:max_bytes(150000):strip_icc()/Health-GettyImages-2164283047-f4765f9080574b81a30b061f6b1646fa.jpg?ssl=1 "What to expect with stomach cancer treatment")
Treatment goals and treatment options for stomach cancer vary Depending on how advanced the cancer is and how far it has spread. Surgery is often an effective treatment option for people with early-stage stomach cancer. Other treatments may include chemotherapy, radiotherapy, and immunotherapy.
An oncologist (a doctor who specializes in diagnosing and treating cancer) will determine the stage of the cancer before developing a treatment plan. Cancer staging is the process of determining how advanced the cancer is. The stage depends on the size of the cancerous tumor and how far the cancer cells have spread throughout the body. In general, the higher the stage, the more advanced the cancer is.
Stomach cancer staging uses the layers of the stomach wall to determine the extent of cancer cells. Cancer usually starts in the innermost layer called the mucosa. From there, the cancer spreads to other layers of the stomach wall, including the submucosal layer. Healthy musclesubserous, and serous.
Treatment of stomach cancer depends on the stage:
- Very early stage: Cancer cells are found in the inner layer of the stomach (mucosa), but have not grown to the outer layers of the stomach wall. Surgery is usually the recommended treatment.
- Possibly resectable (surgical resection): Cancer cells have spread to other layers of the stomach wall. Treatment usually involves surgery, followed by lymph node removal and possible chemotherapy or radiotherapy.
- Undetectable (cannot be removed surgically) locally or regionally: Cancer cells do spread to distant areas of the body, but they cannot be completely removed surgically because they have invaded nearby lymph nodes or organs. Treatment may include chemotherapy, immunotherapy, and radiotherapy.
- Metastatic: Cancer cells spread to distant areas of the body, such as the bones or lungs. This stage is difficult to treat. Treatment usually focuses on measures to relieve symptoms and improve quality of life.
Treatments for stomach cancer at a very early stage
Surgery is the recommended treatment An option for very early stage stomach cancer. The goal of surgery at this stage is to completely remove the cancerous tumor and achieve a cure. Surgery offers the best chance of long-term survival for people with early-stage stomach cancer.
Surgical options for very early stage stomach cancer include:
- Laparoscopic resection: The surgeon passes a flexible tube called an endoscope down the throat and into the stomach to remove the tumor and surrounding normal tissue.
- Total (partial) gastrectomy: The surgeon makes a small incision to remove the part of the stomach that contains the tumor.
- Total gastrectomy: The surgeon removes the entire stomach and nearby lymph nodes. They may also remove nearby organs, including the spleen or parts of the esophagus, intestine, or pancreas. This type of surgery is often recommended when cancer has spread throughout the stomach.
- Lymph node removal: When part or all of the stomach is removed, the surgeon removes nearby lymph nodes to make sure all cancer cells are gone.
Resectable stomach cancer treatments
People with resectable stomach cancer have a cancerous tumor that has grown into more layers of the stomach lining or wall. Treatment may include surgery along with chemotherapy or radiotherapy.
Chemotherapy
Chemotherapy is a medicine that kills cancer cells. Your doctor may recommend chemotherapy before surgery to shrink the tumor, known as Neoadjuvant therapyIn addition to chemotherapy after surgery to ensure that all cancer cells are removed.
Possible side effects of chemotherapy include:
Radiotherapy
People with resectable stomach cancer may also benefit from radiation therapy. Radiation therapy uses high doses of energy beams to kill cancer cells. Your treatment team may recommend radiation before surgery to shrink the tumor or after surgery to kill any remaining cancer cells. Radiation therapy may be given with or without chemotherapy.
Possible side effects of radiation therapy include skin redness, rash or dryness, nausea, vomiting, diarrhea, and fatigue.
Treatments for unresectable local or regional gastric cancer
If your doctor says you have unresectable stomach cancer, this means that the tumor cannot be completely removed with surgery. Localized or regional cancer means that cancer cells have spread to nearby areas of the body, such as lymph nodes or nearby organs.
Although surgery cannot cure cancer, your team may recommend palliative surgery (pain management) to improve your symptoms and quality of life.
Palliative surgical options may include:
- Gastric bypass (gastrojejunostomy): The surgeon connects part of the small intestine to the upper part of the stomach. Your care team may recommend this surgery if you have a large tumor that is preventing food from exiting the stomach.
- Total gastrectomy: The surgeon removes the part of the stomach containing the tumor to help reduce the risk of bleeding, pain, and other complications.
- Feeding tube placement: The doctor inserts a feeding tube through the skin of the abdomen into the lower part of the stomach. This may be helpful if you are unable to eat.
- Endoscopic procedures: The doctor places a flexible tube called an endoscope down your esophagus and into your stomach to treat the tumor. This may be useful for people who are not healthy enough to have major surgery.
Any surgery comes with risks. Many people experience side effects such as nausea, heartburn, diarrhea, and abdominal pain after surgery. Surgery for stomach cancer may cause bleeding, blood clots, organ damage, and infection
In addition to surgery, you may also benefit from chemotherapy and radiation therapy.
Treatments for metastatic stomach cancer
Metastatic stomach cancer refers to stomach cancer that has spread to other areas of the body, such as the bones or lungs. This is the most advanced type of cancer and is often difficult to treat.
Your doctor will likely recommend a combination of palliative surgery, chemotherapy, radiotherapy, and immunotherapy. Immunotherapy enhances the body’s immune response against cancer. One type of immunotherapy called immune checkpoint inhibitors works by helping immune cells recognize and kill cancer cells.
Immune checkpoint inhibitors used to treat advanced stomach cancer are given intravenously (IV), or by vein, and are often given with chemotherapy.
Immunotherapy may cause the following side effects:
- fever
- exhaustion
- weakness
- cough
- nausea
- Diarrhea or constipation
- Skin itching or rash
- Anorexia
- Muscle or joint pain
- shortness of breath
The prognosis and life expectancy of stomach cancer depends on several factors, including the type and stage of cancer. Your age and general health also affect your prognosis.
Here are the five-year survival rates for different stages of stomach cancer:
- Localized stomach cancer: 75%
- Regional gastric cancer: 35%
- Distant or metastatic gastric cancer: 7%
Being diagnosed with stomach cancer is very stressful, and you may feel many emotions. Even after you finish your treatment plan, you may continue to deal with stomach cancer and its complications.
Talk with your health care team about the following aspects of managing your treatment:
- Follow-up appointments: After your treatment is completed, your team will continue to perform tests, including blood tests and imaging studies. Report any new symptoms or side effects to your doctors right away.
- Dumping syndrome: Many people with stomach cancer experience dumping syndrome after treatment. This syndrome causes nausea, diarrhea, sweating, and flushing after eating. There are treatment options available.
- Nutrition support: Stomach cancer and its treatments affect how the body consumes and absorbs nutrients from food. You may lose your appetite and need to eat only small meals throughout the day. Consider seeing a dietitian for support. Your care team may recommend that you take nutritional supplements, especially if part of your stomach was removed during treatment.
- Healthy lifestyle: Work with a dietitian to develop a nutritious diet rich in fresh fruits and vegetables. Aim to be physically active every day, and maintain the weight that you and your doctor decide is optimal for you. Avoid all tobacco products, and talk to your medical team before trying alcohol.