Living without a stomach is a complex reality faced by many who have been diagnosed with gastric cancer. The good news is that advancements in treatments have led to increased survival rates for these patients in Italy. Over 82,000 Italians are currently living after a gastric cancer diagnosis. However, the bad news is that the number of cases is on the rise once again, with approximately 14,000 new cases reported in 2022.
Living without a stomach presents numerous challenges, both physically and psychologically. Accepting the absence of such a vital organ and dealing with the various problems that arise can be difficult. Claudia Santangelo, president of the association Living Without a Stomach, understands these challenges firsthand. Having undergone stomach resection in 2008, she founded the association to provide support to others facing similar difficulties. Managing the fear of relapse and coming to terms with the changes in one’s body, such as malnutrition and weight loss, are common struggles for gastric cancer survivors.
Psychosocial assistance plays a crucial role in helping patients adjust to their new lives. This includes addressing psychological disorders and socio-relational difficulties that may arise. Specialized centers that offer a multidisciplinary approach to treatment are essential for ensuring the best possible outcomes for patients. By involving various doctors who can collectively choose the most suitable therapies for each individual case, the chances of survival and improved quality of life increase.
In a recent meeting organized by the association, the importance of psychological support in the treatment of gastric cancer was emphasized. It was suggested that psycho-oncologists should be included within the multidisciplinary units of treatment centers. Currently, only three Diagnostic Therapeutic Assistance Pathways (PDTAs) for stomach cancer are available in Italy. The inclusion of psycho-oncologists in the treatment process can help address the psychological and emotional needs of patients, making them feel supported and improving their overall well-being.
Unfortunately, gastric cancer is often diagnosed at an advanced stage, making radical surgery and hope for recovery possible for only 40% of patients. Late-stage symptoms include persistent digestive disorders, inappetence, difficulty swallowing, weight loss, feeling of fullness after meals, and other digestive issues. It is crucial for individuals at higher risk, such as those with atrophic gastritis or chronic Helicobacter pylori infection, to be aware of these symptoms and seek medical help promptly.
Living without a stomach requires continuous monitoring and assistance. Individuals must learn to adapt their relationship with food, consulting with nutritionists who specialize in gastrectomized patients. Glycemic swings and excessive weight loss are common challenges faced by survivors. Malnutrition becomes an ongoing concern, with deficiencies in vitamin B12, iron, folin, and vitamin D often occurring. This can lead to various health issues, including weakened hair, teeth, and bones, chronic fatigue, and tachycardia. Post-meal symptoms such as palpitations, fainting, and breathlessness should not be ignored, as they may indicate the need for rest to manage and overcome glycemic swings.
Patients with gastric cancer require comprehensive support that goes beyond tumor treatment. Psychological, nutritional, and socioeconomic assistance, as well as addressing work-related and sexual challenges, are essential. Oncologists and other healthcare professionals need to recognize the importance of providing structured interventions and specialized personnel to meet these diverse needs. Unfortunately, few Italian oncological organizations currently implement this approach, even though it has been proven to be highly beneficial.
Sexual disorders are prevalent among gastroresected patients, with 40% experiencing such issues. Many individuals seek help in overcoming intimate problems, and this need for psychological support continues throughout the advanced stages of the disease. Chemotherapy can lead to a decrease in sexual activity for patients, with 32% halting their sexual lives and 41% engaging in intercourse less frequently. Currently, there is a lack of adequate support and response to address these concerns. Weight loss and chronic fatigue also contribute to changes in body image and overall well-being.
In order to provide patients with the opportunity to move forward and regain a sense of normalcy after battling gastric cancer, a comprehensive and integrated approach is necessary. The involvement of various specialists, including psycho-oncologists, is essential in addressing the physical, emotional, and relational aspects of life after living without a stomach. By recognizing and meeting the needs of these patients, their overall quality of life can be significantly improved.