November 2024 AFROC & ICI Virtual MDT
Exploring Aggressive Gastric Cancers Across Continents
The third virtual Multidisciplinary Team (MDT) session, jointly hosted by the African Forum for Research and Oncology Collaboration (AFROC) and the International Cancer Institute (ICI), took place in November 2024. This session dove deep into the complex world of gastric cancer, highlighting aggressive presentations and unique diagnostic challenges across Africa and Europe.
Clinical Case Spotlight
A case was presented involving a patient with poorly cohesive gastric carcinoma — a notoriously aggressive and elusive form of stomach cancer. The patient underwent endoscopy, but frustratingly, there were no obvious macroscopic lesions. This immediately sparked reflection across the panel.
“They go for endoscopy, but there is nothing macroscopically obvious. Do you also see this kind of patient with poorly cohesive carcinoma in your clinical practice?”
The case reflected a broader concern around late presentation and rapid progression of gastric cancer, particularly in under-resourced regions.
Discussion Highlights
- Tumor Biology and Aggression
Remarks on the fast-moving nature of this disease: “There’s something about the aggression of this disease… once it starts, it progresses quickly.” - Diagnostic Challenges
The lack of visible lesions during initial exams led the team to question early detection approaches. There was consensus that gastric cancers are often missed in initial screenings, especially in countries lacking routine surveillance. “By the time we see the patients, most of the time they already have lesions you can see.” - HIPEC and Treatment Pathways
The discussion also touched on HIPEC (Hyperthermic Intraperitoneal Chemotherapy), used in select cases of peritoneal spread. Panelists noted limited use in Africa, often due to cost or infrastructure constraints. “We’ve done HIPEC in a few patients with peritoneal carcinomatosis, but outcomes haven’t been great. It’s about tumor biology and aggression.” - Global Perspectives
Participants from Europe noted that advanced gastric cancer is not rare in their setting either, especially among underserved populations. This emphasized the global need for earlier intervention and standardized treatment pathways. “Here in Europe, we also see advanced gastric cancers, especially since there’s no screening in rural communities.”
Key Takeaways
- Gastric cancer often presents late, and poorly cohesive subtypes are particularly difficult to detect early.
- Multidisciplinary perspectives are crucial for tailoring care to aggressive cases.
- There’s a need for regional cancer screening programs and early endoscopic diagnostics, especially in rural settings.
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