Care pathway for gastric cancer

Gastric cancer may be asymptomatic for a long time and can only be detected when the tumor has spread or metastasized. Typical first symptoms of gastric cancer are upper abdominal pain, nausea, and fatigue.

If the cancer has spread further, it also causes weight loss and anemia, i.e. a decrease in the blood hemoglobin values. Symptoms may also include difficulty swallowing and blood in the vomit. 

If gastric cancer is suspected, you will have an oral endoscopic examination, i.e. gastroscopy. During gastroscopy, your throat will be anesthetized and, if necessary, you can receive a premedication so that the examination does not feel uncomfortable.

If changes are detected during the gastroscopy, a tissue specimen is taken from the gastric mucosa, from which the pathologist can confirm your diagnosis. 

If the examination result or finding is abnormal, the physician will refer you to HUS. 

When your referral arrives at HUS, a specialist will review your situation, plan the necessary additional examinations, and give a treatment recommendation. After this, you will receive an invitation to HUS Oncology Outpatient Clinic. 

We investigate the extent of the stomach cancer with a computed tomography scan of the body and sometimes also with a PET scan. 

Sometimes a resample is also needed, which we can take during a new gastroscopy. If necessary, we will take a needle sample of a suspicious change through the abdominal wall during a CT scan or ultrasound examination.  

At the appointment, we will review your examination results, overall situation, and treatment plan. At the nurse’s appointment, you will receive information about the practical implementation of your treatment, its adverse effects, as well as possible supportive therapies appropriate for your case. 

We aim to treat cancer that is limited to the stomach curatively. Typically, we try to reduce the size of the tumor with chemotherapy already before the surgery. You may also receive chemotherapy as complementary therapy after surgery.

After treatments aimed at curing the cancer, we monitor your condition with regular gastroscopies, CT scans, laboratory tests, and clinical examinations.  

Good palliative care and psychosocial support are an integral part of cancer treatment. The Palliative Care Center provides help in the stressful life situation caused by the cancer treatments. We help treat difficult symptoms and offer conversational support. 

A decision on palliative, i.e. symptomatic, treatment is made when the focus of your treatment shifts from slowing down the progression of cancer to managing the symptoms. In this case, treatment aims to alleviate symptoms and, as far as possible, to ensure a good and active life with the illness until death. Typically, at this stage, your care responsibility is transferred to the palliative care unit or to the palliative outpatient clinic or a hospital-at-home unit in your area.

Your follow-up at HUS usually ends after five years if your cancer has not recurred.