Stomach cancer treatment and recovery
Your gastrointestinal oncology team will work with you to create the best treatment plan for your situation.
Your treatment plan may include any or all of these treatments:
Surgery for resectable cancer
The main treatment for stomach cancer. Your surgeon will know the right procedure for your case:
- Endoscopic resection. Endoscopic mucosal resection and endoscopic submucosal resection can be used only to treat some very early-stage cancers, where the chance of spread to the lymph nodes is very low. The surgeon passes an endoscope down the throat and into the stomach. Surgical tools can be passed through the endoscope to remove the tumor and part of the normal stomach wall around it.
- Subtotal (partial) gastrectomy. Often recommended if the cancer is only in the lower part of the stomach. Only part of the stomach is removed, sometimes along with part of the esophagus or the first part of the small intestine. The remaining section of stomach is then reattached. Some lymph nodes are also removed.
- Total gastrectomy. Done if the cancer has spread throughout the stomach. It is also often advised if the cancer is in the upper part of the stomach, near the esophagus. The surgeon removes the entire stomach, nearby lymph nodes, and omentum, and may remove the spleen and parts of the esophagus, intestines, pancreas, or other nearby organs. The end of the esophagus is then attached to part of the small intestine.
Palliative surgery for unresectable cancer
For people with unresectable stomach cancer, palliative surgery can often still be used to help control the cancer or to help prevent or relieve symptoms or complications.
- Subtotal gastrectomy. Removing the part of the stomach with the tumor can help treat problems such as bleeding, pain, or blockage in the stomach, even if it does not cure the cancer.
- Gastric bypass (gastrojejunostomy). Tumors in the lower part of the stomach may eventually grow large enough to block food from leaving the stomach. To bypass the lower part of the stomach, the surgeon attaches part of the small intestine (the jejunum) to the upper part of the stomach, allowing food to leave the stomach through the new connection.
- Endoscopic tumor ablation. An endoscope is used to guide a laser beam to vaporize parts of the tumor. This can be done to stop bleeding or help relieve a blockage without surgery.
- Stent placement. Another option to keep a tumor from blocking the opening at the beginning or end of the stomach is to use an endoscope to place a stent—a hollow metal tube—in the opening.
- Feeding tube placement. Some people with stomach cancer are not able to eat or drink enough to get adequate nutrition. We can place a feeding tube through the skin of the abdomen and into the distal part of the stomach or the small intestine and deliver liquid nutrition.
- Radiofrequency ablation. A special probe with tiny electrodes that kill cancer cells.
- Cryosurgery. An instrument that freezes and destroys abnormal tissue.
- Chemotherapy. Drugs that destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. We often use more than one drug at a time for maximum results.
- Targeted therapy or novel therapy. Drugs that target the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. In recent years, targeted therapy has proven to be increasingly successful at controlling myeloma and improving a prognosis.
- Immunotherapy or biologic therapy. Uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.
- Other drug therapy. We may give steroids alone or at the same time as targeted therapy or chemotherapy.
- Radiation therapy. High-energy X-rays or other particles that destroy cancer cells.