Stomach (Gastric) Cancer: Treatment Options

How is it treated?

Many precancerous ulcerations of the stomach are due to an infection with helicobacteria. Treatment with an antibiotic eradicates the lesions before invasive cancer develops.

As with most forms of Cancer, treatment for Stomach Cancer depends on a variety of factors. A physician will consider the type of Cancer, its stage, and its growth patterns when deciding on a treatment. The doctor will also consider the patient's age, overall health, and personal preferences. By far the most common treatment, and the only way to cure Stomach Cancer, is surgery. Surgery is often combined with radiation therapy and/or chemotherapy to destroy as much of the cancer as possible.

Surgery for Stomach Cancer

Surgery is the only effective way known to cure Stomach Cancer. However, doctors often recommend surgery even for patients whose tumors cannot be completely removed. This is done to correct or prevent an incurable tumor from obstructing the path of food, and to relieve pain or bleeding. Nearly all surgical treatments are combined with radiation and/or chemotherapy. There are two surgical procedures commonly used to treat Stomach Cancer:

• Partial (Subtotal) Gastrectomy: The portion of the stomach that contains the tumor is removed, along with portions of nearby tissues and nearby lymph nodes to prevent spreading of the tumor. Depending on the particular patient's symptoms, the spleen may also be removed. The remaining stomach portion is then reconnected to the small intestine, so that the path of food is not interrupted.
  
  
• Total Gastrectomy: The entire stomach is removed, along with nearby lymph nodes and portions of nearby tissues such as the esophagus and the small intestine. The spleen may be removed in some cases. The esophagus and small intestine are then connected to one another to allow eating and swallowing to continue.
  

Other treatments

• Chemotherapy - This is a systemic, or whole body, treatment, the goal of which is to destroy any remaining cancer cells in the body and to keep the cancer from spreading to other organs. The drugs are typically given in cycles of a few days of treatment and then 3-4 weeks to rest, for a period of weeks or months determined by the oncologist. Drugs are administered by mouth or injection to destroy the cancer cells. The drugs enter the blood stream and can, therefore, reach areas of the body where the cancer may have spread. When Stomach Cancer is confined to the abdomen (peritoneal carcinomatosis), chemotherapy may be given directly to the abdominal lining, reducing the number of affected systems and concentrating the drug's effects in the cancer region.
  
  
• Radiation therapy - This is the process in which high-energy waves are directed at the affected area in order to destroy cancer cells. Radiation therapy is local, affecting only the area exposed to the rays. It is typically given five days per week for a period of five or six weeks. In cases of Stomach Cancer, radiation is used more often to relieve some of the symptoms of Stomach Cancer such as pain, bleeding, or obstructions by shrinking the tumor. This is called palliative radiation.
  
  
• Clinical Trials - There are always new experimental treatments being tested that often have promising results. The effectiveness and side effects of clinical trials are not always known, but they can sometimes offer hope of survival especially for end-stage cancer patients. Clinical trials are particularly important in Stomach Cancer because so many cases are diagnosed in advanced stages. Consult your physician or the Rhode Island Cancer Council to find out what clinical trials are going on near you and if you are eligible.
  

What are the side effects of the treatments?

Possible Side Effects From Surgery

• Temporary pain
  
• Heartburn
  
• Bloating
  
• Feeling of fullness after small meals
  
• Vitamin deficiencies (of vitamins normally absorbed by the stomach)
  
• Rare complications: Bleeding, blood clots, damage to nearby organs
  

With the exception of temporary pain, the side effects listed above are usually due to the fact that after gastrectomy, food enters the small intestine too quickly after being swallowed. These symptoms can usually be eliminated or lessened through medication, vitamin supplements, and dietary changes such as smaller, more frequent meals and avoiding drinking with meals.

Possible Side Effects from Other Treatments

*Most side effects are temporary and can often be relieved with medication.

• Radiation Therapy
  
  • Nausea, vomiting, diarrhea
    
  • Irritation to the skin near the radiation site
    
  • Fatigue
    
  
  
• Chemotherapy
  
  • Nausea and vomiting - Loss of appetite
    
  • Loss of hair
    
  • Mouth sores
    
  • Increased susceptibility to infection
    

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