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The present treatment of gastric cancer was explained according to the gastric cancer treatment guidelines 2014. Although indication of endoscopic submucosal dissection (ESD) was limited to pathologically differentiated, mucosal cancer ≦ 2 cm in diameter without ulceration, it now extends to differentiated mucosal carcinoma with partially undifferentiated tissue ≦ 3 cm in diameter with ulceration as curative resection criteria of ESD. PDT is not described in these guidelines. The advantages of PDT are that it preserves the stomach, it is safe with less complications such as bleeding or perforation, it’s easily applicable to ulcerated lesion and residual or recurrent cancer after ESD, it can be used as neoadjuvant therapy, it can be applied to patients receiving antithrombotic therapy, it’s less invasive, it’s applicable to the elderly, it’s inexpensive, etc. In order for PDT to be included in the gastric cancer treatment guidelines, we must write an English paper relating to the results of PDT compared to those of standard therapy, get estimations and achieve a consensus. In this era of an increasing elderly population, evidence of PDT effectiveness should be displayed to build its prestigious status as gastric cancer treatment.

The Advantages of Photodynamic Therapy for Gastric Cancer in This Era of an Increasing Elderly Population – From a Surgeon’s Point of View