Tumors of the stomach

Gastroscopy is the primary diagnostic procedure used to examine the upper gastrointestinal tract, including the oesophagus, stomach, and duodenum. It enables the gastroenterologist to directly visualise the mucosal lining of these organs and accurately identify the location and extent of any suspicious lesions.

The examination is performed using a gastroscope, a thin, flexible tube equipped with a light source and a high definition camera. The instrument is gently inserted through the mouth and advanced into the upper digestive tract, transmitting real time images to a monitor.

In addition to visual assessment, gastroscopy allows tissue samples to be collected from suspicious areas using specialised instruments passed through the gastroscope. These samples are then analysed by pathologists to confirm the diagnosis through histological examination.

Although gastroscopy is not painful, some patients may experience temporary discomfort during the procedure. To improve comfort, local anaesthesia may be administered to the throat, and conscious sedation can be provided when appropriate.

The procedure is typically completed within 5 to 10 minutes and is generally performed on an outpatient basis.

Echoendoscopy ultrasound (EUS) is an advanced diagnostic procedure that combines endoscopy and ultrasound imaging to provide detailed evaluation of the digestive tract and surrounding structures.

The examination is performed using a specialised endoscope equipped with an ultrasound probe at its tip. This technology enables the specialist to assess the layers of the stomach wall and visualise nearby organs and tissues within the abdomen and chest with a high degree of accuracy. Endoscopic ultrasound can detect small lesions that may not be visible with conventional external ultrasound examinations.

In addition to imaging, EUS allows tissue and cell samples to be obtained from suspicious lesions or lymph nodes using a fine needle passed through the endoscope. These samples can then be analysed to support diagnosis, determine tumour characteristics, and guide treatment planning.

Endoscopic ultrasound plays an important role in the diagnosis and staging of stomach cancer, helping specialists assess the depth of tumour invasion and the possible involvement of surrounding lymph nodes and structures.

The procedure is typically performed under intravenous sedation to ensure patient comfort and generally takes between 30 and 40 minutes to complete.

Computed tomography (CT) is a diagnostic imaging technique that uses X rays to generate highly detailed cross sectional and three dimensional images of the body. In patients with stomach cancer, CT plays a key role in determining the extent of the disease and assessing whether the tumour has spread beyond the stomach.

This examination enables specialists to accurately evaluate the primary tumour and identify possible involvement of nearby lymph nodes, as well as the presence of disease in other organs within the abdomen, chest, and neck.

To enhance image quality and improve diagnostic accuracy, a contrast agent is administered intravenously before or during the examination. The scan is performed on an empty stomach within the Radiology Department of the Candiolo Cancer Institute.

The procedure is painless and generally takes approximately 15 minutes. During the scan, patients are asked to remain as still as possible to ensure optimal image acquisition and the highest quality diagnostic results.

The diagnosis of stomach cancer is confirmed through the microscopic examination of tissue samples obtained during biopsy. This analysis is performed by a pathologist, who first determines the histological type of the tumour, identifying the specific type of cells from which it originates.

The most common form of stomach cancer, accounting for approximately 90 to 95 percent of cases, is adenocarcinoma. This tumour develops from the glandular cells of the gastric mucosa, the inner lining of the stomach responsible for producing substances involved in digestion.

The pathologist also evaluates the tumour grade, which reflects how closely cancer cells resemble normal gastric cells and provides information about the expected growth rate and biological behaviour of the tumour. Tumours are generally classified on a scale from Grade 1 to Grade 3:

• Grade 1 (low grade): cancer cells closely resemble normal stomach cells and tend to grow more slowly.
• Grade 2 (intermediate grade): cancer cells show moderate abnormalities and an intermediate growth pattern.
• Grade 3 (high grade): cancer cells appear markedly abnormal, grow more rapidly, and are generally associated with more aggressive disease.

In addition to conventional histopathological evaluation, specialised molecular and immunohistochemical analyses are performed to identify biomarkers that may influence treatment decisions.

One of the most important biomarkers is HER2 (Human Epidermal Growth Factor Receptor 2), a protein involved in regulating cell growth and proliferation. In some stomach cancers, the HER2 gene is amplified, resulting in excessive production of the HER2 protein and promoting tumour growth. These tumours are classified as HER2 positive gastric cancers.

The identification of HER2 positivity is clinically significant because patients with HER2 positive disease may benefit from targeted therapies specifically designed to block HER2 signalling pathways, improving treatment outcomes in selected cases.

Additional immunohistochemical testing includes the assessment of:

• PD L1 (Programmed Death Ligand 1) expression, which may help identify patients who could benefit from immunotherapy.
• Mismatch Repair (MMR) proteins, which play a crucial role in DNA repair. Deficiency of these proteins may indicate increased sensitivity to immune checkpoint inhibitor therapies.

Tumour Staging

Following completion of diagnostic investigations, the extent of the disease is determined through a process known as staging. Accurate staging is essential for treatment planning and prognosis.

Staging evaluates:

• The depth of tumour invasion within the stomach wall
• The involvement of regional lymph nodes
• The presence or absence of tumour spread to distant organs

The most widely used staging system is the TNM classification, which combines three key parameters:

• T (Tumour): size of the primary tumour and depth of invasion into surrounding tissues
• N (Nodes): extent of regional lymph node involvement
• M (Metastasis): presence or absence of tumour spread to distant organs

The combination of these factors determines the overall stage of the disease and guides the multidisciplinary team at the Candiolo Cancer Institute in developing the most appropriate personalised treatment strategy for each patient.

For selected patients with early stage stomach cancer, when the tumour is confined to the inner lining of the stomach (gastric mucosa), is small in size, and shows no evidence of lymph node involvement or deeper tissue invasion, treatment may be performed through endoscopic resection.

This minimally invasive procedure is carried out using an endoscope, a thin flexible instrument inserted through the mouth and advanced into the stomach. Using specialised instruments passed through the endoscope, the specialist can precisely remove the tumour without the need for traditional surgery.

Endoscopic resection offers the advantage of preserving the stomach while avoiding more extensive surgical procedures in appropriately selected patients. The technique may be used both for diagnostic purposes and as a potentially curative treatment for very early gastric cancers.

Following removal, the excised tissue is carefully examined by the pathologists at the Candiolo Cancer Institute. Histopathological analysis provides detailed information regarding tumour type, depth of invasion, resection margins, and other prognostic factors.

Based on these findings, the multidisciplinary team determines whether endoscopic resection alone is sufficient or whether additional treatment, including surgery, may be recommended to ensure complete disease control.

Gastrectomy is the primary treatment for most patients with localised stomach cancer, particularly those with Stage 0 to Stage III disease. The procedure involves the surgical removal of part or all of the stomach and remains the cornerstone of curative treatment for gastric cancer.

Depending on the characteristics of the tumour, surgery may be integrated with systemic therapies. In some cases, chemotherapy is administered before surgery to reduce tumour size and improve the likelihood of complete removal. Following surgery, adjuvant chemotherapy, sometimes combined with radiotherapy, may be recommended to eliminate residual cancer cells and reduce the risk of recurrence.

The extent of surgical resection is determined by the location, size, and stage of the tumour, as well as the patient’s overall health condition.

• Partial Gastrectomy: A partial gastrectomy involves the removal of only the affected portion of the stomach. This approach may be appropriate when the tumour is confined to a specific area and complete tumour removal can be achieved while preserving part of the organ.
• Total Gastrectomy: A total gastrectomy involves the complete removal of the stomach and, when necessary, adjacent tissues or organs involved by the disease. In all cases, the regional lymph nodes surrounding the stomach are also removed, as they represent a common site of tumour spread.

Following either partial or total gastrectomy, the digestive tract is reconstructed by connecting the remaining stomach, or the oesophagus in cases of total gastrectomy, directly to the small intestine. This reconstruction allows food to continue passing through the digestive system.

Minimally Invasive Surgery

At the Candiolo Cancer Institute, whenever clinically appropriate, gastrectomy is performed using minimally invasive surgical techniques, which are associated with reduced postoperative pain, faster recovery, shorter hospital stays, and earlier return to daily activities.

The Institute has particular expertise in robotic surgery, an advanced approach that combines surgical precision with enhanced visualisation and control.

During robotic surgery, the surgeon operates from a dedicated computerised console, controlling robotic arms equipped with miniaturised surgical instruments and a high definition three dimensional camera. Through a series of small incisions, the robotic system provides magnified views of the surgical field and enables highly precise movements that exceed the limitations of the human hand.

For appropriately selected patients, robotic gastrectomy offers several potential advantages, including:

• Greater surgical precision
• Improved lymph node dissection
• Enhanced accuracy during reconstructive procedures
• Reduced blood loss
• Less postoperative pain
• Faster recovery and rehabilitation

Nutritional Support After Surgery

Nutritional care is an essential component of recovery following gastrectomy. After surgery, patients are supported by specialists in clinical nutrition who provide personalised dietary guidance tailored to their individual needs.

The goals of nutritional support are to promote healing, maintain adequate nutritional status, preserve body weight and muscle mass, optimise gastrointestinal function, and support long term quality of life. This multidisciplinary approach ensures that patients receive comprehensive care throughout their recovery journey at the Candiolo Cancer Institute.

Chemotherapy is a systemic treatment that uses anticancer drugs designed to target and destroy rapidly dividing cancer cells. These drugs exploit the higher proliferation rate of tumour cells compared with normal healthy cells.

Because chemotherapy interferes with fundamental cellular replication processes, it can also affect healthy tissues that naturally have a high turnover rate, such as bone marrow, hair follicles, and the gastrointestinal mucosa. This may result in side effects, which are generally temporary and tend to resolve after the completion of treatment.

A wide range of chemotherapy agents is available, and they are often used in combination to enhance therapeutic effectiveness. Before treatment begins, the oncologist defines a personalised therapeutic plan and provides detailed information on the drugs selected, expected outcomes, and strategies to manage potential side effects.

Methods of Administration and Treatment Cycles

• Chemotherapy can be administered in different ways depending on the type of tumour and the drugs used.
• It may be taken orally in tablet form, although it is more commonly administered intravenously. Intravenous chemotherapy is typically delivered on an outpatient basis, and the duration of each session can vary from a few minutes to several hours, depending on the specific treatment regimen.
• Treatment is organised into cycles. Each cycle consists of a period of drug administration followed by a rest phase lasting several weeks. The number of cycles depends on the type and stage of the tumour, as well as the individual patient’s response to therapy.

Chemotherapy in Stomach Cancer

In stomach cancer, chemotherapy may be used at different stages of the treatment pathway and is sometimes combined with radiotherapy.

• Neoadjuvant chemotherapy is administered before surgery to reduce tumour size and facilitate surgical removal.
• Adjuvant chemotherapy is given after surgery to eliminate residual cancer cells and reduce the risk of recurrence.
• Perioperative chemotherapy includes both preoperative and postoperative treatment, typically consisting of a short course of two to four cycles before surgery followed by three to four cycles after surgery.
• In cases of metastatic disease, chemotherapy is used with a palliative intent to control symptoms, improve quality of life, and prolong survival.

Radiotherapy is a cancer treatment that uses high energy radiation to target and destroy tumour cells within a defined area of the body. It acts locally, focusing on the tumour mass while sparing surrounding healthy tissues as much as possible.

The treatment does not require hospital admission and is typically delivered on an outpatient basis. Sessions are administered on consecutive weekdays, usually from Monday to Friday, over a period that varies according to the treatment plan.

In stomach cancer, radiotherapy is often combined with chemotherapy to enhance its effectiveness. This combined approach, known as chemoradiotherapy, can improve tumour control in selected clinical situations.

Treatment Intent

Radiotherapy may be used with different therapeutic goals depending on the stage of the disease and the clinical context:

• Adjuvant radiotherapy: administered after surgery in selected cases to eliminate residual microscopic disease in the surgical area and reduce the risk of local recurrence.
• Palliative radiotherapy: used in advanced stages of disease to alleviate symptoms such as pain or bleeding, with the aim of improving quality of life.

At the Candiolo Cancer Institute, radiotherapy is integrated within a multidisciplinary treatment pathway to ensure that each patient receives a personalised therapeutic strategy tailored to the characteristics of the disease.

Biological therapies, also known as targeted therapies or molecularly targeted therapies, are treatments designed to act selectively on specific molecular structures involved in tumour growth and progression. These targets are typically proteins expressed on cancer cells or within the tumour microenvironment and play a key role in regulating cell proliferation, survival, resistance to conventional treatments, and angiogenesis.

Unlike traditional chemotherapy, which affects both cancerous and healthy rapidly dividing cells, targeted therapies are designed to interfere more precisely with cancer-specific biological mechanisms.

HER2-Targeted Therapy

One of the most relevant molecular targets in stomach cancer is the HER2 (Human Epidermal Growth Factor Receptor 2) protein. In some gastric cancers, HER2 is overexpressed on the surface of tumour cells, leading to increased cell proliferation and tumour growth. Tumours with this characteristic are classified as HER2 positive gastric cancers.

Trastuzumab is a monoclonal antibody that specifically recognises and binds to the HER2 protein. By blocking HER2 signalling, it inhibits tumour cell growth and progression. It is indicated for patients with HER2 positive advanced or metastatic gastric cancer and is administered intravenously in combination with chemotherapy.

In cases where the disease develops resistance to initial HER2 targeted treatment, trastuzumab deruxtecan, an antibody drug conjugate, may be used as monotherapy. This agent combines targeted HER2 binding with a cytotoxic payload that is delivered directly to cancer cells.

Anti Angiogenic Therapy

Another important therapeutic strategy in stomach cancer involves the inhibition of angiogenesis, the process through which tumours develop new blood vessels to sustain growth and metastatic spread.

Ramucirumab is a monoclonal antibody that targets the VEGF (vascular endothelial growth factor) pathway, a key regulator of blood vessel formation. By blocking VEGF signalling, ramucirumab reduces blood supply to the tumour, limiting its growth and dissemination.

It is indicated for patients with inoperable or metastatic gastric cancer and is commonly used in combination with second line chemotherapy, contributing to disease control and symptom management in advanced stages.

Immunotherapy is a form of cancer treatment that enhances the body’s immune response against tumour cells. In many cancers, including stomach cancer, tumour cells can evade immune surveillance by inhibiting immune system activity. Immunotherapy aims to restore and strengthen the immune system’s ability to recognise and attack cancer cells.

In gastric cancer, the main immunotherapy drugs include nivolumab and pembrolizumab. These agents are immune checkpoint inhibitors that act by blocking the PD 1 (Programmed Death 1) protein, a key regulatory receptor that normally suppresses immune activation. By inhibiting PD 1, these drugs prevent tumour mediated immune suppression and allow immune cells to regain their antitumour activity.

Immunotherapy is typically used in combination with chemotherapy in advanced stages of disease. It is generally reserved for patients whose tumours, based on molecular and immunohistochemical profiling, show characteristics that indicate potential sensitivity to immune checkpoint blockade, such as PD L1 expression or other predictive biomarkers.

Through this personalised approach, immunotherapy contributes to improving disease control, prolonging survival, and expanding treatment options for selected patients with advanced stomach cancer.

For selected patients whose tumour presents specific biological characteristics or in whom standard treatments have not achieved the expected results, participation in clinical trials may be considered. These studies may include access to innovative or experimental therapies developed and evaluated by researchers at the Candiolo Cancer Institute.

Clinical trials are carefully designed research protocols aimed at improving current treatment strategies, assessing the safety and efficacy of new drugs, and identifying more effective therapeutic approaches for stomach cancer.

If this option is deemed appropriate by the Interdisciplinary Care Group, it is proposed to the patient in a clear and comprehensive manner. The potential benefits, risks, and alternatives are thoroughly explained, allowing for an informed and shared decision-making process between the medical team, the patient, and their family.

Through this approach, the Candiolo Cancer Institute ensures that every patient is considered for all suitable therapeutic opportunities, including access to the most advanced and innovative treatments available.

All cancer treatments may be associated with side effects that can impact a patient’s quality of life to varying degrees. These effects depend on the type of therapy administered, the stage of the disease, and individual patient factors.

Within the Candiolo Cancer Institute, a multidisciplinary team provides continuous and coordinated support to help patients manage treatment related side effects during therapy and throughout the recovery phase, including the return to daily activities.

This integrated care approach involves several specialised professionals:

• Physicians and nurses, who monitor clinical conditions, manage acute and long term side effects, and adjust treatments when necessary
• Physiotherapists, who support functional recovery and help patients regain mobility, strength, and physical autonomy
• Clinical nutritionists, who provide personalised nutritional guidance to prevent malnutrition, maintain body weight, and support healing
• Palliative care specialists, who focus on the control of pain and other distressing symptoms, improving overall comfort and quality of life
• Psychologists, who offer emotional and psychological support throughout diagnosis, treatment, rehabilitation, and follow up

Through this coordinated and patient centred approach, the Candiolo Cancer Institute ensures comprehensive care that addresses not only the disease itself but also the physical and emotional well being of each patient.

Nutritional support plays a central role in the management of patients with stomach cancer, both because of the anatomical location of the disease and the effects of medical and surgical treatments.

At the Candiolo Cancer Institute, a specialist evaluation by a clinical nutritionist is integrated into the care pathway from the first oncology consultation. This early assessment helps ensure adequate nutritional status, which is essential to support treatment efficacy, reduce complications, and improve overall quality of life.

Establishing an appropriate nutritional plan from the outset can also help mitigate side effects associated with both medical and surgical therapies, including loss of appetite, digestive difficulties, and weight loss.

Following surgery, particularly when partial or total removal of the stomach has been performed, the body undergoes an adaptation phase that may last several months. During this period, patients may experience digestive symptoms and significant weight loss, especially in the early postoperative phase. These changes can affect recovery, quality of life, and tolerance to ongoing treatments.

For this reason, continuous nutritional counselling provided by the clinical nutritionist is essential. It supports patients in adapting to their new dietary requirements, maintaining adequate nutritional intake, and promoting a gradual and safe recovery process at the Candiolo Cancer Institute.

The diagnosis and treatment of stomach cancer can have a profound impact on a patient’s emotional and psychological well being. Cancer represents a highly stressful and potentially traumatic life event that can affect all dimensions of a person’s life, often leading to feelings such as anxiety, fear, anger, sadness, or depression.

In addition to the emotional burden of the diagnosis itself, patients with stomach cancer, particularly those who have undergone partial or total gastrectomy, may experience prolonged physical fatigue during the recovery period. This can persist for months after treatment and may contribute to feelings of discouragement or reduced confidence in the recovery process.

At the Candiolo Cancer Institute, psychological care is an integral part of the overall treatment pathway. Alongside advanced medical therapies, patients have access to specialised psycho oncology support provided by qualified professionals who help them manage the emotional impact of the disease and treatment.

This support assists patients in coping with both the physical and psychological challenges of the disease, promoting adaptation and improving overall quality of life throughout treatment and recovery.

In addition, patients may participate in structured psychological support groups, which offer the opportunity to share experiences with others facing or having faced similar conditions. These group settings can foster mutual understanding, reduce feelings of isolation, and provide additional emotional support during the care journey.

Patients with cancer often require close and continuous medical support throughout their care journey. Given their clinical vulnerability, timely access to specialist advice is essential, particularly when new symptoms arise or when side effects related to treatment occur. In such situations, rapid clinical assessment through a dedicated “fast track” system can help ensure appropriate and timely management.

At the Candiolo Cancer Institute, an assistance service is available from Monday to Friday, from 8:00 a.m. to 5:00 p.m., to facilitate direct communication with the clinical team. Patients who require an urgent consultation can contact the secretariat of the Oncology Day Hospital at +39 011.993.3775, clearly indicating the need for prompt medical advice.

Following the request, the patient is quickly contacted by their reference specialist, who assesses the clinical situation and determines the most appropriate course of action.

This service is designed to ensure continuity of care, rapid response to clinical needs, and ongoing support throughout the treatment pathway.

The Social Service Department at the Candiolo Cancer Institute provides dedicated information and guidance to patients and their families regarding access to local services and legally recognised welfare and social security benefits.

This support includes orientation on procedures related to disability recognition, assistance for medical aids and prostheses, work leave arrangements, and other entitlements provided under national and regional regulations. The aim is to help patients and families navigate administrative and social pathways during the course of illness and treatment.

The service is available on Wednesdays and Fridays from 9:00 a.m. to 1:00 p.m. Patients and caregivers may contact the department by telephone at +39 011.993.3059 to request information or schedule an appointment.

Through this service, the Candiolo Cancer Institute ensures comprehensive support that extends beyond clinical care, addressing the practical and social needs of patients throughout their treatment journey.

At the conclusion of active treatment, patients enter a structured follow up phase. During this period, a series of clinical visits and diagnostic examinations are carried out to monitor treatment effectiveness, evaluate possible side effects, and assess functional recovery.

Follow up plays a crucial role in the long term management of stomach cancer, as it allows for the early detection of any disease recurrence and enables timely therapeutic intervention when necessary. It also provides an important opportunity for ongoing communication between the patient and the treating specialist.

Follow up care is coordinated by the same specialist physician responsible for the patient’s treatment plan. During scheduled visits, the physician evaluates the patient’s clinical condition and reviews all relevant test results.

Monitoring is typically organised over a period of 5 to 10 years, with the frequency of assessments gradually decreasing over time. The schedule and type of examinations are determined based on tumour stage, treatment received, and individual clinical needs.

In general, follow up for stomach cancer includes:

• First two years after treatment completion: clinical evaluation approximately every 4 months, with blood tests and imaging or other instrumental investigations performed when clinically indicated, according to medical judgment
• Subsequent three years: clinical evaluation approximately every 6 months, with additional laboratory and instrumental tests as required

For patients who have undergone partial gastrectomy, gastroscopy is typically recommended every 2 to 3 years during the first 5 years, and subsequently every 3 to 5 years thereafter.

This structured follow up programme ensures continuous monitoring, supports long term recovery, and contributes to the early identification of any changes in the patient’s condition at the Candiolo Cancer Institute.

The high volume of patients treated each year makes the Candiolo Cancer Institute a national reference centre for the management of stomach cancer.

This extensive clinical experience enables the multidisciplinary team to manage even the most complex cases, ensuring a high level of expertise across all stages of the disease.

Care pathways are designed in a highly personalised manner, taking into account not only the biological and clinical characteristics of the tumour, but also the individual needs, overall health status, and personal circumstances of each patient. This tailored approach ensures that every therapeutic strategy is optimised to achieve the best possible clinical outcome while preserving quality of life.

Every care pathway at the Candiolo Cancer Institute begins with a precise and timely diagnostic assessment, which is essential for defining the most appropriate therapeutic strategy.

Patients have access to advanced imaging techniques, including high definition computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), as well as state of the art endoscopic procedures. These tools allow for accurate localisation and staging of the disease.

These imaging methods are complemented by advanced laboratory investigations, including molecular and genomic analyses. These tests are essential for characterising the biological behaviour of the tumour and identifying specific biomarkers that guide personalised treatment decisions.

Through the integration of imaging, pathology, and molecular diagnostics, the Candiolo Cancer Institute ensures a comprehensive and highly precise evaluation of each case, supporting optimal clinical decision making.

When surgical treatment is indicated, the Candiolo Cancer Institute prioritises minimally invasive techniques, such as laparoscopic surgery, whenever clinically appropriate. These approaches are associated with reduced surgical trauma, faster postoperative recovery, shorter hospitalisation, and improved patient comfort.

Minimally invasive surgery allows precise operative intervention while limiting the impact on surrounding healthy tissues, contributing to better functional outcomes and an earlier return to daily activities.

Treatment decisions are always discussed within the Interdisciplinary Care Group (GIC), ensuring a fully integrated and multidisciplinary evaluation of each case. This coordinated approach brings together specialists from different fields to define the most appropriate and personalised therapeutic strategy for every patient, based on clinical evidence and individual needs.

As an IRCCS, the Candiolo Cancer Institute integrates clinical care with advanced translational and clinical research activities. This close connection between research and patient care allows continuous development of new diagnostic and therapeutic strategies for stomach cancer.

Within this framework, patients may be eligible for participation in national and international clinical trials. These studies offer access to innovative and investigational treatments, including novel molecularly targeted therapies and immunotherapy approaches, that are being evaluated for safety and efficacy.

Clinical trial participation is always considered within a multidisciplinary evaluation and proposed only when appropriate for the individual patient. This ensures that each potential option is carefully assessed in relation to the clinical characteristics of the disease and the patient’s overall condition, while maintaining the highest standards of safety and ethical oversight.

The Interdisciplinary Care Group (GIC) follows each patient throughout the entire care pathway, from diagnosis through treatment and into long term follow up. This continuous and coordinated management ensures consistency of care and close clinical monitoring at every stage of the disease.

Alongside oncological treatment, patients have access to integrated supportive services, including nutritional counselling, psychological support, and assistance with reintegration into daily life. These services are designed to address the physical, emotional, and practical needs that may arise during and after treatment.

The objective is not only to achieve optimal clinical outcomes, but also to safeguard overall well being and quality of life. Through a patient centred and multidisciplinary approach, the Candiolo Cancer Institute ensures continuous, comprehensive, and human focused care throughout the entire therapeutic journey.