Managing Side Effects and Quality of Life in Stomach Cancer

Stomach cancer, also known as gastric cancer, is a condition marked by the growth of malignant cells within the lining of the stomach.

Although it has become less common in many parts of the world, it remains a significant health challenge due to its often late presentation and poor prognosis. The management of side effects stemming from stomach cancer and its treatments is critical, not only for prolonging survival but also for improving the quality of life of patients.

Addressing symptoms promptly and effectively can help patients maintain their functional abilities, minimize discomfort, and support their emotional and psychological well-being throughout their cancer journey.

Types of Treatment Modalities

Surgery

Surgery is often the primary treatment modality for stomach cancer particularly when the disease is diagnosed at an earlier stage. The procedure, which may involve partial or total gastrectomy, aims to remove the tumor and surrounding margins to achieve a cancer-free status. Depending on the extent of the disease, lymph nodes near the stomach may also be removed as part of the surgical intervention.

Chemotherapy

Chemotherapy uses potent drugs to destroy cancer cells and is usually administered after surgery to eliminate any residual disease, a process known as adjuvant therapy. It may also be provided before surgery, known as neoadjuvant therapy, to shrink tumors and make them easier to remove. In advanced cases, chemotherapy can help to slow the progression of the disease and alleviate symptoms.

Radiation Therapy

Radiation therapy involves the use of high-energy rays to target and kill cancer cells. It is often used in combination with chemotherapy, either before surgery to shrink tumors or after surgery to destroy any remaining cancer cells. Radiation can also be an option to relieve pain and other symptoms in patients with advanced stomach cancer that cannot be surgically removed.

Side Effects Associated with Each Modality

Surgery

Surgery for stomach cancer may lead to both immediate and long-term side effects. Short-term side effects can include pain, bleeding, and risk of infection at the site of the operation. Long-term consequences might involve digestive issues due to the reduction in stomach size or changes in the way the stomach and intestines work together, potentially leading to conditions such as dumping syndrome or nutritional deficiencies.

Chemotherapy 

The side effects of chemotherapy are varied and can affect individuals differently. Common side effects include fatigue, nausea and vomiting, hair loss, anemia, and increased susceptibility to infections due to lowered white blood cell counts. Long-term effects may also involve possible damage to the heart and kidneys, as well as nerve and muscle effects that can sometimes be permanent.

Radiation Therapy

Radiation therapy, too, comes with a set of potential side effects primarily focused on the areas being treated. Patients may experience skin changes resembling sunburn, fatigue, loss of appetite, and gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Long-term effects can include changes in bowel habits and structure and a potential increased risk of developing another cancer due to radiation exposure.

Adherence to treatment plans is critical in managing stomach cancer effectively. A patient’s commitment to following the prescribed modalities, whether surgery, chemotherapy, or radiation, can significantly impact the outcome and prognosis.

Ensuring that the treatment regimen is followed meticulously can help to maximize the benefits of therapy, minimize the risk of cancer progression, and improve overall survival rates. It also helps the onco team to monitor the patient’s response to treatment and make timely adjustments as needed.

Consequently, patients should report any issues that may arise due to side effects or other concerns.

Gastrointestinal Side Effects

Managing gastrointestinal side effects is crucial for patients undergoing stomach cancer treatment. Here’s how some common issues can be addressed:

Nausea and Vomiting

Medications and Lifestyle Modifications

Patients might be prescribed antiemetic drugs to help control nausea and vomiting. It is also helpful to make small lifestyle adjustments, such as eating small, frequent meals and avoiding foods with strong odors that might trigger these symptoms.

Dietary Recommendations

Dieticians often recommend a bland diet, including foods like bananas, rice, applesauce, and toast, known as the BRAT diet, to help manage nausea.

Diarrhea and Constipation

Nutritional Guidance

For issues like diarrhea and constipation, a balanced intake of fiber is vital. Soluble fiber from sources such as oats may help to regulate bowel movement, while staying hydrated is essential.

Medication Management

Over-the-counter or prescription medications can also be used under the guidance of a pain specialist to help control these symptoms.

Hematologic Side Effects

Hematologic side effects are common in patients receiving treatment for stomach cancer and can significantly affect their quality of life. Managing these conditions is a key aspect of the overall cancer care regimen.

Anemia

• Iron and Vitamin Supplementation

    Anemia often results from deficiencies in iron or certain vitamins. Supplements may be prescribed to address these deficiencies and boost red blood cell production.

• Blood Transfusions

    For more severe cases of anemia, blood transfusions may be administered to increase the number of red blood cells and improve oxygen delivery to tissues.

Neutropenia

• Infection Prevention Strategies

 Neutropenia, a reduction in the number of white blood cells, places patients at a higher risk of infections. It is important to employ strategies such as maintaining good personal hygiene and avoiding large crowds or ill contacts.

• Growth Factor Support

 To help stimulate the production of white blood cells, your doctor may recommend treatments with growth factors, a form of biologic medication.

Fatigue

Fatigue is one of the most frequently reported side effects by patients undergoing treatment for stomach cancer, impacting a significant aspect of their daily lives.

  1. Exercise and Physical Activity

Engaging in light to moderate exercise can be beneficial in reducing cancer-related fatigue. Activities such as walking, yoga, or tai chi may improve overall energy levels and enhance physical functioning.

  2. Sleep Hygiene

Promoting good sleep hygiene is critical for patients to manage fatigue. This includes establishing a regular sleep routine, creating a comfortable sleep environment, and limiting exposure to screens before bedtime

Pain associated with stomach cancer can significantly affect a patient’s quality of life. To manage this symptom, a multidisciplinary approach is often recommended. This may include:

• Pharmacological Interventions

 Medications such as analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) may be utilized to alleviate pain. For more severe discomfort, stronger prescription medications like opioids could be necessary.

• Non-Pharmacological Therapies

 Techniques such as acupuncture, massage, or the use of heat and cold may also provide relief. Guided imagery and relaxation exercises can further assist in pain reduction.

• Palliative Care Consultations

 A consultation with a palliative care specialist can be vital in devising a comprehensive pain management plan that addresses both the physical and emotional aspects of pain.

Regular monitoring of treatment response is essential in managing stomach cancer. This often involves a combination of imaging tests, such as CT scans or endoscopies, and laboratory tests to assess tumor markers.

It’s crucial for patients to maintain consistent follow-up appointments to evaluate the effectiveness of treatments and make timely adjustments if necessary.

Addressing Long-Term Side Effects

Long-term side effects from stomach cancer and its treatments can significantly impact a patient’s life. Issues such as nutritional deficiencies, weight loss, and gastrointestinal disturbances require ongoing management.

Dieticians and gastroenterologists often play key roles in helping patients to navigate these challenges and maintain an adequate quality of life.

Early Detection of Recurrence

The early detection of stomach cancer recurrence is paramount for improving patient outcomes. Regular follow-ups, symptom monitoring, and the understanding of personal risk factors are vital components in the early identification of cancer recurrence.

Patients should be educated on the signs to watch for and the importance of immediate reporting to their doctor should these arise.

In the fight against stomach cancer, every step, from initial treatment to long-term care, is integral to enhancing patient wellbeing. It is a collective responsibility where patients, oncologists, and caregivers must remain vigilant and proactive.

Let’s work together to ensure that every individual facing this battle is supported, informed, and empowered to take charge of their health journey.