Stomach Cancer Chemotherapy

Chemotherapy for Stomach Cancer

Cancer Treatment Centers of America (CTCA) offers advanced medical treatments, hope and a unique approach to fighting stomach cancer. We aggressively fight the disease with chemotherapy, and oftentimes use it in conjunction with surgery and radiation treatment.

When Is Chemotherapy Used to Treat Stomach Cancer?

Chemotherapy is often a treatment for patients who have cancer that has grown through the wall of the stomach and spread to other parts of the body. Below are the stages of the disease commonly treated with chemotherapy:

• Stage IB stomach cancer
• Stage II stomach cancer
• Stage III stomach cancer
• Stage IV stomach cancer

Chemotherapy is the primary treatment for stomach cancer particularly when the disease has spread to lymph nodes that are far from the tumor and to the liver, lungs and/or bones.

Chemotherapy before/after stomach cancer surgery

In highly selective cases, chemotherapy may be given before the patient undergoes surgery. This is called neoadjuvant therapy. For example, if you have few cancerous lymph nodes and the disease has not spread to the liver or other organs, your medical oncologist may consider chemotherapy treatment prior to surgery. Neoadjuvant chemotherapy may help shrink the tumor. Radiation may also be used in combination with chemotherapy as a neoadjuvant therapy.

Chemotherapy treatment following stomach cancer surgery is known as adjuvant therapy. It may be used along with radiation treatment. Also known as chemoradiation, patients receive both forms of treatment within the same time period. Adjuvant therapy can help destroy stomach cancer cells that remain after surgery.

Treating recurrent stomach cancer

Because stomach cancer is often found in stage III or IV of the disease, recurrence is common. Treatments for recurrent disease tend to be the same as treatments for stage IV stomach cancer. If you have recurrent stomach cancer, your medical oncologist will consider several factors before making a treatment recommendation, including:

• What chemotherapy drugs did you receive in the past?
• How were those drugs delivered?
• How well did you respond to the chemotherapy treatment?
• Did you receive radiation treatment? If so, how did you respond to the radiation treatment?
• What is your nutritional status?

CTCA: Stomach Cancer Experts in Chemotherapy and Other Medications

At CTCA, our medical oncologists have significant experience treating patients who have advanced stage stomach cancer (i.e., stage III or stage IV stomach cancer). These doctors specialize in treating cancer with medications such as chemotherapy and targeted therapy.

When you come to a CTCA hospital, you’ll meet with the members of your core team of cancer experts. As a critical care provider on your team, your medical oncologist will thoroughly evaluate you and determine what diagnostic imaging or other tests you may need in order to properly diagnose and stage the disease.

Your medical oncologist will talk with you in detail about your stomach cancer diagnosis, and help you understand your treatment options. If he or she recommends chemotherapy, together you will decide on the chemotherapy regimen that’s most appropriate for you and map out your course of treatment.

Throughout your treatment, your medical oncologist will monitor the effects of the chemotherapy through diagnostic imaging tests such as CT and PET/CT scans. He or she will also employ blood tests that look for tumor markers CEA and CA 19-9, and other lab tests. If the disease is resisting treatment, or you are not tolerating it, your medical oncologist will recommend modifying your treatment regimen or using a different chemotherapy.

Your medical oncologist will work in partnership with the other doctors and clinicians on your care team to ensure you receive comprehensive, integrated care. For example, he or she will work closely with your dietitian and naturopath to see that you receive nutritional support to stay strong.

Chemotherapy Drugs & Innovative Chemotherapy Delivery Methods for Stomach Cancer

Stomach cancer chemotherapy drugs

Chemotherapy drugs we commonly use to treat stomach cancer include:

• Fluorouracil (5-FU)*
• Cisplatin
• Epirubicin
• Etoposide
• Irinotecan
• Capecitabine
• Docetaxel
• Oxaliplatin

* This is the most common chemotherapy drug used to treat stomach cancer.

Your medical oncologist will help you determine which chemotherapy drug, or combination of drugs, is most suitable for your specific type and stage of stomach cancer.

FOLFOX, a combination of leucovorin calcium, fluorouracil and oxaliplatin, may be an appropriate treatment option for esophageal-gastric junction tumors, a type of tumor that develops where the stomach and esophagus meet. These tumors are adenocarcinomas that act like cancer of the stomach.

Note: The chemotherapy information above is solely intended for educational purposes. It’s meant to help those fighting stomach cancer learn more about how the disease is treated.

Stomach cancer chemotherapy delivery methods

Intravenous (IV) infusion

Typically, chemotherapy for stomach cancer is administered through intravenous (IV) infusion. For this method of delivery, first a needle is inserted into a vein in your arm or hand. Then, a catheter (i.e., thin plastic tube) is inserted and the needle is removed. The chemotherapy flows through a tube attached to the catheter. The tube extends from an IV bag or bottle containing the medicine. The chemotherapy is slowly released into your bloodstream, traveling throughout your body.

CVC or PICC line infusion

So that you receive chemotherapy treatment without the repeated, painful poking and prodding of needle insertion, your medical oncologist may advise having minor surgery for a central venous catheter (CVC) or peripherally inserted central catheter (PICC) line. In these 30-minute procedures, a soft, plastic tube is implanted into a vein in your chest (CVC) or arm (PICC). The opening of the tube—the port—is just under your skin. Through the port, you’ll receive your chemotherapy and have your blood drawn.

Metronomic chemotherapy

To help minimize chemotherapy side effects, your medical oncologist may suggest metronomic chemotherapy. With this innovative way of administering chemotherapy, the treatment is delivered intravenously in smaller amounts over a prolonged period rather than in one large dose. The chemotherapy is given at frequent intervals to shrink the tumor. It does this by slowing or stopping the growth of the blood vessels that feed the tumor. Metronomic chemotherapy also aims to destroy cancer cells. This approach can make the treatment less toxic and easier to tolerate than traditional chemotherapy.

Regional chemotherapy

With regional (localized) chemotherapy, the treatment is delivered to a particular area of the body. In some cases, such as when cancer has spread (i.e., metastasized) to the liver, these treatments may be appropriate.

Below are advanced, regional chemotherapy treatments we offer at CTCA:

• Hyperthermic Intraperitoneal Chemoperfusion (HIPEC) (delivered to the abdomen)
• Intra-Arterial Chemotherapy (for cancer that has metastasized to the liver)
• Chemoembolization (also for cancer that has metastasized to the liver)

Preventing or Counteracting Side Effects of Stomach Cancer Chemotherapy

While there are a number of side effects of stomach cancer chemotherapy, medications and holistic therapies are available to help you manage or cope with the following:

• Loss of appetite
• Mouth sores
• Nausea
• Vomiting
• Diarrhea
• Fatigue
• Shortness of breath
• Neuropathy (i.e., numbness or tingling in the hands and/or feet)
• Hair loss

Your CTCA care team will strive to prevent as many of the toxic effects of chemotherapy as possible. For example, your medical oncologist will provide a combination of medications to help ease nausea and/or vomiting. Your naturopath can also recommend natural therapies to prevent or treat side effects such as mouth sores, diarrhea and neuropathy.

Next Topic: Tumor Molecular Profiling