Surgery is the most common treatment of stomach cancer. In this type of surgery, called a gastrectomy, the stomach and possibly some of the surrounding tissue is partially or completely removed. The esophagus is then connected directly to the small intestine. Lymph nodes near the tumor are often removed and examined to determine if the cancer has spread.
A distal subtotal gastrectomy involves the removal of the lower portion of the stomach. A proximal subtotal gastrectomy involves the removal of the upper portion of the stomach. A total gastrectomy removes the entire stomach.
This surgery requires a long recovery period. For the first few days following the gastrectomy, patients are fed intravenously, and then graduate to liquids, then soft, then solid foods. Patients who receive complete gastrectomies cannot absorb vitamin B12, a vitamin necessary for the proper function of the blood and nerves, and must receive regular injections of the vitamin. Gastrectomy patients will have to follow a special diet for weeks, months and possibly for life.
Some patients also experience what is called the dumping syndrome. If too much food or food rich in sugars is eaten, patients are hit with cramps, nausea, dizziness and diarrhea. The dumping syndrome, which may be temporary or permanent, can be controlled by eating smaller, more frequent meals, avoiding sugar, eating foods high in protein and not drinking liquids at mealtime. Patients can also take medication to manage the syndrome.
Another side effect is the back up of bile from the small intestine into the remaining portion of the stomach or esophagus. Medication can control this symptom.
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