Getting treated for stomach cancer at City of Hope means your care is in the hands of world experts in robotic and minimally invasive surgery and precision medicine.
It means comprehensive, multidisciplinary care from physicians offering the newest and best treatments for both early and late stage disease.
And our commitment to high quality, personalized care means we place your concerns and quality of life at the center of your treatment.
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City of Hope’s world renowned stomach cancer care team uses the latest technology and innovation to treat cancer while providing compassionate care. Call 800-826-HOPE or request an appointment online.
City of Hope is internationally-recognized for its research and breakthrough treatments, has been named one of America’s top cancer hospitals by U.S. News & World Report for over a decade and is a National Cancer Institute-designated comprehensive cancer center.
We are one of only a few high-volume centers for gastric surgery in the country and our patients have access to some of the most promising new therapies as part of our clinical trials program.
City of Hope’s team of surgeons, gastroenterologists, medical oncologists, nurses, radiologists, and genetic and nutritional counselors work together closely at all stages to provide seamless, coordinated care. We balance that approach with personalized medicine — not just when it comes to your cancer, but the kind that makes you feel supported throughout your treatment.
When we care for you at City of Hope, we are not just focused on leading-edge care and innovation — we are working to make you whole again.
Stomach (Gastric) Cancer
Gastrointestinal stromal tumors of the stomach
Neuroendocrine tumors of the stomach
Other less common types of stomach cancer
Noncancerous tumors of the stomach
January 24, 2014
Providing the best available treatment options for every one of my gastric cancer patients – and offering hope, whether it is with curative surgery or combination of therapies — I find that to be the most enriching part of my day. Yanghee Woo, M.D., surgeon
Stomach cancer — also called gastric cancer — is a rare disease in the United States, however it is a leading cause of cancer death worldwide. Nearly 1 million patients worldwide will be diagnosed with stomach cancer this year. About 26,000 of those cases will be diagnosed in the United States, according to the American Cancer Society.
The two types of gastric adenocarcinoma include:
The stomach is a large pouch – shaped like a “J” – that connects the esophagus to the intestines, and is where the food you eat is partially digested before being passed through to the small intestine. It expands and contracts and has the capacity to hold a large volume of food and fluids.
Stomach cancer develops when cancer-causing substances from foods come into contact with the layers lining the stomach, or when a condition that causes inflammation (an abnormally sustained immune response) changes the character of the stomach lining.
The stomach lining has five main layers:
Layers of tissue inside the stomach form what is called the wall. The innermost layer of that wall, called the mucosa, is where stomach cancer usually starts. Abnormal cells in the mucosa may grow uncontrollably, joining together to form a growth called a tumor.
It is difficult to pinpoint exactly how stomach cancer starts, but there a few conditions that may lead to this disease:
Stomach cancer stages depend on which structures are involved:
In early stage gastric cancer, the tumor cells are contained within the inner layers of the stomach. As the cancer progresses, it grows deeper into the stomach wall, begins to drain into surrounding lymph nodes and eventually spreads to distant sites such as the omentum, peritoneum, liver, lung and brain. The risk of regional and distant spread of the cancer increases over time — and with the depth of tumor invasion through the stomach wall layers.
Things that put you at higher risk for getting stomach cancer are called risk factors. Since the main role the stomach plays in the body is digesting food, an important risk for developing this type of cancer is related to what you eat. Other things like genetics, age and whether you smoke also play a role. Some major risk factors for getting stomach cancer include:
Other risk factors:
Stomach cancer prevention (H3 header)
Quitting smoking, maintaining a healthy weight and avoiding smoked, pickled, preserved and salted foods may lower your risk. Eating a diet rich in fruits and vegetables may also reduce risk and, as with many cancers, being physically active and avoiding processed foods and meats helps.
Studies are ongoing to find out if things like antibiotic treatment and eating an antioxidant-rich diet could thwart one of the biggest risks for stomach cancer: H. pylori.
During early stages, stomach cancer may not cause any symptoms, or they may not be specific — like indigestion or stomach discomfort that does not go away. Since these symptoms mimic other, less serious conditions, many people may dismiss them.
Symptoms may be different during later stages and can affect other parts of the body — like the liver, lungs and bones. Stomach cancer that is advanced may block the stomach or intestines. Later symptoms may include:
Other medical conditions, like peptic ulcers and gastritis, share these symptoms. If you are treated for these conditions and symptoms like bloating, heartburn or indigestion do not go away, you may need further consultation to rule out stomach cancer.
At the end of the day, I really feel like I made a difference — I really made an impact in someone’s life. James Lin, M.D., gastroenterologist
Screening involves looking for cancer before you have symptoms and increases your chances of catching it at an early stage, when it is more likely to be treated and cured. In the United States, low rates of stomach cancer mean there is no practical reason for early screening but studies in other countries like Japan — where this type of cancer is more common — show that screening programs in high-risk groups successfully find disease when it is more treatable. Screening is most appropriate in groups of people known to have a high risk of stomach cancer.
City of Hope physicians are committed to finding and treating stomach cancer in its earliest stages. If you are concerned about persistent and troubling gastrointestinal symptoms — or you have a family history or genetic risk of stomach cancer — you may require a consultation.
Inheriting certain genetic diseases puts you at risk of getting stomach cancer and being diagnosed earlier in life. Inherited conditions that influence your risk include:
Although hereditary factors account for a small percentage of stomach cancers, your chances of having one of these conditions is higher if close family members, like siblings or parents, have been diagnosed.
City of Hope’s Division of Clinical Cancer Genetics offers genetic counseling and screening that can identify whether inherited conditions influence your risk — and guide you to the best treatments.
Stomach cancer is a complex disease that is challenging to accurately diagnose and stage. City of Hope’s team of internationally trained gastric specialists use their clinical expertise and leading-edge technology to provide you with the most accurate diagnosis — and the most effective treatment.
If cancer is suspected we may perform other tests to better visualize the cancer and determine if it has spread:
A PET CT scan is a procedure in which a positron emission tomography scan and computed tomography scan are done at the same time. It involves injecting radioactive glucose and seeing where in the body it is used most, since malignant tumors need more glucose than normal cells.
City of Hope’s approach to treating stomach cancer starts with a coordinated, multidisciplinary care team whose main goals are helping you live a long, healthy, cancer-free life. We combine leading-edge technologies — like minimally invasive, laparoscopic and robotic surgery — with the latest therapeutic and radiological advances. Our treatment approach involves:
For early stage gastric cancer, surgery alone is a common treatment option that involves removing the cancer and surrounding lymph nodes. For more advanced disease, your care team will discuss a plan that may involve a combination of treatments including surgery, chemotherapy and radiation. Treatments available to our patients include:
City of Hope is one of only a few dozen centers in the country that treat stomach cancer using a comprehensive approach — by a team whose sole focus is treating this type of cancer. Your care includes regular interaction and input from a team that includes surgeons, oncologists, gastroenterologists, radiologists and pathologists — along with nurses, social workers, nutritionists and specially trained support staff. And we provide nutritional counseling, physical therapy and spiritual support at all stages of treatment.
The goal of surgery for gastric cancer is long-term survival and maintaining the patient’s quality of life. To achieve these two goals, I use the most up to date and innovative surgical approaches tailored to each individual patient. Yanghee Woo, M.D. Surgical Oncologist
Surgery for stomach cancer depends on the stage at which the disease is diagnosed, how much of the stomach area is involved and whether cancer has spread to nearby lymph nodes or distant organs.
Properly treating stomach cancer involves removing either a portion or all of the stomach, along with the associated lymph nodes. Three surgical approaches to gastric cancer are:
For advanced stage gastric cancer, surgery can be challenging because of the need to remove the soft tissues surrounding the lymph nodes — and because of their proximity to blood vessels — which requires a highly specialized approach.
City of Hope gastric surgeons are internationally-recognized experts on removing stomach cancer using both conventional and advanced methods like D2 lymphadenectomy and the newest endoscopic procedures.
About 10 percent of gastric cancer operations in the United States are performed minimally invasively and less than 5 percent are performed robotically. Yet minimally invasive approaches to gastric cancer surgery have significant benefits for certain patients compared to an open approach.
City of Hope surgeons are experts at using minimally invasive techniques (especially robotic surgery) for complex abdominal operations, offering several advantages, including:
If a tumor is blocking the stomach, preventing the cancerous area from being removed completely using standard surgery, other options exist:
Chemotherapy is cancer treatment that uses drugs to either kill cancer cells or stop them from growing.
Exciting advances in chemotherapy at City of Hope are allowing patients with advanced disease to get drug combinations designed to shrink tumors, slow down disease progression and improve quality of life. And City of Hope is leading a study combining radiation therapy with chemotherapy to treat late-stage disease.
City of Hope uses the latest technology to spot genetic vulnerabilities in cancer cells and use medications — or combinations of medications — to stop them from growing. This allows us to create targeted therapies: drugs or drug combinations that would work best to treat specific cancers.
All Stage 4 gastric cancer patients at City of Hope have their tumors molecularly profiled, which means the genetic code of the patient’s specific type of cancer is dissected and used to determine the best, most individualized treatment course.
Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. City of Hope offers advanced radiation treatments that are highly targeted to cancer cells including:
Having part of your stomach removed is a life-changing event. Care at City of Hope includes counseling and nutritional education, support and palliative care from our staff — who are lifelong partners in your healing.
City of Hope’s renowned physicians and researchers utilize the latest in technology and innovation to treat cancer, coupled with our enduring belief in providing unparalleled compassionate care.
Getting treated for stomach cancer at City of Hope means you are steps away from labs where new treatments for cancer are being developed every day. That proximity means you benefit from something unique in cancer care — bench to bedside treatment. “Bench to bedside” means innovative research we are conducting in our labs is moved quickly to the bedside to treat our patients.
Cancers are able to survive and thrive because of genetic abnormalities that keep them from being detected and destroyed by the body’s immune system. Research is revealing the specific mutations (problems within the DNA in a cell) causing these abnormalities, and using that information to tailor therapies to specific patients’ tumor cells.
For example, with stomach cancer, recent advances have revealed ways that chromosomes in cells can rearrange — leading to inflammation, and eventually cancer. Other cellular problems may break down the stomach lining, allowing cancer to spread. Precision medicine techniques, such as those being used at City of Hope, are attempts to target those problems within cells, and disrupt the process that leads to cancer.
Stomach cancer is an extremely complex disease that can act many different ways in the body. Research at City of Hope — driven by patient-specific individualized treatment strategies — is focused on those differences, and on designing therapies that affect how stomach cancer develops, progresses and spreads. Click here to learn more about clinical research at City of Hope.
When you come to City of Hope, you have access to a strong network of support services and staff to help you and your family along your cancer journey. That support includes everything from talk therapy to meditation to being paired up with a patient navigator.