Stomach Cancer Treatments
Our treatment approach involves:
- An initial consultation with a specially-trained gastric surgeon who will lead your treatment strategy
- Input from experts in various subspecialties at every stage of your treatment
- Nutritional support throughout your treatment — including before and after surgery, during radiation or chemotherapy, and after treatment
- Palliative care and pain management
Stomach (Gastric) cancer treatment options
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:
- Robotic surgery for highly precise surgery with smaller incisions, less pain and quicker recovery time
- Endoscopic mucosal resection, an advanced minimally invasive endoscopic procedure that is used to treat early gastric cancers with smaller lesions
- Endoscopic submucosal dissection, a newer technique that can remove larger lesions at one time when compared with EMR
- Precision medicine approaches for late-stage disease, designed to provide treatment tailored to individual patients’ cancers
- Clinical trials that are finding new drug therapies and combinations to treat advanced cases
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. 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.
A focus on minimally invasive techniques
City of Hope surgeons are experts at using minimally invasive techniques (especially robotic surgery) for complex abdominal operations, offering several advantages, including:
- Less blood loss during surgery
- Fewer transfusion requirements
- Less pain after surgery
- Shorter postoperative recovery
- Earlier return of bowel function
- Earlier discharge after surgery
Types of gastric surgery
- Subtotal or partial gastrectomy removes the section of stomach that has cancer and nearby lymph nodes — and in some cases the spleen
- Total gastrectomy removes the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine and other involved areas
- D2 lymphadenectomy is a technically challenging procedure performed during gastric cancer surgery to remove more cancerous lymph nodes.
Other surgical options
If a tumor is blocking the stomach, preventing the cancerous area from being removed completely using standard surgery, other options exist:
- Endoluminal stent placement involves inserting an expandable tube into passages that need opening. To reopen a stomach area being blocked by a tumor, stents may be placed between the stomach and esophagus, or the stomach and small intestine.
- Endoluminal laser therapy is a procedure in which a laser, attached to a tube, is inserted into the body and used as a knife.
- Gastrojejunostomy is surgery that involves removing a section of the stomach that is blocking the opening of the small intestine. The surgeon then creates a new path for food from the stomach to the small intestine by connecting a part of the small intestine called the jejunum to the stomach.
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:
- External beam radiation therapy, where radiation from outside the body is directed at tumors
- Intensity modulated radiation therapy and image-guided radiation therapy, ways of directing radiation directly at a tumor while protecting normal tissue around it
- Four-dimensional CT scanning to more accurately target cancer cells to reduce side effects
- Advanced PET/CT scanning (positron emission tomography/computed tomography), high-resolution imaging that helps to positively and clearly define tumors that, using other scanning techniques, might otherwise be missed
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.