Gastric or stomach cancer is one of the most deadly cancers in the United States because it develops aggressively before symptoms begin to present themselves. In fact, although it is only the 15th most commonly diagnosed cancer, it is the third most common cause of cancer-related death in the world. While gastric cancers are slow growing and precancerous changes might be observed in the stomach's mucous lining, there is no safe and effective screening process for the disease that is not invasive, such as an endoscopy. Only 1 in 5 cases of stomach cancer is found before it has spread to other parts of the body.
Gastric cancer can develop anywhere in the stomach, from its upper junction with the esophagus to the lower junction with the duodenum. 90 to 95% of stomach cancers are called adenocarcinomas, meaning that the growth develops in the rapidly dividing cells that compose the mucous lining of the stomach. Stomach cancers can invade through the walls of the stomach into other organs or metastasize and spread through blood vessels into the lymph nodes, liver, lungs, and bones.
While symptoms of gastric cancer do not usually show up during early stages of the disease when they do come they can be severe. Patients may experience
- Heartburn, indigestion, nausea, or vomiting
- Weight loss or a sense of abnormal fullness after eating small meals
- Abdominal pain, swelling, discomfort, or buildup of fluid in the stomach
- Anemia, leading to weakness and pallor of the skin
More severe symptoms including fluid buildup around the lungs, complete gastric obstruction, internal bleeding, and jaundice, all of which will present as acute pain.
In order to diagnose gastric cancer, physicians have multiple tests. If a primary physician believes a patient may have gastric cancer, they will generally refer them to a gastroenterologist for further testing. This doctor will usually perform an endoscopy in which a thin flexible tube with a light on the end of it is inserted into the patient's throat. They can then visually search for abnormalities such as tumors or growths. They might also perform a CT, an x-ray, an MRI, or an ultrasound to get a clearer picture of the tumor before surgery and determine how far it may have spread. A biopsy will then be taken of the abnormality either through the endoscopy or with a small hollow needle inserted through the stomach's wall so that the tumor can be tested for certain proteins which will help determine which chemotherapy drugs will be most effective.
If a patient is lucky enough to be diagnosed in an early stage of stomach cancer (0, I, or II), surgery will likely be the only chance for recovery and survival. In early gastric cancer, the surgery can sometimes be performed through the less invasive procedure of endoscopic resection, in which surgical tools are passed through a thin tube down the esophagus. In more extensive surgeries with cancer that has spread significantly, part or all of the stomach and possibly the surrounding lymph nodes are removed from the body. Doctors may prescribe chemotherapy either before or after the surgery to shrink the tumor or target the remaining cancerous cells in the body.
Unfortunately, most often, treatment for gastric cancer is not intended to cure a patient, but to extend their lives and relieve their discomfort in their final months. Palliative surgery, or surgery which is only intended to reduce pain but not rid the patient of cancer, can be performed on stage III and stage IV stomach cancer patients. In addition, some forms of chemotherapy are administered in late stage stomach cancer to extend the patient's life.
Taxotere as a Treatment Option for Gastric Cancer
For gastric cancer that cannot be removed surgically or that recurs after surgery, multiple chemotherapy options are available, some of which include Taxotere. In 2008, Taxotere was approved as a first-line chemotherapy treatment, meaning that it could be used if the patient had not undergone other chemotherapy treatments prior. In its first use, it was added to the pre-existing standard treatment of cisplatin and fluorouracil for a three-part treatment. In clinical trials, the addition of Taxotere added, on average, two months to the length of time a patient had before the disease progressed.
A study in 2013 suggested that docetaxel (Taxotere) should be used as a second-line chemotherapy treatment for late stage stomach cancer as well. This means that it might be used after a different regimen of chemotherapy was completed to extend a patient's life. In clinical trials, Taxotere as a second line treatment extended patient's survival from 3.6 months to 5.2 months with no significant difference in the quality of life.