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Digestive Diseases

Aggressive multidisciplinary approach at UCLA improves outcomes for patients with gastric cancer

04/05/2010

Digestive Diseases-Gastric CancerThe best results for patients with gastric cancer are being achieved at centers like UCLA that use leading-edge therapies in a multidisciplinary setting. The multidisciplinary team may include surgeons, gastroenterologists, medical oncologists and radiation oncologists.

Surgeon experience leads to better outcomes

Surgeon experience, a well-documented factor contributing to better surgical outcomes, plays a significant role at UCLA. In addition to a mortality rate of zero at 30 days following the surgery and an extremely low complication rate following surgery — about 2 percent — gastric cancer patients at UCLA experience a rapid recovery after surgery in comparison to other U.S. treatment centers. While 15 to 20 percent of all gastric cancer surgery patients experience gastric dumping syndrome after surgery — characterized by palpitations, flushing and diarrhea — less than 1 percent of patients at UCLA report this problem.

These favorable surgical outcomes allow patients to recover and continue with other therapies that members of the multidisciplinary treatment team feel will be beneficial to them following surgery.

Leadership in medical gastric cancer care

UCLA GI oncologists are at the forefront of international gastric cancer research. Earlier-stage patients benefit from new pre-surgical treatments, which can improve the surgeon’s ability to operate and improve the likelihood of curing the cancer. In addition to significantly improving survival in patients with resectable gastric cancer, new medical therapies can prolong the lives of patients with metastatic and inoperable gastric cancer. UCLA is expanding the treatment options for gastric cancer patients with new therapies based on our laboratory studies, which are now being validated in clinical trials.

Ongoing research includes the use of targeted therapies that utilize knowledge of the tumor’s biological pathways. For example, gastric cancer, like breast cancer, has a high rate of alterations in the HER-2/neu oncogene. Building on work from our own laboratories, UCLA researchers are leading an international trial taking place in 21 countries using the HER-2/neu inhibitor lapatinib. Other UCLA researchers are leading nationwide trials with drugs that block the epidermal growth factor receptor (EGFR) and mTOR pathways, strategies that have proven helpful in other cancers. Other studies are currently available, with more being developed.

Full range of services

In addition to highly experienced and innovative experts in surgery, medical oncology, nutrition and gastroenterology, UCLA provides outstanding ancillary services, including a radiation oncology department that has been a leader in advancing the understanding of cancer’s natural biology and the application of radiation therapy.

UCLA radiation oncologists have contributed to the developments and implementation of state-of-the-art technologies and can offer the most advanced treatments available. UCLA physicians see a large population of first- and second-generation Asian patients, who are at higher risk for the disease. This demographic generally follows a different diet than non-Asian patients, in terms of what they consider healthy and palatable, and frequent follow-up allows doctors to make more personal and realistic dietary recommendations. Certain high-risk demographic groups also may benefit from increased screening.

Aggressive treatment increases long-term benefits

Dietary changes and a reduction in infection with the bacteria Helicobacter pylori have led to a decrease in gastric cancer in the United States, resulting in fewer surgeries being performed.

“Because gastric cancer is not as common as it once was, patients often don’t reap the benefits of having surgeons highly experienced in the procedure,” says Darryl T. Hiyama, M.D., gastric cancer surgical specialist and professor of clinical surgery at UCLA. Dr. Hiyama and other UCLA surgeons are working to improve outcomes by performing more meticulous surgeries, resulting in lower recurrence rates, fewer complications during surgery, and a higher likelihood of patients returning to their original weight.

“The cure rate for gastric cancer has been significantly improved for resectable gastric cancer by adding chemotherapy, and in appropriate cases, radiation therapy,” adds J. Randolph Hecht, M.D., director of the GI Oncology Program at UCLA. “We are leading international efforts to identify treatments that may be less toxic — yet improve survival — in both early and advanced gastric cancers.”

Participating Physicians

Frederick (Fritz) Eilber, M.D.
Assistant Professor of Surgery
David Geffen School of Medicine at UCLA

James Farrell, M.D.
Associate Clinical Professor of Medicine
David Geffen School of Medicine at UCLA

J. Randolph Hecht, M.D.
Professor of Clinical Medicine
David Geffen School of Medicine at UCLA

Darryl T. Hiyama, M.D.
Professor of Clinical Surgery
David Geffen School of Medicine at UCLA

Saeed Sadeghi, M.D.
Assistant Professor of Medicine
David Geffen School of Medicine at UCLA

Zev Wainberg, M.D.
Assistant Clinical Professor of Medicine
David Geffen School of Medicine at UCLA

Contact Information
(310) 586-2097
Susannah Cobb, Coordinator





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