Treatment plans for stomach cancer may vary depending on the size, location, and stage of the disease, as well as the patient's overall health.
Surgery is a common treatment of all stages of stomach cancer. Types of surgery include:
- Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor. The spleen, an organ that filters blood and removes old blood cells, may be removed.
- Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen may be removed. The esophagus is connected to the small intestine so the patient can continue to eat and swallow.
- Endoluminal stent placement: For tumors blocking the passage into or out of the stomach, a stent is inserted to help open the lumen, or tunnel, to allow passage of liquids and foods. The stents are often placed in the passage from the esophagus to the stomach or from the stomach to the small intestine. This does not treat the cancer, but helps improve symptoms of a blockage from the cancer.
- Endoluminal laser therapy: A procedure in which an endoscope with a laser attached is inserted into the body to remove the cancer and other tissues.
- Gastrojejunostomy: Removal of the part of the stomach with cancer that is blocking the opening into the small intestine. The stomach is connected to the middle part of the intestine, called the jejunum.
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The type of radiation therapy used depends on the type and stage of the cancer.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Systemic chemotherapy, which is taken by mouth or injected into a vein or muscle, targets cancer cells throughout the body. Regional chemotherapy, which is placed directly into the affected organ, targets cancer cells in that specific area, or region, of the body. The type of chemotherapy used depends on the type and stage of the cancer.
Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both. Chemoradiation given after surgery, called adjuvant therapy, lowers the risk that cancer will return. Chemoradiation given before surgery, called neoadjuvant therapy, shrinks the tumor to make surgery safer and more effective.
Monoclonal antibody therapy is a type of targeted therapy that attacks specific cancer cells. Monoclonal antibodies are given by infusion.