Abstract
Background: Gastric cancer has the fifth highest incidence rate among cancers, accounting for 5.7 percent of all new cases. Cancer anorexia-cachexia syndrome, along with cancer pain, has been identified as one of the two most common and devastating problems affecting people with advanced cancer,so palliation may be the only option for treatment.
Aims and objectives:
To study the clinical presentation of advanced gastric cancer and various options of palliative care & their response to surgically incurable gastric cancer at M.K.C.G. Medical College and Hospital, Berhampur.
Material and Methods:
Cases were selected randomly among the admitted patients inwards and from those visiting the outpatient departments at M.K.C.G. Medical College and Hospital, Berhampur, Odisha over a period of two years from July 2017 to June 2019. The cases were diagnosed as advanced gastric cancers both by clinical examination as well as thorough investigations.
Results: In the present series, 63 of the 81 patients with diagnosed gastric cancer had an advanced disease that was not amenable to curative resection. In this study, 08 patients underwent palliative gastrectomy (partial or subtotal) and these patients were given P+C chemotherapy. In 19 cases gastrojejunostomy and combination therapy with paclitaxel and carboplatin were given. Irrespective of surgical palliation, 21 patients received chemotherapy with PC and a response rate of 14.3% was noted.
Conclusions:
Palliative gastrectomy should be considered in all fit patients not amenable to curative resection and all patients who can tolerate chemotherapy must be started on chemotherapy (ideally combination therapy). Every effort should be made to relieve the distress of gastric outlet obstruction and a GJ must be undertaken whatever possible. Endoscopic stenting might be an option. Diagnostic laparoscopy must be undertaken to avoid the stress of unnecessary laparotomy in an already debilitated cancer patient.

Key words: Gastric, Cancer, Palliative, Surgery, Chemotherapy