Managing Pain and Improving Quality of Life for Patients with Advanced Gastric Cancer

When dealing with advanced gastric cancer, the primary goal is to improve the patient's quality of life by managing symptoms and reducing discomfort. There are three key areas to focus on when addressing the needs of patients in the later stages of this disease.

Effective Pain Management Using the Three-Step Analgesic Ladder

Pain is a common issue for patients with advanced stomach cancer. To manage this, doctors typically follow the World Health Organization's three-step analgesic ladder. This approach starts with mild pain relievers such as paracetamol, progresses to mild opioids like codeine for moderate pain, and finally uses stronger opioids such as morphine for severe pain. Oral medications are often preferred and should be taken regularly, ideally before the onset of pain, to maintain comfort and reduce suffering.

Timely Treatment of Complications Such as Obstruction, Bleeding, and Perforation

Advanced gastric tumors can lead to serious complications, including gastrointestinal obstruction, internal bleeding, and perforation. For patients experiencing blockage in the upper stomach (pyloric obstruction) or lower esophagus (gastric cardia obstruction), the placement of a stent or feeding tube can help maintain nutrition and reduce discomfort. In cases of bleeding, medications can be used to control blood loss, while more severe cases may require interventional radiology or emergency surgery. If the stomach lining ruptures, it can cause peritonitis, a life-threatening condition that must be treated immediately through surgical intervention.

Providing Adequate Nutritional Support to Combat Cachexia

Many patients with advanced gastric cancer suffer from a condition known as cachexia, characterized by severe weight loss and muscle wasting. Nutritional support is essential in these cases. For those unable to eat normally, parenteral nutrition (intravenous feeding) can be used to supply essential nutrients. If a blockage is present, stent placement may help restore the ability to eat. In some cases, procedures like gastrostomy or enterostomy can provide alternative routes for enteral feeding, often combined with intravenous nutrition to ensure the patient receives sufficient calories and proteins.

By focusing on pain relief, managing complications, and providing proper nutrition, healthcare providers can significantly reduce the suffering of patients with advanced gastric cancer and help maintain their dignity and comfort during this difficult time.