What information is correct about stomach cancer?
A. Stomach pain is often a late symptom.
B. Surgery is often a successful treatment.
C. Chemotherapy and radiation are often successful treatments.
D. The patient can survive for an extended time with TPN.
Correct Answer: A. Stomach pain is often a late symptom.
Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor when cancer reaches that point. In the United States, most patients have symptoms of an advanced stage at the time of presentation. The most common presenting symptoms for gastric cancers are non-specific weight loss, persistent abdominal pain, dysphagia, hematemesis, anorexia, nausea, early satiety, and dyspepsia.
Option B: Surgery has minimal positive effects. Patients with localized, resectable gastric cancer have the best chance of long-term survival with surgery alone. The main goal of surgery is complete resection with adequate margins (more than 4 cm), and only 50% of patients will obtain R0.
Option C: Chemotherapy and radiation have minimal positive effects. Neoadjuvant chemotherapy has been shown to downstage primary tumors and regional lymph nodes to attempt higher long-term curative resections. Neoadjuvant therapy should be offered to patients at high risk of developing distant metastases (bulky T3/T4, perigastric nodes, linitis plastica, or positive peritoneal cytology), sparing unnecessary surgery in case an emerging metastasis appears.
Option D: TPN may enhance the growth of cancer. Total parenteral nutrition is known to be effective in cases of malnutrition in patients who do not have cancer. However, TPN has not been shown to positively affect the nutritional status in patients with cancer. This is due in part to the metabolic changes associated with cancer.
No comments:
Post a Comment