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Developing  New Ways to Detect Stomach Cancer and Improve Patient Outcomes

A first-time diagnosis of cancer is difficult no matter the circumstance. But when this type of life-changing event happens during a trip to the hospital Emergency Department (ED), our research suggests this means the patient is sicker and less likely to benefit from treatment.

Does the location of diagnosis matter for patient outcomes?

Montefiore-Einstein researchers Haejin In, MD; Ian Solsky, MD; Bruce Rapkin, PhD —conducted a study focused specifically on Gastric (Stomach) Cancer diagnoses made in the Montefiore Medical Center ED.

The Montefiore-Einstein study published in The American Journal of Surgery, explored how and if the diagnosis of stomach cancer in the ED had an impact on patient outcomes. As a result of this research, our team believes they can better identify, develop and implement life-saving cancer screenings and interventions. 

“The most effective way to fight cancer is to prevent it,” explains senior study author Dr. In, surgical oncologist and assistant professor, Montefiore, Albert Einstein College of Medicine. “This study is the first step to being less reliant on pronounced symptoms to identify and treat stomach cancers earlier than ever before.”

Among other things, Montefiore-Einstein researchers discovered three possible explanations for why many stomach cancers are diagnosed in the ED and why these patients have a higher risk of death compared to those diagnosed in other clinical settings, like ambulatory primary care centers:

  1.  Patients who go to the ED for evaluation have different characteristics (more likely to be older and have symptoms, other medical conditions, etc.) than those who go to other types of medical facilities. 
  2.  Non-specific symptoms of stomach cancer aren’t easily associated with the condition in the early stages. Unfortunately, by the time patients are symptomatic, they usually have advanced disease. 
  3. Initial management in the ED makes it more challenging to coordinate the complex cancer care that is needed to improve patient outcomes, which results in less than ideal treatment.

Improving Outcomes for Patients with Stomach Cancer

Stomach cancers are often diagnosed late because early symptoms such as poor appetite, indigestion, and heartburn, initially may not seem life threatening. Bleeding, weakness, fatigue and pain were commonly listed as the reasons Montefiore patients sought care in the ED. According to our researchers, this makes early and reliable screening methods critical.

The study concludes that in the fight against stomach cancer health care providers must: 

  • Focus on new ways to identify tumors in patients before symptoms occur and the cancer is curable;
  • Develop new screening programs that do not rely on late-stage cancer symptoms; and
  • Identify high-risk individuals for a targeted screening programs to promote early detection.

As a result of this research, Montefiore is at the forefront of developing a criterion to identify high-risk individuals who should be offered stomach cancer screening. The researchers are working   with the Alliance for Clinical Trials in Oncology, to conduct a national study to develop care guidelines for stomach cancer screening. Our researchers are also working with the Emergency Medicine Network to enhance education and communication between emergency departments and cancer specialists across the country.