My daughter was just diagnosed with stomach cancer this friday/any advise?

My $0.02 as a recently diagnosed patient...
1. Inform Yourself About the Disease and About Treatment

The survey I found most helpful was this one at the National Cancer Institute:

http://www.cancer.gov/cancertopics/pdq/treatment/gastric/Patient

One thing to be aware of: from reading the document and talking to my oncologist, I learned that staging (evaluating the state) of the disease with stomach cancer is quite complicated. Often full blown staging does not happen until surgery.

Some things to be aware of:
—where is the tumor located in the stomach?
—how large is the tumor?
—has the tumor penetrated the stomach wall? (this may require a CT scan)
—are any lymph nodes involved (again, this may require a CT scan)
—is there any spread to other organs? (this may require a CT, or an MRI, or a PET scan)

Regarding treatment, what I've found is this:
—Part or all of the stomach is removed. If all the stomach is removed, a new stomach-like cavity is formed from the end of the intestines and the bottom of the esophagus
—Chemotherapy follows the surgery. Sometimes radiation is added.
—Some places are treating stomach cancer with pre-surgery chemo and radiation in addition to the usual post-surgery chemo and radiation.

Something I've discovered from reading people's experiences here is that learning to eat again after the surgery is a damn difficult part of the process.

2. Get the best care you can.

You may ask, "How do I know what's best?" Here are two surveys of Cancer Centers I posted elsewhere:

http://www.cancerlinksusa.com/centers.htm

http://cancer.about.com/od/treatmentoptions/tp/tophospitals.htm

There is also the list from the National Cancer Institute of NCI-designated cancer centers:

https://cissecure.nci.nih.gov/factsheet/FactsheetSearch.aspx?FSType=1.2

Note that some of the places in the National Cancer Institute list do research only. But of these places that take patients, I figure you can be certain that they are more up-to-date and focused on cancer care.

With a condition on the decline in the US like stomach cancer, I think it's best to find someone who has experience treating it. I got the impression from the GI who diagnosed me that he hadn't seen a case in a while, and was quite shocked to see it in someone my age. My oncologist, on the other hand, sees quite a few cases and, while its a very serious disease, was not shocked or disturbed when speaking to me.

3. Make sure your daughter has adequate pain relief in the meantime

Before I was diagnosed when I thought I had reflux, I was taking Prilosec and other acid-inhibiting drugs. They didn't help much. My diagnosing doctor (the GI) gave me a script for Tramodol, which is much more effective. If keeping a positive attitude is key to fighting the disease, minimizing or eliminating pain where possible helps A LOT.

The same goes for anxiety. If it's unbearable for her, she should get some anti-anxiety meds. Dread doesn't help maintain a positive attitude either.

4. Support your daughter as she needs it

If your daughter says that just having you around helps lift her mood, then by all means, hang around. If, on the other hand, she needs some space, give her that. If she wants hugs, give her those. If she wants to make gruesome jokes, laugh at them.

5. Statistics are not destiny

An excellent essay on this is Stephen Jay Gould's "The Median Isn't the Message" available on line at

http://www.cancerguide.org/median_not_msg.html

In a nutshell, statistics are measures of general tendencies given a large number of cases. Your daughter's case is may have many factors that separate it from the "average" stomach cancer case—that's she's young and female already makes her atypical.

I wish I could say more, but I'm new to this myself. I'm count myself very lucky in that I have a caring sig.other (suzjazz) and many friends who are providing emotional support. Know that you and your daughter are in my thoughts, and I'd be happy to answer any private messages you send to me.

Tomissimo said:

Suprised at the younger cases
I find it ironic that this cancer is usually common in the 50 to 60+ age group for men. Yet there seems to be a number of younger (20 and 30ish) people being diagnosed. I was 31 when I was diagnosed myself.

As Scissors mentioned the care really depends not only on the type of cancer, but for us the location of the cancer within the stomach as well. Mine was at the junction of esophagus and stomach, so I saw a Thoracic surgeon instead of a gastrointestinal one. I also went to the Cleveland Clinic where they are world renowned for their Heart Center. Of course the heart is located in the thoracic region of the body so I was lucky to be in their care. Scott Hamilton (the ice skater) was Treated at the Clinic and he has the Scott Hamilton cares foundation run through their Taussig Cancer center.

My experience was it was miserable until they actually decided on a course of treatment, because it simply is "We may do this" or "We may do that", but until they know what they are doing with they really can't formulate a treatment plan. It's hard on our end, because we want to know and start moving forward with treatment.

Not sure if anyone else dealt with this either, but you can find all kinds of statistics on the web. Scissor's pointed a few out. I tend to not give it myself because what I found was fairly depressing, but I know the desire of wanting to know too. One thing is that my oncologists never really discussed statistics with me. And I can see their point of view. 1) The outlook is grim compared to many cancers, but not as bad as Pancreatic. Which has the worst outlook because symptoms are usually not observable until it has spread to other organs causing symptoms. 2) Stomach cancer is actually a pretty broad range of symptoms and treatments again depending on location. Topic http://csn.cancer.org/node/162792 lists a couple of different surgery types. I listed my basic surgery there as did Labguy who had a different procedure approach.

Also as a mother you are going to have a hard time with it as well. My wife and mother had a harder emotional time then I did I think through this whole scenario. No one wants to see anything bad happen to their child. I feel that way with my 2 yr old daughter.

Stats
I didn't mean to give out stats, even indirectly, but I suppose I did. What I wanted to emphasize is that it's really true that every case is unique, and you shouldn't take a stat as if its a valid prediction.

*IF*—only if—you choose to investigate statistics, always keep in mind they are not destiny, but measures of outcomes over a large number of cases. Then realize that a single stat mixes together results from different groups at different levels of disease, diagnosed at different times, etc.

I mentioned the Gould essay because it's something by a person who in his work as a scientist really understood statistics, and quickly discovered that the general stats for his cancer meant very little for his case. I think his essay is not merely comforting, but inspiring, and I'd like to quote two passages that I find particularly inspiring (my emphasis added):

"But all evolutionary biologists know that variation itself is nature's only irreducible essence. *Variation is the hard reality*, not a set of imperfect measures for a central tendency. *Means and medians are the abstractions.* Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because *I know that variation itself is the reality. I had to place myself amidst the variation.*"

and

"It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die - and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy - and *I find nothing reproachable in those who rage mightily against the dying of the light.*

*The swords of battle are numerous, and none more effective than humor.* My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn't expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain's most famous line of all: the reports of my death are greatly exaggerated."

Here is to us all reigning in a bunch of undisciplined cells who think they can mess with our lives!

Scissors

ScissorsMacGillicutty said:

Stats
I didn't mean to give out stats, even indirectly, but I suppose I did. What I wanted to emphasize is that it's really true that every case is unique, and you shouldn't take a stat as if its a valid prediction.

*IF*—only if—you choose to investigate statistics, always keep in mind they are not destiny, but measures of outcomes over a large number of cases. Then realize that a single stat mixes together results from different groups at different levels of disease, diagnosed at different times, etc.

I mentioned the Gould essay because it's something by a person who in his work as a scientist really understood statistics, and quickly discovered that the general stats for his cancer meant very little for his case. I think his essay is not merely comforting, but inspiring, and I'd like to quote two passages that I find particularly inspiring (my emphasis added):

"But all evolutionary biologists know that variation itself is nature's only irreducible essence. *Variation is the hard reality*, not a set of imperfect measures for a central tendency. *Means and medians are the abstractions.* Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because *I know that variation itself is the reality. I had to place myself amidst the variation.*"

and

"It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die - and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy - and *I find nothing reproachable in those who rage mightily against the dying of the light.*

*The swords of battle are numerous, and none more effective than humor.* My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn't expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain's most famous line of all: the reports of my death are greatly exaggerated."

Here is to us all reigning in a bunch of undisciplined cells who think they can mess with our lives!

Scissors

Apologies
I should have edited my message. Wasn't meant to be confrontational or correcting. We are going to want the information and it was valuable that you provided the links to it. As users if we don't want it we don't have to click it. I looked up the information myself obviously and do try to check out the new releases of information. My comment was more that I didn't like what I found. As you stated it's good to know, but don't live by the statistics.