Hasenoehrl, Barbara

2024-03-19

Introduction : A study reviewing gastrointestinal cancers in the Northern Territory looked at data from 1990 – 2017 showed a significant decrease in incidence of gastrointestinal adenocarcinomas in individuals aged > 50 years, whilst the younger cohort (18-50 year) remained unchanged with a noticeable trend towards an increase. In both cohorts there is a significant improvement noted, but Aboriginal and Torres Strait Islander people living in the Territory still have worse survival outcomes. Case Report: The following demonstrates the case of a 43-year-old indigenous woman diagnosed with advanced Stage III gastric adenocarcinoma. The patient has two young children, who together with her family are living in the remote area of the Anangu Pitjantjatjara Yankunytjatjara (APY) lands. These remote parts in the far northwest of South Australia are covered by the only Cancer Services in Central Australia located in Alice Springs. The patient initially presented with abdominal pain and malnutrition. The patient was transferred to Adelaide for examinations, where gastric adenocarcinoma with linitis plastica was confirmed. The MDM recommendations included to have 4 cycles of pre-operative chemotherapy (FLOT: fluorouracil, leucovorin, oxaliplatin and docetaxel), followed by surgery (gastrectomy) and then a further 4 cycles of post-operative chemotherapy. The impacts on the patient were not only physical (several hospital admissions, jejunostomy tube insertion, peripheral neuropathy impacting on her painting ability) but also emotional/psychological (increased isolation, frustration, not being able to go home and see her children related to factors like traveling distance, lack of safe follow up care in remoter areas, not completing all cycles of chemotherapy due to side effects and long-term prognosis) Discussion: This case highlights the impact of gastric cancer diagnosis for a patient from a remote indigenous community.

https://hdl.handle.net/10137/14210

Gastric Adenocarcinoma- Impact of a cancer diagnosis for a remote indigenous patient: A case study

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