The primary treatment options for stomach cancer include surgery, chemotherapy and radiation therapy. The type of treatment you receive will depend on a number of different considerations, such as the type of stomach cancer you have, its stage, your overall health and your treatment preferences. This page aims to give you a comprehensive overview of how stomach cancer treatment works.
Stomach Cancer
Understanding treatment for stomach cancer and how it is delivered
Last modified: January 31, 2022
Surgery for stomach cancerSurgery
Most people with stomach cancer will receive surgery at some point in their treatment, with the goal of keeping as much healthy tissue as possible while ensuring that all of the cancer has been removed.
There are a number of surgeries you may receive depending on the size and stage of your cancer and its location within the stomach.
Endoscopic resection
This procedure involves an endoscope which is passed down the throat and into the stomach to remove small cancerous tumours and layers of the stomach wall. This is a treatment option for very early-stage stomach cancer which has not grown deeply into the stomach wall.
Subtotal or partial gastrectomy
For people with cancer confined to a small section of the stomach, this surgery involves the removal of part of the stomach alongside the omentum and nearby lymph nodes. If the cancer has spread outside of the stomach to nearby organs, parts of these may also need to be removed. This surgical procedure has a much smaller impact on normal eating habits compared to removal of the entire stomach.
Robotic-assisted prostatectomy
This surgery is performed if the cancer has spread extensively within the stomach. It involves the removal of the entire stomach, the omentum and nearby lymph nodes, in addition to any other affected parts of organs such as the spleen, oesophagus or intestine. The oesophagus is then connected to the small intestine. People who receive a total gastrectomy will no longer be able to eat large amounts of food and may experience side effects from eating too quickly.
Lymphadenectomy
This involves the removal of any nearby lymph nodes that have been affected by cancer.
Open gastrectomy or laparotomy
A long incision is made through the skin and abdominal wall to access your stomach and other internal organs.
Laparoscopic gastrectomy
A minimally invasive procedure that uses several small incisions to access the stomach. Laparoscopic procedures result in less postoperative pain and complications, shorter hospital stay and faster recovery compared to open gastrectomy.
Robotic-assisted gastrectomy
This procedure uses a robotic system to perform laparoscopic gastrectomy remotely, allowing greater precision in comparison to standard laparoscopic surgery.
Radiation therapy for stomach cancerRadiation therapy
Radiation therapy for stomach cancer can be used in a number of ways:
- As chemoradiation together with chemotherapy to help shrink the size of the stomach cancer cells before surgery
- After surgery to help destroy any remaining stomach cancer cells and prevent them from spreading and growing elsewhere
- To help relieve symptoms such as pain for advanced or metastatic stomach cancer
External beam radiation therapy
Stomach cancer patients who have radiation therapy will usually receive external beam radiation therapy (EBRT). External beam radiation therapy is used to treat stomach cancer by delivering highly targeted radiation therapy beams to the stomach and other areas where cancerous cells have been detected.
Intensity modulated radiation therapy
The most common type of EBRT treatment for stomach cancer is the intensity modulated radiation therapy (IMRT). This is a radiation therapy technique that uses 3D mapped images of the stomach cancer to deliver high dose radiation while limiting the impact on surrounding healthy tissue.
Chemotherapy for stomach cancerChemotherapy
Chemotherapy uses a range of drugs to kill and slow the growth of stomach cancer cells. Stomach cancer patients can receive chemotherapy alone, alongside radiation therapy (a treatment method known as chemoradiation) or after surgery (adjuvant chemotherapy). While chemotherapy can be delivered in a number of different ways, it is most common for stomach cancer patients to be given chemotherapy intravenously. When you are treated with chemoradiation, your radiation therapy will begin on the same day as your first chemotherapy treatment.
Learn more about chemotherapy and how it is delivered.
Chemotherapy treatment for stomach cancer takes place over several sessions, known as a cycle. Your care team will walk you through how many cycles you may need for your course of treatment, with most people completing chemotherapy in a period of three to six months.
Targeted therapies for stomach cancer Targeted therapies
Targeted therapies use specialised drugs to destroy specific proteins in stomach cancer cells.
Learn more about targeted therapies and how it is delivered.
When you are diagnosed with stomach cancer, your oncologist will develop your treatment plan as part of a multidisciplinary team based on the stage of your cancer.
Common treatment options for each stage of stomach cancer include:
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Stage 0 (early-stage) stomach cancer
If the cancer has not grown deeply into the stomach wall, surgery by endoscopic resection will usually be recommended to remove the cancer and any affected lymph nodes. You may receive chemotherapy and radiation before surgery to help shrink the tumour or after surgery to destroy any remaining cancer cells.
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Stage I stomach cancer
Depending on the size and location of your cancer, you may receive surgery to remove the cancer from within your stomach. If surgery isn’t a suitable option or possible based on other health reasons, you may receive different treatments such as chemotherapy alone, chemotherapy and radiation therapy or chemotherapy and targeted therapy.
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Stage II stomach cancer
In stage II stomach cancer, surgery is a common treatment option to remove cancerous cells within the stomach and any affected lymph nodes. You may have radiation therapy and/or chemotherapy before surgery to help shrink the cancer cells or after surgery to help destroy any remaining cancer cells and prevent the cancer from returning in the future.
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Stage III stomach cancer
At this stage, surgery is usually performed to remove cancerous cells and affected lymph nodes where possible. You may have radiation therapy treatment before your surgery (neoadjuvant radiation therapy) to help to shrink the cancer cells. Your treatment may also include chemotherapy alone, chemotherapy and radiation therapy or chemotherapy and targeted therapy.
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Stage IV (advanced) stomach cancer
If the cancer has spread to other areas of the body, the goal of treatment is to control the growth and spread of your cancer and to relieve any symptoms it may be causing. You may receive chemotherapy or chemotherapy alongside a targeted therapy. Radiation therapy may be used to help stop the spread of cancer and to relieve symptoms such as pain, bleeding and difficulty swallowing.
ReferencesReferences
For a full list of references, click here.
- Cancer Council NSW. (2021). Radiation therapy for stomach cancer. Last retrieved 13 December 2021 from https://www.cancercouncil.com.au/stomach-cancer/treatment/radiotherapy/
- American Cancer Society (2021). Radiation Therapy for Stomach Cancer. Last retrieved 11 December 2021 from https://www.cancer.org/cancer/stomach-cancer/treating/radiation-therapy.html
- Stomach Cancer: A Guide for Patients. Last retrieved 13 December 2021 from https://www.esmo.org/for-patients/patient-guides/stomach-cancer
- eviQ (2019) Medical Oncology. Upper gastrointestinal: Gastric and oesophageal cancer. Last retrieved 13 December 2021 from https://www.eviq.org.au/medical-oncology/upper-gastrointestinal/gastric-and-oesophageal
- American Cancer Society. (2021) Stomach Cancer. Treatment Choices Based on the Extent of Stomach Cancer. Last retrieved 13 December 2021 from https://www.cancer.org/cancer/stomach-cancer/treating/by-stage.html
- Cancer Council Victoria. Stomach and Oesophageal Cancer. Treatment for Stomach Cancer. Last retrieved 13 December 2021 from https://www.cancervic.org.au/cancer-information/types-of-cancer/stomach_and_oesophageal_cancer/treatment_for_stomach.html
- Yoon, Harry H. MD, MHS. Progressive, locally advanced unresectable, and metastatic esophageal and gastric cancer: Approach to later lines of systemic therapy. UpToDate (Nov 2021) Retrieved Jan 20, 2922 from https://www.uptodate.com/contents/progressive-locally-advanced-unresectable-and-metastatic-esophageal-and-gastric-cancer-approach-to-later-lines-of-systemic-therapy
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