How DPC Can Help Manage Your Gastric Cancer

Gastric Cancer and Direct Primary Care (DPC): Your Partner in Full Cancer Care

Getting a diagnosis of gastric cancer (stomach cancer) is very difficult, both around the world and in the United States. It is still one of the most common and deadly cancers in the world. In the US, the disease is less common than in places like East Asia, but it affects some communities more than others and is often diagnosed at later stages. Direct Primary Care (DPC) is a unique, patient-centered model that can be your main hub for coordinated, continuous, and personalized management throughout your cancer journey. Specialized oncology and surgical care are very important, but DPC can also help you with these things. Let's look at how DPC helps people and families with gastric cancer in very important ways.

Learning about gastric cancer

Gastric cancer continues to pose a substantial global health challenge, characterized by pronounced variations in incidence and mortality rates. It is the fifth most common cancer in the world and the third most common cause of cancer death.

• The disease is more common in non-White racial and ethnic groups in the United States. For example, Black and Hispanic Americans are almost twice as likely as White Americans to get stomach cancer or die from it. Rates are also very high among Asian Americans and Pacific Islanders (AAPI), especially those who came to the U.S. as first-generation immigrants from places like Korea and Japan where the disease is common. For instance, Korean American men and women had a 14.5-fold higher rate of non-cardia gastric cancer (the most common type) than non-Hispanic White people. It is also more common among people with lower socioeconomic status and those who are stuck in poverty.
• Some of the most important risk factors are:
  • Infection with Helicobacter pylori (H. pylori): This bacterium is the primary modifiable risk factor. About half of the people in the world have H. pylori, and most of the cases of gastric cancer that can be linked to it (about 76%) happen in Asia (67%), the Americas (13%), and Africa (12%).
  • Family history of stomach cancer: A strong family connection raises the risk.
  • Hereditary cancer syndromes, including Lynch syndrome and familial adenomatous polyposis.
  • Age: The risk goes up as you get older.
  • Dietary factors: eating a lot of salt, not enough fruits and vegetables, and eating foods that are salted and smoked.
  • Tobacco use: Smoking is a known risk factor.

Finding and stopping stomach cancer

Primary prevention strategies emphasize the detection and elimination of H. pylori, which randomized trials (mainly conducted outside the US) have demonstrated to decrease gastric cancer-specific mortality.

• Endoscopic screening and surveillance are part of secondary prevention, especially for people who are at high risk. However, there is no universal screening program in the US because the disease is not very common and it would not be cost-effective for most people. The American Gastroenterological Association, on the other hand, suggests that each person should have their own risk assessment based on things like:
  • Place of origin
  • History of the family
  • Syndromes that run in families
• This method helps find people who might benefit from a targeted endoscopic evaluation. Endoscopy is still the best way to diagnose and keep an eye on things, but it can't be used all the time because it costs a lot and you have to choose your patients carefully.
• It can be hard to tell if someone has gastric cancer because the symptoms are not very specific and can also be caused by other, less serious gastrointestinal problems. Early diagnosis is very important because surgery is often the best way to cure the disease. Unfortunately, many cases are found too late. The overall 5-year survival rate for gastric cancer in the United States is about 33% when all stages are taken into account. The 5-year relative survival rate for localized disease is about 70%. However, about 60% of cases are found at the regional or distant stage, where the 5-year relative survival rates are only 31% and 6%, respectively. There are still racial differences in survival, with Asian patients having the longest median survival, followed by Hispanic, Black, and White patients.

Taking care of gastric cancer

For people with gastric cancer, treatment usually includes:

• Surgery is the main treatment for localized disease that is still in its early stages.
• Chemotherapy is often used before (neoadjuvant) or after (adjuvant) surgery, or for advanced disease.
• Radiation therapy: It is sometimes used with chemotherapy.
• Immunotherapy and targeted therapies are new options for advanced disease that are based on molecular profiling.
• It is important to have care from many different types of doctors, such as surgical oncologists, medical oncologists, radiation oncologists, and others.

How DPC Changes the Way Gastric Cancer Is Treated

Direct Primary Care (DPC) is a way of doing things in which patients pay a membership fee directly to their primary care provider to get better access to primary care services. It stresses better accessibility, stronger relationships between patients and providers, and continuity of care, all while making things easier for administrators. There are worries about how easy it will be for vulnerable groups to get in because of membership fees and the possibility of excluding complicated patients. However, for those who are enrolled, DPC provides a unique way to deal with the problems that come with a cancer diagnosis. Primary care is becoming more and more important throughout the cancer continuum, from prevention and early detection to survivorship and end-of-life care. Patients with complicated needs and multiple comorbidities can benefit greatly from primary care's strengths, such as continuity, coordination, and a whole-person approach. DPC models, which have these features, are well-suited to provide thorough, proactive, and personalized care. Here's why DPC is a big deal for people with gastric cancer:

Care that is unique to you Based on Medical Knowledge

• DPC doctors have the time to look closely at your unique risk factors, family history, and symptoms. They can spend more time with you during appointments to really get to know your situation, which is very important for a complicated disease like gastric cancer. This makes it possible for:
• DPC makes it easier to quickly spot subtle, nonspecific symptoms and major risk factors (like chronic gallstones or unexplained weight loss). This makes it easier to send patients for diagnostic imaging and specialist evaluation right away. This is very important because a lot of people are diagnosed late.
• Long-term management of comorbidities: DPC's structure lets you keep managing other health problems (like diabetes or heart disease) while you are getting cancer treatment, so you stay as healthy as possible.
• Plans for personalized care: Taking into account each person's risk profile, preferences, and needs throughout the entire cancer care process, from diagnosis to long-term follow-up.
• Psychosocial support: The strong relationship between patients and providers in DPC gives patients a steady source of support to deal with the strong emotional and mental effects of a cancer diagnosis.

Help and advice that is clear and cheap

• DPC clinics can often lower costs and make care more efficient by:
• Labs and imaging at wholesale prices: DPC doesn't do cancer treatment, but many DPC practices offer much lower prices for routine blood work or initial imaging, which can help find cancer sooner or keep an eye on it.
• Streamlined referrals and coordination: DPC can make sure that endoscopic evaluations are done on time when they are needed. This could cut down on the long wait times for diagnoses that are common in fragmented care systems. DPC also helps oncology and surgical teams work together smoothly.
• Addressing access barriers: DPC might make it easier for underserved populations at higher risk to get preventive services and follow-up care by reducing administrative burdens and allowing direct communication. These groups often have trouble with language, transportation, and insurance.

Ongoing help for long-lasting results

• You get the following benefits from better access to and direct communication with your DPC doctor:
• Better patient experience and adherence: Putting a lot of emphasis on accessibility and continuity may help patients stick to their follow-up appointments and treatment plans.
• Ongoing coordination of care and making decisions together: It's important for gastric cancer patients to be involved in their own care in order to get the best results.
• Integrated survivorship care includes regular checkups for new cancers, treatment for late effects of treatment (like nutritional deficiencies after a gastrectomy, fatigue, and neuropathy), and follow-up care for people who have had cancer. The patient-centered medical home model, which has a lot in common with DPC, has been shown to work well for cancer survivors by giving them complete, coordinated care.
• Follow-up that focuses on the patient: Making sure that your care plan changes as your needs change along the way.

Success Stories from Real Life

These stories show how DPC's personalized approach and full range of services are very helpful when dealing with a cancer diagnosis like Gastric Cancer:

• Case 1: Maria, 58, is a first-generation immigrant from East Asia who has been having trouble digesting food and losing weight for no apparent reason. In a traditional system, she might have had to deal with language barriers and long waits. Dr. Sanchez, Maria's DPC doctor, spoke Spanish and took a detailed history in her native language. He knew that Maria was at a higher risk because of where she came from and her family's history of H. pylori. Dr. Sanchez quickly ordered tests for H. pylori and, based on the results, quickly set up an urgent endoscopy. Maria was able to have surgery that would cure her localized gastric cancer because it was found early. After Maria's surgery, Dr. Sanchez continued to take care of her nutritional needs and worked closely with her oncology team, offering important language and cultural support throughout her treatment.
• Case 2: James, 65, a long-time smoker with a family history of gastric cancer, was always tired and felt full quickly. He often skipped going to the doctor because he had felt rushed in the past. Dr. Lee, James's DPC doctor, spent a lot of time with him going over his diet, lifestyle, and full family history. Dr. Lee did a personalized risk assessment and suggested a targeted endoscopic screening, even though James didn't have any classic cancer symptoms. This led to the discovery of a precancerous lesion, which was successfully removed, stopping cancer from spreading. After the procedure, Dr. Lee kept seeing James for regular check-ups, stressing the importance of quitting smoking and making changes to his diet. He also kept a close eye on James for any signs of recurrence, providing ongoing, proactive preventive care.

Questions and Answers: Gastric Cancer and DPC

• Q: Can DPC do surgery or treat gastric cancer itself?
  • A: No. DPC is an extra service that works with the highly specialized care that surgical oncologists, medical oncologists, and radiation oncologists give to people with gastric cancer. Your DPC doctor focuses on finding problems early, managing risk factors, helping you deal with treatment side effects (like those after a gastrectomy), and making sure that all parts of your care work together.
• Q: Is it worth it to pay for DPC to find out if you have cancer?
  • A: Yes, for sure. DPC members pay their fees directly, but the extra access, full primary care, and careful care coordination can make a big difference. This could include making it possible to find out about conditions earlier (which is important for prognosis), better managing treatment side effects, cutting down on unnecessary trips to the ER or urgent care, and giving people with a lifelong condition psychosocial and educational support that is priceless. DPC can't pay for the high costs of cancer treatment itself, but it can make your whole healthcare experience more efficient and focused on you.
• Q: How does DPC help keep an eye on things after cancer treatment?
  • A: DPC doctors are very good at taking care of people who have survived. They can make personalized follow-up plans, keep an eye out for recurrences, deal with the late or long-term effects of treatment (like nutritional deficiencies, dumping syndrome, fatigue, and neuropathy), and make sure you stay up-to-date on all of your general health screenings and preventive care. This continuity is very important for health and quality of life in the long term.

Why DPC Is Good for People with Stomach Cancer

Patients with gallbladder cancer often have complex needs and multiple comorbidities, so the strengths of primary care, such as continuity, coordination, and a holistic approach, are especially helpful.

DPC means this for people with gastric cancer:

• Precision management: Personalized risk assessment to customize prevention and monitoring strategies, taking into account the interaction of genetic, environmental, and social health determinants.
• Access on time: Early identification of high-risk patients and prompt referral for endoscopic evaluation may decrease diagnostic delays.
• Holistic focus: ongoing coordination of care, shared decision-making, management of comorbidities, and integration of survivorship care (monitoring for recurrence, dealing with late effects, psychosocial support, and patient education) into everyday practice.

Getting a diagnosis of gastric cancer is scary, but you don't have to go through it alone. With DPC, you get a partner who understands how complicated your condition is, provides clear and easy-to-understand care, and gives you the tools you need to take an active role in your cancer treatment for the best possible outcomes and quality of life. Are you ready to find out how Direct Primary Care can change the way you deal with your gastric cancer?