Stomach cancer is among the top 10 most common cancers in Singapore. Based on the 2022 Singapore Cancer Registry, it accounts for about 3.2% of all new cancer cases diagnosed in the period 2018 to 2022. However, deaths are disproportionally higher at 5% of all cancer deaths. One reason for this may be that due to the silent nature of the disease and lower rate of screening, the cancer is often detected only in the later stages. Treatment for later stage cancer is more difficult and have poorer outcomes. There is now a novel approach to stomach cancer treatment that may offer better outcomes than traditional approaches.
This novel approach combines chemotherapy with minimally invasive surgery to deliver cancer drugs more directly into the peritoneal cavity (a membrane lining the abdominal cavity and covers the abdominal organs). This can be used when cancer has spread from the stomach into the peritoneal cavity.
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Current Approaches To Stomach Cancer Treatment
Endoscopy Or Surgical Treatment
For stomach cancer treatment that is still in the early stage and has not spread, there is good potential for curing it via endoscopy or surgery to remove it. Such surgical treatment is usually minimally invasive, using only “keyholes” to remove the cancer. Keyhole surgery helps to improve outcomes, minimise complications and allows for faster post-operation recovery.
Conventional Chemotherapy
In the case of stomach cancer that is late stage and has spread to the peritoneal cavity, treatment will require chemotherapy.
Chemotherapy is one of the key methods of treating cancer. Conventionally, it involves administering cancer drugs via drips or tablets to kill cancer cells. The drugs are absorbed into the bloodstream and is delivered to the whole body. As a result of the toxicity, patients undergoing conventional chemotherapy usually experience numerous side effects (e.g. nausea, low white blood cell count, etc).
An impediment to chemotherapy for stomach cancer treatment is that there is poorer blood supply to tumour cells on the peritoneum. This results in a reduced ability for conventionally administered cancer drugs to reach the cancer cells. The effectiveness of chemotherapy for such cases is hence diminished.
Learn More: Chemotherapy And Cost Of Cancer Treatment In Singapore >>
A Targeted Approach To Advanced Stomach Cancer Treatment
There is now a novel approach that can improve the efficacy of chemotherapy for stomach cancer. Called the Pressurised Intraperitoneal Aerosol Chemotherapy (PIPAC) method, it involves the delivery of aerosolized cancer drugs as a mist directly into the peritoneum cavity. This is done via a small hole made in the abdomen.
This method innovatively uses patient’s peritoneal cavity as an “aerosol chamber”. It enables the drug to be dispersed deeper into the cancer cells, and more evenly. The advantages:
- Increased efficacy of the drugs;
- Less cancer drugs are absorbed into the bloodstream;
- Fewer side effects;
- Allows more accurate assessments of the peritoneal cavity to see the response to treatment (compared to medical imaging such as CT scans).
The PIPAC treatment can also be used for other cancers in the abdomen, e.g. colorectal and ovarian cancers.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.