General measures
- Nicotine restriction (refraining from tobacco use).
- Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
- Preservation of normal weight strive!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
- Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
- Avoidance of environmental stress:
- Benzo(a)pyrene – found in exhaust fumes, smoke and tar.
Conventional non-surgical therapy methods
In inoperable tumors, creation of a feeding fistula may be indicated.
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination
Regular checkups
- Regular follow-up examinations for early detection of relapse (recurrence of the disease): every six months for the first two years after therapy and annually until the fifth year.
- After gastrectomy (stomach removal), regular parenteral vitamin B12 substitution should be performed for life.Substitution with pancreatic enzymes should be performed in patients with fatty stools [S3 guideline].
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Preoperative [“before surgery”] nutritional therapy [S3 guideline]: patients should be motivated to take balanced drinking solutions in addition to normal nutrition for 5-7 days preoperatively even without signs of malnutrition.
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means:
- Consume only limited energy-rich foods.
- Moderate total fat intake
- Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for gastric carcinoma (stomach cancer).
- High-fiber diet (whole grains, vegetables).
- Little red meat (pork, beef, lamb, veal) and sausages.
- Daily total of 5 servings of fresh vegetables and fruit (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- Keep consumption of toasted and charcoal-grilled foods low. Toasting and charcoal grilling produces benzpyrene, which is considered a risk factor for gastric cancer.
- Refrain from contaminated foods such as offal and wild mushrooms.
- Do not eat moldy foods – the aflatoxins produced by the mold Aspergillus flavus or Aspergillus parasiticus act carcinogenic (cancer-causing).Aspergillus flavus is found in peanuts, pistachios and poppy seeds; Aspergillus parasiticus is found in peanuts.
- Diet rich in:
- Vitamins (A, C, D, E, folic acid)
- Minerals
- Trace elements (selenium, zinc)
- Omega-3 fatty acids
- Secondary plant compounds (e.g. carotenoids, polyphenols).
- If necessary, special dietary recommendations due toPostgastrectomy syndrome (various symptoms after gastrectomy / stomach removal), dumping syndrome (fall emptying of liquid and solid food from the stomach into the small intestine with its consequences), malassimilation (disturbance of pre-digestion in the stomach, the enzymatic breakdown of food components (exocrine pancreatic insufficiency / disease of the pancreas associated with insufficient production of enzymes), fat emulsification (eg. Bile acid deficiency in cholestasis / bile stasis) and the absorption or removal of the absorbed food).
- Selection of appropriate foods based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- Stress management, if necessary
- Detailed information on psychosomatics (including stress management) can be obtained from us.
Complementary treatment methods [S3 guideline]
- Mistletoe therapy – aimed at improving quality of life but not prolonging life.
- Probiotics – for diarrhea (diarrhea); the indication must be strictly regulated, because isolated cases of sepsis and chemotherapy/immunosuppression have been observed.
- Acupuncture – to relieve cancer-related pain and to alleviate therapy-related side effect (nausea, vomiting fatigue).