How long do people live with a diagnosis of abdominal cancer?

February 11, 2020

Stage 4 liver cancer means both the presence of distant metastases and a large tumor without metastases. Both options are within the same stage, but approaches to treatment, and, accordingly, prospects for future life differ significantly. In both groups, the prognosis is spoiled by the initial chronic liver pathology, which contributed to the development of the carcinoma itself and interfered with its adequate treatment: cirrhosis and hepatitis of various etiologies.

Our expert in this field:

Ryabov Konstantin Yurievich

Oncologist-surgeon, endoscopist, head of the department of surgery

Call the doctor

Instrumental diagnostics:

• endoscopic examination - FGDS (allows you to assess the location of the tumor, the degree of stenosis (narrowing) of the stomach, take material for histological examination - biopsy);
• radiography;
• magnetic resonance imaging, which records the spread of the tumor to neighboring organs, the localization (location) of distant metastases;
• diagnostic laparoscopy - an operation that reveals the dissemination of cancerous foci throughout the peritoneum;
• histological examination of the structure of a biopsy (tissue taken from an area affected by cancer) for the presence of atypical malignant cells.

Symptoms

The last stage of stomach cancer is characterized by the following clinical signs:

1. All general symptoms characteristic of the previous stage intensify. In this case, the following are observed:

• worsening belching, heartburn, heaviness;
• intensive weight loss and development of exhaustion;
• feverish state, severe weakness;
• the appearance of pain of a high degree of intensity in the stomach, lower abdomen, with irradiation to the sacrum, lower back, perineum, which is associated with damage to nerve fibers and the inflammatory process in neighboring organs.

2. In addition, the following appear:

• frequent attacks of vomiting, mixed with blood, feces of a dark color, tarry consistency (during the disintegration of a tumor, gastric bleeding);
• constant vomiting, characteristic of gastric obstruction;
• poisoning of the body with cancer toxins;
• abdominal enlargement - with a stage 4 malignant stomach tumor is associated with metastases to the pancreas, liver, peritoneum (the membrane covering the internal organs of the abdominal cavity) and the accumulation of ascites (fluid) in the abdominal cavity; yellowing of the skin and sclera of the eyes with metastases to the liver;
• You can often palpate (feel) enlarged lymph nodes in the left supraclavicular region, left axillary region.

Causes

The sources of abdominal cancer formation have not yet been fully investigated. Possible reasons:

1. cancer .
2. Cancers of the abdominal . This primary source is directly determined by the presence of stress, hormonal imbalance, sudden climate change and solarium abuse.
3. Severe degree of glandular dysplasia. Belongs to the group of precancerous conditions. If cancer is suspected, the patient should be kept under the strict supervision of an oncologist.
4. Genetic predisposition.

Abdominal carcinoma often develops in people of retirement age. Women get sick more often than men.

Treatment

Treatment of stage 4 gastric cancer is carried out within the framework of palliative and symptomatic treatment, which does not cure the pathology itself, but stops the aggression of the disease, maximizing the patient’s condition.

Surgical

At stage 4 of stomach cancer, the main task of surgeons is to carry out interventions that alleviate the patient’s condition and, if it is in their power, to prolong his life. Tasks that are solved through operations:

1. Restoring the passage of food if the lumen of the stomach is blocked by an overgrown tumor. With such obstruction, the patient is not even able to drink water. To achieve this goal, a bypass digestive “tract” is formed to move food (an anastomosis is formed between the stomach and the small intestine - gastroenteroanastomosis), which passes by the tumor, which is often performed in case of cancer of the outlet of the stomach.
2. Formation of a gastrostomy when it is impossible to evacuate food from the esophagus to the stomach (in case of incurable cancer of the cardiac region) - a surgically created opening between the stomach and the external environment for artificial feeding through a tube. Or installing a stent to expand the narrowed cavity.
3. Palliative resection or removal of an organ for stomach cancer, which is performed in the event of life-threatening complications (tumor decay with gastric bleeding).

Considering the condition of patients at stage 4 of gastric cancer, operations are prescribed only if there are no symptoms of severe exhaustion (cachexia) and the oncological process has not invaded the peritoneal tissue.

Chemotherapy

Chemotherapy can stabilize the condition of 50% of patients. In combination with radiation therapy, a more pronounced result is obtained. But combined chemoradiotherapy is only possible if the patient is not malnourished or it will lead to life-threatening multiple organ failure (decrease in organ function).

As a rule, various combinations of antitumor drugs based on 5-fluorouracil, Xeloda, oxaliplatin, leucovorin (FOLFOX, XELOX, CF, CX) are used.

If an immunohistochemical study of gastric tumor tissue determines the presence of HER2 receptors, trastuzumab is used.

The selection of a treatment regimen is individual and is carried out by a chemotherapist.

Chemoembolization is a method aimed at “bleeding” a tumor with the simultaneous administration of an anticancer agent, which is concentrated directly in its tissue and has a focal local effect. Often used for metastatic liver disease.

Stages of stomach cancer

Stomach cancer is the second most common. This is a dangerous and serious disease of the gastrointestinal tract. The danger of this pathology is that it does not manifest itself in any way for a long period. The outcome of the tumor process depends on the stage of the disease, location and selected treatment.

The following stages of progression of gastric cancer are distinguished:

• Stage 0. A mutation of normal cells into precancerous cells occurs. They are located in the epithelial cells of the stomach and do not enter the internal tissues. This condition does not cause symptoms.
• Stage 1. There are subgroups A and B. Belonging to one type or another depends on the location of the neoplasm. Stage 1A is an indication that the tumor has affected only the mucosal tissue, and 1B indicates the penetration of malignant cells into the lymph nodes. Other tissues may be affected at this stage.

• Stage 2. The neoplasm cells penetrate all tissues of the stomach, but do not affect the lymphatic formations.

• Stage 3. The tumor penetrates all structures of the stomach, affecting neighboring tissues. New malignant foci are formed.

• Stage 4 is divided into 3 substages. The first is characterized by the spread of the process throughout the visceral zone of the peritoneum and damage to any number of lymph structures. The second is a neoplasm of any diameter that has not affected other organs, but the lymph nodes are already affected. And the last is the most severe type of cancer, when metastases affect all systems of the body and secondary foci of tumor growth begin to form.

This is interesting: Primary liver cancer: symptoms, signs, treatment, causes and life prognosis

Symptomatic therapy

Medicines used in the context of symptomatic treatment are prescribed to prevent and alleviate the symptoms of cancer and the complications caused by it. In addition, eliminating painful manifestations for the patient significantly increases the quality of life.

Anesthesia

For stage 4 oncology, pain relief is the basic part of therapy, since the intensity of the pain syndrome at this stage is most pronounced.

Basic principles:

• Analgesics should be used immediately, without waiting for pain to worsen;
• selection of the best drug or combination of several is carried out taking into account the characteristics of the cancer process and the patient’s condition;
• drugs are prescribed according to the degree of enhancement of the analgesic effect - from the maximum dose of a moderate analgesic to the minimum dose of a stronger one.

As a rule, non-steroidal anti-inflammatory drugs are prescribed for moderate pain; For severe pain, narcotic analgesics are prescribed.

Among the special methods of pain relief, when possible, the following are used:

• Spinal and epidural anesthesia, especially when metastatic lesions appear in the bones.
• Neurolysis. It consists of chemical destruction of the sensory nerve “responsible” for pain.

Preventing nausea and vomiting

The following groups of drugs are used:

• serotonergic (ondansetron, metoclopramide)
• dopaminergic (metoclopramide)
• antihistamines (cyclizine, promethazine)
• anticholinergic drugs

If treatment with one drug is ineffective, individual combinations are selected.

Nutritional support

Considering the extreme degree of exhaustion of patients with stage 4 gastric cancer, distinguishable high-calorie enteral (by mouth) and parenteral (intravenous) nutritional mixtures are used. In some cases, they can maintain a stable condition of the patient for a long time even in the complete absence of the possibility of regular nutrition.

Prevention of infectious complications

The patient’s body at this stage is in a critically exhausted state, the immune system is extremely weakened. Therefore, in order to prevent or treat infectious complications, antibacterial drugs are prescribed. The selection of antibiotics is carried out by the doctor, taking into account the localization of the infectious process, the type of infectious agent, and the excretory function of the patient’s liver and kidneys.

Treatment of ascites

With metastatic damage to the liver and peritoneum, patients often experience fluid accumulation in the abdominal cavity. To treat this complication, drug therapy with diuretics is used and laparocentesis (puncture of the anterior abdominal wall) is performed to remove fluid.

Treatment of jaundice

Jaundice is formed when there is massive damage to the liver by metastases, which, in turn, leads to impaired bile secretion. A patient with this condition notes icterus (yellowing) of the skin and sclera; urine becomes intensely colored and feces colorless; intense skin itching appears. This condition is life-threatening and, without correction, quickly leads to death. Conservative treatment consists of prescribing infusion therapy in combination with diuretics; antihistamines, antibiotics, hepatoprotectors (drugs that protect liver tissue). Surgical treatment is most often carried out using x-rays - surgeons puncture the skin and insert a drainage (tube) into the bile ducts of the liver so that the bile flows out.

Diet

This is part of the treatment and prevention of the development of the disease. It’s worth talking about it separately. It helps adherence to the regimen, and with the right diet, the patient lives longer and feels better. The diet performs the following functions:

• Getting vital substances into the patient’s body is not easy if part of the gastrointestinal tract is missing and the functioning of the remaining organs is impaired.
• Increasing immunity is a key role in the fight against disease of the immune system, supported by available methods, such as food.
• Stabilization of the blood composition for a stable patient, in order to supply the brain with the necessary substances.

To achieve your goals, the menu includes:

• Fermented milk products with low fat content.
• Broths boiled with lean meat.
• Vegetables, pureed for ease of chewing and digestion.
• Lean meats and poultry.
• Purees and soups.
• Natural sources of vitamins: berries, fruits and freshly squeezed juices from them.

The patient is strictly prohibited from:

Remember, in case of severe cancer, it is extremely important to follow the recommendations of doctors. The measures are aimed at improving the patient’s condition; the disease cannot be cured, but the patient can live longer and better.

Forecast

Increasing the duration and improving the quality of life of patients diagnosed with stage 4 gastric cancer is the main and priority area of ​​work for doctors. The determining role in this difficult process is given to the patient’s immediate environment: relatives, friends.

The life expectancy of a patient after surgery or in the case of an unresectable tumor is influenced by a whole range of factors, including:

• type of stomach cancer: exophytic form, in which the cancerous node is limited in area of ​​spread, favorable for long-term prognosis, infiltrative type of tumor is more aggressive and gives a lower percentage of survival; patient's age and immune system resistance;
• degree of exhaustion of the body, psychological state;
• correct diagnosis and well-developed treatment program;
• The prevalence of metastatic foci is one of the leading factors influencing life expectancy. The smaller the volume of tissues and organs in which metastases have formed, the longer the patient will live.

Today, with proper treatment, the availability of the necessary medications, and compliance with doctor’s recommendations, up to 10% of patients continue to live for 5 years after diagnosis of stage 4 cancer.

In conclusion, it must be said that the most important factor that gives a sick person hope and strength is his loved ones. A patient with a terminal stage should not be alone and feel abandoned. Every day should be filled with the participation and caring attitude of loved ones. Only in this case will he know what he fights and lives for.

How to stop vomiting

First aid depends on the patient's condition. If the attacks are prolonged, incessant, and the masses are black in color, then you should immediately contact an ambulance. First aid before the arrival of specialists is as follows:

• the patient is placed in bed with his head slightly raised;
• during an attack, you need to turn the patient on his side and tilt his head so that the masses do not enter the respiratory tract;
• It is recommended to apply cold to the stomach area, this will reduce discomfort and help reduce the intensity of bleeding, if any;
• To restore water balance, it is necessary to give the patient solutions prepared from pharmaceutical drugs against dehydration to drink.

Advice! The most famous drug for restoring water-salt balance is Regidron powder. It is diluted with water and taken orally.

Medicines

As already mentioned, during attacks in the first hour it is important to drink solutions for dehydration. In addition, a specialist may prescribe special medications. They are prescribed individually, depending on the indications. It could be:

• Scopolamine is a remedy for relieving spasms and reducing secretion;
• Blockers of 5 HE3 receptors - used to relieve nausea that occurs during chemotherapy;
• Methylprednisolone is prescribed if the reflex occurs with an increased level of excitability of the cerebral cortex.

Traditional methods

You can fight attacks with the help of folk remedies. Recommended use:

• Ginger tea. Pieces of fresh root are added to green or black tea when brewing.
• Chamomile tea – helps relieve tension and relaxes.
• Peppermint tea is good for relieving nausea. You can take mint not only in the form of tea, but also in tablets.