Why Access to HER2 Positive Stomach Cancer Treatment and Patient Support Matters
When a patient receives a diagnosis of HER2-positive gastric cancer, they will experience a variety of problems and need medical treatment, as well as information and support to help them combat the emotional, financial and medical challenges to deal with this disease and their treatment. Patients and their families may benefit from timely diagnosis and access to care from an experienced cancer team.
Stomach cancer with an overexpression of HER2 (Her2 positive stomach cancer) is a cancer type where the cancer cells have an increased amount of the human epidermal growth factor receptor 2 (HER2) protein, which is involved in the growth of cancer cells. Due to the higher amount of HER2 protein on the surface of cancer cells, certain targeted therapies have been evaluated in clinical studies for eligible patients with HER2-positive stomach cancer. Access to appropriate treatment as well as to adequate support for patients and their families can however be greatly affected by factors such as the availability of and access to adequate medical care at local hospitals, the patients’ financial means and their place of residence.
Why Access to Appropriate Treatment Matters
Treatment for stomach cancer is based on several factors including the location of the tumor, the cancer stage, HER2 status, the patient’s general health, prior treatment and other tumor characteristics. For localized stomach cancer patients, treatment can be a combination of chemotherapy and surgery to remove the part of the stomach where the cancer started. For advanced HER2 positive gastric cancer patients, targeted HER2 therapy, in the form of tislelizumab can be given in combination with chemotherapy.
For patients with advanced and/or metastatic HER2-positive gastric cancer, targeted agents such as tislelizumab can be administered in conjunction with chemotherapy. For patients who have received prior therapy for advanced her2 positive stomach cancer treatment, agents such as tislelizumab as well as immune therapies may be considered.
Access to appropriate treatment for gastric cancer is important for patients to be able to discuss their treatment options with their doctors, with full information of the potential benefits and problems for that individual. Patients may benefit from timely evaluation, access to necessary diagnostic tests, and consideration of available treatment options.
Understanding the Importance of HER2 Testing
To select the appropriate treatment for a patient with HER2-positive stomach cancer a correct diagnosis of the disease is essential. HER2 status of a patient’s tumor can be determined by means of HER2 testing, which can be done by means of IHC and/or additional tests to get more detailed information about the HER2 status of the patient’s tumor.
Additionally, details of the pathology report should be explained to patients and how the results of the biomarkers may affect treatment options. This could include other biomarkers, such as the patient’s expression of PD-L1 and their tumor’s mismatch repair status which can be used to consider immunotherapy. Access to appropriate diagnostic services can help patients and their oncologists to choose the appropriate treatment plan for their specific cancer, based on the tumor’s biological characteristics and other individual factors.
How Patient Support Improves the Treatment Experience
Support for Patients undergoing treatment for Cancer is not limited to the actual treatment given. Patients suffer from Fatigue, Nausea & Vomiting, Loss of Appetite, Bowel disorders, Anxiety and many more symptoms and are worried about their illness and treatment for a long time. Thus, it is very important to have support services for patients for a long period of time.
Help to be at appointments, including transport, to manage treatment in the form of written information, organized medicines, healthy food and help with financial matters.
Family members and even friends can also support a cancer patient by recording appointments and even writing down all the questions the patient needs to ask the doctor. Even more importantly, they can also monitor any new or worsening symptoms and report them to the doctor accordingly. The patient should still be in control and make independent decisions regarding their care.
Financial and Geographic Barriers to Care
Even when appropriate cancer treatment is available, the cost of cancer can be a heavy burden on many patients and their families. Not only can the cost of diagnostic tests, of doctor visits, of hospital stays and of specific cancer medications be dear, but also the cost of travel to receive treatment, of eating well to have the strength to receive treatment and of supporting family and loved ones while dealing with cancer.
The hospital social worker and the patient’s financial counselor can explore with patients and families what kind of financial and treatment assistance is available through various assistance programs and can explain the patients’ insurance benefits. In some cases, the oncology team can even describe patients’ alternative treatments that are clinically appropriate and which may be available to the patient when the initially recommended treatment is not affordable.
There are, however, several barriers that limit access to proper stomach cancer care. Geographic location and the lack of referral networks and appropriate coordination between doctors can create problems for some people with cancer and their families. As well as that, while increasing use is being made of telehealth for cancer consultations, many investigations and treatments cannot be carried out over the phone or via video conferencing.
Finding Reliable Information About Treatment
Information on her2 positive stomach cancer online can come from many sources, often out of date or contain misinformation including promises of ‘cure’. This information must come from well-informed, experienced health care professionals, reputable organizations for cancer treatment and others who provide up to date medical information.
For example, a patient should ask the treating oncologist which treatments for her2 positive cancer are appropriate given his/her specific diagnosis. It may be necessary to further investigate. For the various treatments of stomach cancer (for example the chemotherapy and/or the radiation therapy) the patient should ask about the goal of the treatment, the potential side effects, the necessary follow-up and the possible alternatives if the cancer becomes resistant to the treatment.
Clinical trials can provide patients with Her2 positive stomach cancer with access to the investigational therapies being studied. It is best to discuss clinical trials with the patient’s oncology team as they can detail the purpose of the clinical trial(s), criteria for participation, potential risks, and decide if a particular clinical trial is best for the patient.
When researching her2 positive stomach cancer treatment, patients should prioritize reliable medical information and discuss available options with their oncology team.
The Role of Emotional and Nutritional Support
In addition to practical support, many people with gastric cancer experience fear, frustration, sadness, etc. Counseling or a support group of other stomach cancer patients can help them come to terms with their new situation and to adjust their lives accordingly. Patients should also talk to their family and loved ones as well as their friends and caregivers about their feelings and concerns.
Nutritional needs and support – Nutrition is an important consideration for gastric cancer patients and those that are going through treatment for gastric cancer. Patients with gastric cancer often lose their appetite, are unable to eat comfortably and can experience dehydration. An oncology dietitian will be able to offer patients advice on what type of nutrition would be best for them to ensure that they are maintaining their weight and to manage their symptoms while undergoing treatment for gastric cancer.
Caregivers need to report persistent weight loss, difficulty swallowing, signs of dehydration and an inability to eat and drink at all to the medical team.
Building a Coordinated Support System
When it comes to managing a person with cancer and their treatment, it is often better to have a variety of health care professionals from different backgrounds to be able to manage different parts of the person’s treatment and provide multidisciplinary care. This can include the oncologist who treats the cancer, as well as the nurses, dietitians, pharmacists, and social workers from various organizations and health care settings.
Patients and families can also help keep their patients on track by keeping all pathology, imaging, as well as copies of the patient’s medications and all appointments for treatments as well as other health care services. Also, knowing who to call with side effects or a medical emergency is very important for patients as well as their families.
Looking Ahead
The importance of having access to the best possible treatment and patient support in managing people with HER2 positive stomach cancer is highlighted in this look to the future and how best to manage their HER2 positive gastric cancer in order to manage their treatments in the best possible way and to live with their cancer and its treatment side effects.
Although individual results will vary, it is important that patients have access to clear information regarding all their treatment options and can receive the coordinated care from an interdisciplinary of health care professionals who are coordinating to manage all aspects of their cancer care.
Disclaimer: The information provided in this article is intended for educational purposes only and should not be interpreted as medical advice, a clinical guideline, or a recommendation for any specific treatment.
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