Treating Gastric Cancer
There are many factors – medical and personal – to consider as you make treatment decisions. Don’t hesitate to ask questions and seek additional opinions.
Video Source: Astellas
It is advantageous to receive treatment at a medical facility that treats many patients with gastric cancer.
Gastric cancer is a serious and complicated disease that requires the expertise of a coordinated, experienced and skilled team of healthcare professionals. This team may include gastroenterologists, surgeons, medical oncologists, and radiation oncologists, as well as oncology nurses, dietitians and social workers.
This level of care is most available at a major cancer center or academic medical center that treats a large number of gastric cancer patients.
National Cancer Institute recognizes centers around the country that meet rigorous standards for transdisciplinary, state-of-the-art research focused on developing new and better approaches to preventing, diagnosing, and treating cancer. Find an NCI-Designated Cancer Center near you.
After initial treatment, it is sometimes possible for patients to return to their local community hospital for follow-up care.
Cancer patients usually receive a combination of treatments, which may include one or more of the following approaches.
Most gastric cancer treatments have side effects. The types of side effects that you may experience depend on the dosage, duration, or invasiveness of your therapy or procedure. Your health care team can give you medicines and suggest other ways to help with these problems, which usually go away when treatment ends.
Gastrectomy
Gastrectomy, the removal of part or all of the stomach, is the main surgery for stomach cancer.
Total Gastrectomy
A surgeon removes the entire stomach, nearby lymph nodes, parts of the esophagus and small intestine, and other tissues near the tumor. Rarely, the spleen may also be removed. The surgeon then connects the esophagus directly to the small intestine.
Partial Gastrectomy
A surgeon removes the lower part of the stomach with the cancer. The surgeon then attaches the remaining part of the stomach to the intestine. Nearby lymph nodes and other tissues may also be removed.
Gastrojejunostomy
Gastrojejunostomy removes cancer that is blocking the opening of your small intestine, which is called the duodenum. Your doctor then connects your stomach directly to the middle part of your small intestine, which is called the jejunum. After this procedure, food and medicine will pass directly from the stomach into the small intestine.
Chemotherapy
Most people with gastric cancer receive chemotherapy, which uses drugs to kill cancer cells. Chemotherapy for stomach cancer is usually systemic. This means that it kills both cancerous and non-cancerous cells.
Chemotherapy may be given before or after surgery. After surgery, radiation therapy may be given along with chemotherapy. Chemotherapy may be administered in an outpatient hospital setting, at the doctor’s office, or at home, while some individuals may require hospital stays during treatment.
Radiation
Radiation therapy (also called radiotherapy) administers high-energy rays to kill cancer cells.
Unlike chemotherapy, radiation targets localized cells, meaning it only kills cells in the specific part of the body that has cancer. In gastric cancer treatment, radiation therapy is often given alongside chemotherapy. Radiation therapy is administered in a hospital or clinic, typically about five days a week over the span of several weeks.
Immunotherapy
Immunotherapy treatments help the immune system recognize cancer cells and destroy them.
One approach commonly used in gastric cancer involves inhibiting “checkpoints”, which are proteins that help cancer cells hide from the immune system.
Currently, the two main immune checkpoint inhibitor therapies for gastric cancer are nivolumab and pembrolizumab. There are several other immunotherapy treatments in clinical trials for gastric cancer, including personalized cell-based therapies made from patients’ own immune cells.
Targeted Therapies
Targeted therapies are drugs that destroy cancer cells by selectively attacking specific genetic mutations or other abnormalities in tumors.
Recent advances in biomarker testing allow for the increased use of targeted therapies, as doctors are able to tailor treatment plans to a patient’s specific type of cancer molecules.
To learn more about targeted therapies in gastric cancer, visit our Biomarkers and Gastric Cancer page.
Laser Therapy
Laser therapy may be done when your cancer blocks the passage into or out of the stomach. A laser is a concentrated beam of intense light that kills tissue with heat. The doctor uses an endoscope to place the laser in your digestive tract. The laser destroys the cancer cells blocking the digestive tract.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
Hyperthermic intraperitoneal chemotherapy (HIPEC), is under study for stomach cancer treatment and may be available at certain centers. After surgery to remove as much cancer as possible, a warmed chemotherapy drug is injected directly into the peritoneal cavity for about 2 hours through a thin tube. The surgeon then drains and rinses the abdomen before closing the incision.
Endoscopic Mucosal Resection
Endoscopic mucosal resection uses an endoscope to remove stage 0 cancer from the lining of the digestive tract. These abnormal cells are not actually cancer but may become cancer and spread into nearby normal tissue.
Stent Placement
Stent placement may be done if your cancer blocks the passage into or out of the stomach. Your doctor uses an endoscope to place a stent (a tube made of metal mesh or plastic) in your intestine. It can be placed either from the esophagus to the stomach, or the stomach to the small intestine. Food and liquid can then pass through the center of the tube.
Our clinical trial finder tool helps match you with appropriate trials in your area.
Why are clinical trials important in gastric cancer treatment?
Clinical trials are rigorous research studies that assess innovative treatments by comparing them to established approaches for various medical conditions, including cancer. These studies may involve new drugs, treatment combinations, or alternative administration methods, and are a necessary part of paving the way for improved patient care.
For many patients, participation in clinical trials can offer a chance to benefit from new treatments that cannot be obtained elsewhere.
Learn more about ongoing clinical trials and participant eligibility on our Clinical Trial Finder page.
We acknowledge the following references for portions of the preceding content. Our use of information does not express endorsement of any organization or product.
NIH National Cancer Institute
American Cancer Society
GI Cancer Chronicles (Astellas)
Mayo Clinic
Test Your Biomarkers
