Mayo Clinic gastric surgeons are successfully performing minimally invasive and complex multivisceral surgeries for patients who traditionally have not been candidates for surgery. Patients with locally advanced or metastatic gastric tumors benefit from an aggressive treatment approach. At Mayo Clinic in Rochester, Minnesota, surgical oncologists Michael L. Kendrick, M.D. , Cornelius A. Thiels, D.O., M.B.A. , and Travis E. Grotz, M.D. , explain that accurate staging of gastric tumors is crucial to providing the right treatment. Because gastric cancer can be challenging to identify on CT and PET scans, upper endoscopy or staging laparoscopy is often necessary to achieve accurate staging.
Mayo Clinic's team of gastric specialists collaborates with patients and their providers to optimize quality of life and achieve the best possible health outcomes.
The treatment of gastric cancer has changed a lot in the last few decades. And an example of that is for those with very advanced disease. From a surgical point of view, we are even more aggressive and able to, to treat certain locally advanced tumors that we couldn't before. In addition to that, those patients with tumor that has spread into the abdominal cavity, we now have newer options that really provide hope and longevity of life and quality of life for those patients as well. Gastric cancer tends to actually be one of the more challenging cancers to identify on scans. It's sometimes difficult or even possible to see on AC T scan or even a pet scan sometimes and really it comes down to doing sometimes more mentally invasive treatments like an upper endoscopy and a staging laparoscopy where we can actually visually see the tumor. And sometimes we combine those with things like ultrasound or endoscopic ultrasound or really good, a good idea of the stage of the tumor. And that's really one of the most important things we think is getting an accurate stage of the tumor. So we know which treatments the patient needs from the get go Mayo clinic sees a fair amount of gastric cancer. And so with that volume, we are able to apply newer technologies in a very time efficient way and repetitively so that we can make very quick adjustments to improve the outcomes of those procedures. And then we have clinical trials looking at, you know, immunotherapy and systemic therapy and radiation. And so there's a whole gamut from basic understanding of just how the cancer works and why people are getting it to research, looking at the best treatment outcomes. One of the unique things we offer here is uh options for patients that have more locally advanced or metastatic gastric cancer. Those types of tumors have traditionally not been candidates for surgery. And we do know that surgery is the best means for obtaining a cure of gastric cancer in most cases. And so if we can expand the options for patients who are eligible for surgery, we think that we can help more patients. And so that type of surgery really depends on the patient's tumor. Sometimes patients who have a locally advanced tumor benefit from chemotherapy as well as even chemo radiation before surgery and some patients benefit from immunotherapy. And so those are all options that we explore other times, patients may need a more radical surgery and that can include removing other organs and we work with other specialists as need be. And we also often routinely do those operations here for both gastric cancer and other indications. So we're very comfortable doing those types of multi visceral resections or advanced resections. One of the things that, that we're offering here, that's unique compared to other places, includes intra gene therapy. We've developed a kind of a pathway here of treatment with systemic chemo and also chemotherapy that's given directly into the abdomen that we can get some patients to potentially cured of surgery. And so where some of these patients may not have had really any hope before. Now, we're offering patients hope that long term survival patients referred to the Mayo Clinic with gastric cancer are considered an individual patient and we look at them and the referring provider as an important part of our team. It's not uncommon for us to treat patients collaboratively with the referring provider such as they get their chemotherapy closer to home, but come to the Mayo Clinic for surgery. The majority of the operations here are done million invasively which then you know, it typically leads to quicker recovery patients return back home, less complications, um less delays to get into therapy. I think it's advantage for those patients to go somewhere that has a multidisciplinary team that specializes in gastric cancer can offer patients clinical trials when indicated and offer more radical or mental invasive therapies when possible stomach cancer is a very tough uh cancer. And so you really want to make sure you have the best team and the best plan going forward.
