An alternative to surgery is a stomach cancer stent used when a tumor needs to be bypassed, but at a time when the malignancy cannot be cured.
These are either placed by radiologists, using x-ray technology, or by endoscopists with or without the aid of fluoroscopy (a form of x-ray in real time).
There are many different designs, but they are essentially hollow tubes made from plastic or more commonly wire mesh.
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To insert a stent, you will be made nil by mouth for 4-6 hours. Normally, you will be given sedation or possibly an anesthetic depending on your local hospital.
To place one endoscopically, an endoscope (I suspect you are familiar with this, but if not take a look in the endoscopy section) is passed through your mouth and down the esophagus to your stomach.
They can be placed if the tumor is high up and invading the esophagus or obstructing the exit in the area known as the pylorus.
A guide wire is inserted down the endoscope and through the tumor. Often there is a small lumen or hole through which a guide wire can be placed.
If there is very little to see, fluoroscopy or x-ray can be used to safely guide the wire through the tumor mass. The endoscope is then removed with the wire in place.
A stent is threaded over the wire. It is normally collapsed down over a fine hollow tube and it is this tube that has the wire threaded through.
It is pushed along the wire to the tumor and just beyond it. Once in the right place, the endoscopist can release the tube which then uncoils in to place.
The most common ones used these days are wire mesh which squash against the tumor as it is released.
The mesh holds in place by pressure and also by the tumor itself growing within the mesh.
Fortunately the risks are minimal when compared to the potential benefit of having one placed.
There are risks of endoscopy like any other test including the sedative risk, bleeding and perforation (putting a hole in the gut).
Pain is a relatively common symptom with stomach cancer stent placement, but this can be controlled with medications usually.
Some people retch a lot when they are inserted, but this usually settles. Because you now have a stent placed, there is no mechanism to prevent reflux of gastric contents and acid. Heart burn is reduced by the use of acid suppressing drugs.
Bleeding can occur after insertion. Tumors are often very soft and what we call ‘friable’. By this I mean they can be traumatized easily and bleed. Fortunately this usually settles.
Stomach cancer stents can migrate or move from the area intended. This is because there is no "stickiness" until the tumor starts growing in to the stent. It is only held by pressure of the unravelled stent, when first placed.
If migration happens, you may need to have a further one inserted.
They can become blocked either by the food you eat or by the tumor itself which continues to grow. If this happens, you may need to have an endoscopy to remove the ‘food bolus obstruction’ or to treat the ‘tumor ingrowth’.
A special diet is needed to allow foods to pass through. They are mainly soft foods or even liquidised food and should be eaten with a sauce or gravy to make it easier.
Examples would include tenderised, well chopped or minced meat, boneless fish, scrambled or poached egg, grated or cream cheese and soups.
Try to avoid grisly meats, battered food items, chunky foods, nuts and bread (particularly crusty or new bread).
Try to drink in between mouthfuls to aid passage of food. Carbonated drinks are ideal for this as they aid passage and break-up of the food.
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