Understanding Endoscopy for Stomach Cancer Treatment

Introduction and Terminology of the Procedure

An endoscopy is a procedure that allows doctors to examine the interior of a patient’s body using a flexible tube called an endoscope. In the context of stomach cancer, an upper gastrointestinal endoscopy, commonly referred to as an EGD (esophagogastroduodenoscopy), is often utilized. EGD allows the doctor to view the esophagus, stomach, and beginning of the small intestine. This procedure is instrumental in diagnosing, staging, and occasionally treating stomach cancer.

Every year, thousands of endoscopies are performed in the United States, providing vital information for the management of various gastrointestinal diseases, including stomach cancer.

Indications for Endoscopy

Endoscopy, particularly EGD, can be indicated for several reasons when it comes to stomach cancer:

• Diagnosis: If you’re experiencing symptoms suggestive of stomach cancer, such as persistent indigestion, stomach pain, nausea, vomiting, or unintentional weight loss, your doctor might recommend an EGD.
• Staging: If stomach cancer is diagnosed, an endoscopy can help determine the extent (stage) of cancer. This helps in formulating an effective treatment plan.
• Surveillance: If you’ve had a previous diagnosis of stomach cancer or are at a higher risk, your doctor might recommend regular endoscopies to monitor your condition.
• Treatment: Sometimes, endoscopy is used as a treatment tool. Special instruments can be passed through the endoscope to perform procedures, such as removing polyps or early-stage tumors, taking biopsies, or providing palliative care to ease symptoms in advanced cancers.

Remember, the decision to proceed with an endoscopy is a mutual one between you and your doctor, taking into account your specific circumstances, symptoms, and overall health.

Pre-Op Preparation

Proper preparation is crucial to ensure a successful endoscopy procedure. Your preparation may include the following:

• Fasting: You will likely need to fast (no food or drink) for several hours before the procedure.
• Adjustments to medications: You may need to adjust the dosages or timings of certain medications. Importantly, discuss with your doctor about any blood-thinning medications you take.
• Pre-op labs or imaging: Depending on your medical history, your doctor might request certain laboratory tests or imaging studies before the procedure.
• Pre-clearance authorization: Ensure that the procedure has been authorized by your health insurance provider to avoid unnecessary costs.
• Considering transportation: Since you’ll be sedated, plan for a ride home after the procedure.
• Work or school notes: You might need to take the day off for your procedure. We can provide necessary documentation for your workplace or school.

Note: Please consult your doctor for exact pre-operative instructions tailored to your unique situation. As your primary care provider, we’re here to help with pre-operative clearances and ordering of pre-op labs and imaging through our telemedicine service.

Procedure Technique for Endoscopy

Undergoing an endoscopy, particularly an EGD (esophagogastroduodenoscopy), can feel intimidating. Let’s demystify the process by going through it step by step:

Step 1: Arrival and Check-in

Upon arrival at the facility, you’ll check in at the reception. The staff will confirm your details, including your health history and the medications you’re currently taking.

Step 2: Pre-Procedure Preparations

You will be taken to the pre-procedure area where a nurse will help you prepare. You will be asked to change into a hospital gown and your vital signs will be checked. A small needle, or IV, will be placed in your vein to deliver medications during the procedure.

Step 3: Sedation

A sedative will be administered through the IV to help you relax and often make you drowsy. You might not remember the procedure afterwards due to the amnesic effect of the sedative. An anesthesiologist or nurse anesthetist will be present to ensure you are comfortable and safe during the procedure.

Step 4: Starting the Endoscopy

Once you are sedated, the procedure can begin. You’ll be asked to lie on your left side. A mouth guard will be placed to protect your teeth and the endoscope.

Step 5: Insertion of the Endoscope

Your doctor will gently feed the endoscope – a thin, flexible tube equipped with a light and camera – through your mouth and down your esophagus.

Step 6: Examination

The doctor will carefully guide the endoscope further down into your stomach and possibly the first part of your small intestine. The camera transmits images to a screen, allowing your doctor to observe any abnormalities. The endoscope also blows air into your stomach to expand it for a better view.

Step 7: Biopsy or Treatment

If an abnormal area is found, your doctor can pass special tools through the endoscope to take a biopsy (tissue sample) for later analysis. If there is a treatable issue such as a polyp or early-stage tumor, the doctor may remove it using tools passed through the endoscope.

Step 8: End of the Procedure

Once the examination is complete, the doctor will carefully withdraw the endoscope. The procedure usually lasts 15 to 30 minutes, depending on the findings and whether any biopsies or treatments are performed.

Remember, while this is a general step-by-step guide to the endoscopy procedure, every individual’s experience might be slightly different based on their specific medical circumstances.

Duration of Endoscopy

The endoscopy procedure typically lasts between 15 to 30 minutes. The duration can vary based on individual circumstances, such as the need for a biopsy or treatment during the procedure.

Post-Op Recovery from Endoscopy

After the endoscopy, you’ll be moved to a recovery area where nurses monitor you as the sedation wears off. This usually takes about an hour. It’s advisable to have a companion to take you home, as you’ll likely be drowsy. Rest for the remainder of the day and avoid heavy meals and alcohol.

Follow-up appointments with your doctor may be scheduled within one to two weeks after the procedure. This is especially important if biopsies were taken or treatments were carried out.

Most people can return to work the day after the procedure, unless otherwise instructed by their doctor. There are typically no specific rehabilitative needs after an endoscopy. However, any lifestyle changes, such as dietary modifications, will be discussed with you based on the findings of the procedure. As for full recovery, barring any complications, patients generally feel back to normal within a day or two.

Remember, our practice is available for same-day appointments until 9pm on weekdays and 5pm on weekends, should you need any work or school notes.

Effectiveness of Endoscopy

The effectiveness of an endoscopy in treating stomach cancer largely depends on the stage and location of the cancer. For early-stage cancers and pre-cancerous lesions, endoscopic resections can be highly effective, removing the affected tissues entirely.

According to a study published in the Gastroenterology Journal, endoscopic resection for early gastric cancer has a success rate of approximately 85%. However, these favorable outcomes mostly apply to cancers that have not spread beyond the stomach’s lining.

Several factors can influence the effectiveness of endoscopic treatment. The size, location, and type of cancer, as well as the patient’s overall health, are significant considerations. For instance, cancers located in the lower part of the stomach are generally easier to treat endoscopically than those in the upper part.

Conversely, situations that can lower the effectiveness of the procedure include advanced cancers, where the disease has spread to deeper layers of the stomach or other organs. Here, endoscopy serves more as a diagnostic and palliative measure, rather than a curative one. In such cases, additional treatments like chemotherapy, radiation, or surgery may be required.

Lastly, it’s crucial to remember that early detection greatly improves treatment success. Regular check-ups and timely reporting of symptoms can lead to early diagnosis and more effective interventions.

Adverse Events with Endoscopy

Endoscopy, like any medical procedure, carries potential risks. These adverse events are generally rare but can include:

• Bleeding (2.5%): This can occur when a biopsy is taken or a polyp is removed. Most of these cases are minor and self-limiting, but severe bleeding may need further medical intervention.
• Infection (<1%): Though infections are very rare after an endoscopy, they can happen. Your healthcare provider will take all necessary precautions to minimize this risk.
• Perforation (1%): A small hole, or perforation, might form in the wall of the stomach. This is a serious complication and usually requires surgery to repair.
• Adverse reactions to sedation (1-2%): Some people may have reactions to the sedative used, such as respiratory problems or an allergic reaction.

The mortality rate associated with endoscopy is extremely low, estimated at 0.007% or 7 deaths per 100,000 procedures.

Alternatives to Endoscopy

Endoscopy is one of the primary methods for diagnosing and treating stomach cancer, but other options exist. Depending on the stage and location of the cancer, alternatives may include surgery, radiation therapy, chemotherapy, or targeted drug therapy. In some cases, a combination of these treatments may be used. Lifestyle modifications, like a balanced diet and quitting smoking, can also contribute to overall health and recovery.

Experimental or Emerging Technologies

There are also some promising experimental technologies being studied for stomach cancer treatment. One such approach is immunotherapy, which uses the body’s immune system to fight cancer. Another is molecular targeted therapy, which uses drugs to target specific genes and proteins involved in the growth and survival of cancer cells. More research is needed to confirm the effectiveness and safety of these methods.

Conclusion

Endoscopy is a valuable tool in the diagnosis and treatment of stomach cancer. Although it comes with certain risks, they are relatively low and the procedure’s benefits often far outweigh them. Other treatment options, like surgery or chemotherapy, are available if required. Emerging technologies show promise, and ongoing research aims to further improve outcomes for those dealing with stomach cancer. As always, the best course of action depends on individual circumstances, and we recommend discussing these options with your healthcare provider.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.