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Stomach Cancer: Effects and Management
The location of the stomach cancer and the extent of its spread determine how it is treated. Stomach cancer is also referred to as gastric cancer. However, other elements including a person's age, general health, and preferences might also be crucial. If possible, surgery to remove the cancer is usually included in treatment since it provides the highest chance for long-term survival. However, if the cancer has progressed far or if a person is not in good enough health for it, surgery might not be a good option. In addition to or instead of surgery, other therapies like chemotherapy and radiation therapy are frequently used in medical care. In some circumstances, newer therapies including immunotherapy and medicines with specific targets may be beneficial.
About the Speaker
Dr Srinath Bharadwaj
Medical oncologist at Apollo Cancer centre
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Biosimilars and Cancer Supportive Care
Biosimilars are biological products that are highly similar to and have no clinically meaningful differences from an existing approved reference biologic drug. In cancer supportive care, biosimilars have become increasingly important for managing various aspects of cancer treatment, including supportive therapies. One significant application of biosimilars in cancer supportive care is in the management of chemotherapy-induced neutropenia. Neutropenia, characterized by low levels of neutrophils (a type of white blood cell), is a common side effect of chemotherapy that can increase the risk of infections. Biosimilar versions of granulocyte colony-stimulating factors (G-CSFs), such as filgrastim and pegfilgrastim, are used to stimulate the production of neutrophils and reduce the duration and severity of neutropenia.
Medical management of GI Neuroendocrine tumor
The medical management of gastrointestinal neuroendocrine tumors (NETs) involves a tailored approach based on the tumor's grade, stage, and specific hormonal secretion patterns. Somatostatin analogs, such as octreotide and lanreotide, are commonly used to control symptoms related to hormone hypersecretion and to stabilize tumor growth. For well-differentiated NETs with advanced disease, targeted therapies like everolimus and sunitinib may be considered to inhibit mTOR and tyrosine kinase pathways, respectively. Peptide receptor radionuclide therapy (PRRT) with agents like lutetium-177 DOTATATE has shown efficacy in certain cases. Systemic chemotherapy, often with streptozocin-based regimens, may be employed for poorly differentiated or aggressive tumors. Close monitoring through imaging studies, biomarker assessments, and multidisciplinary collaboration between oncologists, endocrinologists, and surgeons is essential for an integrated and individualized approach to the medical management of GI neuroendocrine tumors. Additionally, patient education and support are crucial components to address the chronic nature of this condition and optimize the patient's overall well-being.
Management of Malignant Biliary Strictures
The management of malignant biliary strictures involves a multidisciplinary approach aimed at relieving obstruction, improving quality of life, and potentially extending survival. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is a common intervention to alleviate biliary obstruction. Metal stents are preferred over plastic stents for their durability and longer patency. In cases where ERCP is not feasible, percutaneous transhepatic biliary drainage may be employed. Systemic chemotherapy or radiation therapy may be considered as part of a comprehensive treatment plan, particularly in cases where the malignancy is unresectable. Surgical resection remains the curative option when feasible. Palliative care plays a crucial role in managing symptoms and enhancing the overall quality of life for patients with advanced disease. Close collaboration among gastroenterologists, oncologists, interventional radiologists, and surgeons is essential for the optimal management of malignant biliary strictures.