries themselves have the ability to induce and attract cancer cells, so the incidence of secondary ovarian cancer is very high and deserves attention.