This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on May 23, 2022.
Surgery is the primary treatment for stomach cancer, also known as gastric cancer. The care team may also recommend radiation therapy, chemotherapy or targeted therapy. Immunotherapy may be an option for some patients with advanced disease.
After a patient is diagnosed with stomach cancer, a multidisciplinary team of stomach cancer experts will answer his or her questions and recommend treatment options based on his or her unique diagnosis.
Surgery is a first-line treatment for stomach cancer. Surgery may also be necessary if the stomach cancer has spread to other parts of the body. The care team may consider several types of surgery to treat stomach cancer, based on the patient's specific stomach cancer type.
Gastrectomy, a minimally invasive alternative to open surgery, is designed to reduce side effects and recovery time.
Two types of gastrectomies may be performed:
For patients with small, early-stage stomach cancer that hasn't spread outside the mucosal membrane (the stomach lining), the care team may suggest an endoscopic mucosal resection. During this procedure, the surgeon removes the tumor, which is then sent to a pathologist for further analysis.
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.
A liver resection may be required if the stomach cancer metastasizes, or spreads, to the liver. These procedures may be performed as a traditional, open surgical procedure or as a less invasive, laparoscopic procedure.
Radiation therapy 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 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 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-positive breast cancer, may be used in combination with chemotherapy for stomach cancer. In some cases, this form of targeted therapy may be used alone.
The care team may recommend chemotherapy during different stages of stomach cancer treatment:
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.