The Story Behind
She is just 32 years old and mother of two children living in a remote village of Solukhumbu. She came to Nepal Medical College at Jorpati with a history of weight loss of 20 kg in 2 months with recurrent vomiting. After relevant investigations she was diagnosed to have advanced stage (Stage – IV) aggressive type cancer of stomach with complete obstruction at entrance of intestine from stomach due to tumor.
Now the only treatment option she has is to go on an aggressive course of chemotherapy which can have very harmful side effects and even death if given in frail patients like her. She was evaluated by Dr. Shekhar Poudel and his team and was advised for SEMS placement to build her nutritional status, so she can face the harmful side effects of chemotherapy well. She was referred to Bhaktapur cancer hospital after placement of SEMS as she was able to eat everything.
What is SEMS (Self expanding metal stent)?
It is a type of metal stent, which is placed across the tumor and other lesions that cause blockage to the lumen of the intestine. When placed through the endoscope it gradually expands and makes the lumen reopens so that food can pass normally into the distal intestine.
Though, it can be relatively costlier but is more physiological and allows the patient to eat normally. It is very safe and easy to insert and even does not require any incision or anesthesia. We can avoid surgery and other invasive procedures that were used conventionally to treat these conditions.
Gastroenterologist who is expert in doing this can carry out the procedure. There are very few gastroenterologists in Nepal who have expertise in carrying such advanced procedures.
With the doctors having super specialization degrees in medical and surgical gastroenterology at Nepal Medical College, Jorpati, this procedure has also been started here with affordable prices unlike most other hospitals in Nepal.
This procedure can really bring dramatic symptomatic improvement in the people with cancer in the food pipe and stomach who cannot eat normally.
Many of such patients now undergo difficult surgery or placement of tubes through the nose or directly into the intestine which can really be annoying and difficult for the patients and relatives. With the start of such procedures at affordable rates many patients can be benefited in future.
Dr. Shekhar Poudel, MD, DM(Gastroenterology – AIIMS) pioneering and expert on Self Expanding Metal Stent (SEMS) works in Nepal Medical College Jorpati, Nepal.