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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Black Stools, Blood In Vomiting, Low HB, Diagnosed With Stomach Cancer, Biopsy Showed Positive Lymph Nodes. Best Course Of Treatment?

Dear doctor, My father is 50 years old, he has been havin black stool for over a month and 3 weeks back he vomited blood , due to which the Hb went down to 6.5. After a CTScan and biposy he was diagnose with stomach cancer , at the stomach and food pipe junction. 2 weeks back he was operated upon, during which the entire stomach was removed. 5 cm extra radius was cut for biopsy , which suggested positive lymph nodes. Kindly help us with the best possible course of action that we could follow at this point if time. What are your views about Ion - beam therapy? What are the success rates? What other course of action do you suggest?
Tue, 24 Sep 2013
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Oncologist, Surgical,  's  Response
I am assuming that your father is in a good general condition and does not suffer from any comorbid conditions like diabetes, high blood pressure, heart disease, etc. Also, since you have not mentioned it, i assume that the cancer had not spread to any other body part and that the biopsy report shows adenocarcinoma ( a type of cancer). If the margins of resection in the biopsy report are free from tumor then i would suggest your father to undergo further treatment in the form of chemotherapy. Chemotherapy is a type of cancer treatment in which we give special injections into a vein. These injections then kill the remaining tumor cells in the body although they have a number of manageable side effects. Since your father has node positive disease, further chemotherapy is mandatory. However, if the biopsy report says that the margins of resection are involved by the tumor, then i would suggest a course of radiation therapy alongwith low dose chemotherapy (to increase the effect of radiation) followed by full dose chemotherapy. All this treatment should preferably be undergone at a dedicated cancer care unit.
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Black Stools, Blood In Vomiting, Low HB, Diagnosed With Stomach Cancer, Biopsy Showed Positive Lymph Nodes. Best Course Of Treatment?

I am assuming that your father is in a good general condition and does not suffer from any comorbid conditions like diabetes, high blood pressure, heart disease, etc. Also, since you have not mentioned it, i assume that the cancer had not spread to any other body part and that the biopsy report shows adenocarcinoma ( a type of cancer). If the margins of resection in the biopsy report are free from tumor then i would suggest your father to undergo further treatment in the form of chemotherapy. Chemotherapy is a type of cancer treatment in which we give special injections into a vein. These injections then kill the remaining tumor cells in the body although they have a number of manageable side effects. Since your father has node positive disease, further chemotherapy is mandatory. However, if the biopsy report says that the margins of resection are involved by the tumor, then i would suggest a course of radiation therapy alongwith low dose chemotherapy (to increase the effect of radiation) followed by full dose chemotherapy. All this treatment should preferably be undergone at a dedicated cancer care unit.