Cancer of the Stomach
CANCER of the stomach is regarded by some physicians as the equivalent of a death warrant. This view is fostered by the infrequency of cured cases in the experience of any single physician, as well as by some published reports that stress the pessimistic aspects of the disease. No such implication attaches to cancer of the breast; yet, if the patient with cancer of the breast has fixation of the tumor to the chest wall, or distant metastases to bone, no mastectomy is carried out and, in most series, the patient does not figure in the five-year survival statistics. Not so with cancer of the stomach; most studies scrupulously include every instance of the diagnosis, whether or not the patient ever is examined by a surgeon, and whether or not the diagnosis is confirmed by histologic study of tissue removed from the tumor or one of its metastases.
In studies of cancer of the stomach, we should distinguish between the different stages of the disease at the time treatment is carried out. It is not at all unusual to read that five-year survivors comprise 25 to 30 per cent of all patients with gastric cancer in whom a gastric resection “for cure” has been carried out (i.e., all gross evidence of tumor has been eradicated). The percentages are not very different from those for five-year survivals reported for radical mastectomy for cancer of the breast, and at the time of surgery the two conditions are comparable: as far as the . . .