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Stomach cancer

Stomach cancer treatment options

Surgery is the primary treatment for stomach cancer. Our stomach cancer program also offers radiation therapy, chemotherapy and target therapy. Immunotherapy may be an option for some patients with advanced disease. Your multidisciplinary team of stomach cancer experts will answer your questions and recommend treatment options based on your unique diagnosis. Treatment options for stomach cancer include:

Surgery

This is a first-line treatment for stomach cancer, also known as gastric cancer. Surgery may also be necessary if the stomach cancer has spread to other parts of the body. Types of surgery used to treat stomach cancer include:

Gastrectomy may be required to treat stomach cancer. At Cancer Treatment Centers of America® (CTCA), many gastrectomies may be performed with robotic surgery using the da Vinci® Surgical System. This minimally invasive alternative to open surgery is designed to reduce side effects and recovery time. Two types of gastrectomies may be performed:

  • Subtotal gastrectomy, also called a partial gastrectomy, is surgery to remove the cancerous portion of the stomach. In most cases, this surgery is performed if the cancer is in the lower portion of the stomach, near the intestines.
  • Total gastrectomy removes the entire stomach.

Hyperthermic intraperitoneal chemotherapy (HIPEC) uses highly concentrated, heated chemotherapy drugs that are delivered directly to the abdomen during surgery. HIPEC may be helpful for stomach cancer patients with abdominal tumors that have not spread to organs such as the liver or lungs, or to lymph nodes outside the abdominal cavity.

Liver resection may be required if the stomach cancer metastasizes to the liver. These procedures may be performed as a traditional, open surgical procedure or as a less invasive, laparoscopic procedure.

Radiation therapy

Radiation approaches may be used to treat adenocarcinoma of the stomach or lymphoma of the stomach. Radiation therapy may help destroy cancer cells that remain after stomach cancer surgery, alleviate pain and stop bleeding or shrink tumors that may be blocking the digestive tract. Radiation therapies used to treat stomach cancer include:

Intensity modulated radiation therapy (IMRT) allows a radiation oncologist to use higher radiation doses than traditional therapies. IMRT may also help spare more of the surrounding healthy stomach tissue from harmful doses of radiation.

Trilogy® allows a radiation oncologist to deliver controlled doses of radiation to stomach tumors with increased accuracy. The technology’s real-time imaging allows a radiation therapist to monitor stomach tumor motion during treatment.

TomoTherapy® combines IMRT and CT scan technology and is designed to deliver precise radiation to match tumor shapes while avoiding sensitive healthy tissue. TomoTherapy targets hard-to-reach stomach tumors by sculpting small, powerful and more precise radiation beams at the tumors from a full 360 degrees.

Interventional radiology may be a treatment option for stomach cancer that has spread to the liver. These minimally invasive procedures allow doctors to deliver radiation or chemotherapy drugs in high doses directly into liver tumors.

Immunotherapy

Immunotherapy drugs called checkpoint inhibitors work by blocking signaling receptors that help cancer cells hide from immune cells. The U.S. Food and Drug Administration has approved a checkpoint inhibitor to treat some forms of advanced or metastatic adenocarcinomas in the stomach and the gastroesophageal junction, where the stomach meets the esophagus. Checkpoint inhibitors and other immunotherapy treatments may be used in combination with other treatments, such as surgery. Immunotherapy may not be recommended for all patients, and responses to the treatment vary widely.

Targeted therapy

Targeted therapy may be a treatment option for patients with advanced stomach cancer whose cancer cells test positive for human epidermal growth-factor receptor 2 (HER2). This means their stomach tumors have a type of gene that stimulates cells to grow and become cancerous. HER2-positive stomach cancers may be treated with a monoclonal antibody that targets the HER2 gene. This drug, often used to treat HER2-postive breast cancer, may be used in combination with chemotherapy for stomach cancer. In some cases, this form of targeted therapy may be used alone.

Gastroenterology

Gastroenterology procedures may be required to diagnose, stage or treat stomach cancer. These procedures include placing stents or inserting tubes and balloon dilation to relieve obstructions.