Patients who have undergone a potentially curative resection for carcinoma of the stomach should be considered for adjuvant chemoradiotherapy. A large multicenter trial clearly demonstrated a survival benefit for adjuvant treatment and established the standard of care (Macdonald et al, 2001). Specifically, the current standard protocol consists of 5-FU and leucovorin along with radiation therapy to 45 Gy. There is a separate chapter on gastric cancer (GC) management (Chapter 34, "Gastric Cancer").

When surgery is not possible, radiation therapy also can be useful in the palliative management of GC. Radiation can assist in shrinking tumors, controlling pain, and decreasing bleeding. There is currently insufficient evidence from randomized trials to support neoadjuvant chemora-diotherapy or immunotherapy, either alone or in combination, outside of a clinical trial.

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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