Table of Contents
- Overview
- Surgery
- Chemotherapy
- Radiation Therapy
- Targeted Therapy
- Immunotherapy
- Clinical Trials
There are several effective treatments for stomach (gastric) cancer. The RMCC oncologists will review your diagnosis, including the cancer type, stage, and any biomarker findings, and build a plan tailored to you. In many cases, treatment includes more than one approach, given in a specific order to provide the best chance of controlling the cancer and supporting quality of life.
Surgery for Resectable Stomach Cancer
Surgery to completely remove the tumor can be part of the treatment process, especially if it’s early-stage stomach cancer. Surgery can also be used for later-stage cancer to relieve symptoms. The surgical approach depends on the stage and location of the cancer. You will consult with a gastric surgeon who will discuss their recommendations with you and with our oncologists.
Endoscopic Resection
For very early-stage stomach cancers, the tumor and some layers of the stomach wall may be removed using an endoscope passed through the throat rather than an incision. This can include techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), when appropriate.
Gastrectomy
A gastrectomy removes part or all of the stomach. A subtotal (partial) gastrectomy removes the portion of the stomach that contains the cancer, along with nearby lymph nodes and, in some cases, nearby tissues. A total gastrectomy removes the entire stomach, nearby lymph nodes, and may include nearby portions of the esophagus or small intestine; the digestive tract is then reconstructed so swallowing and digestion can continue.)
Palliative Surgery for Unresectable Stomach Cancer
When stomach cancer cannot be completely removed, surgical procedures may still be recommended to reduce symptoms and help you maintain nutrition. Depending on the situation, this can include bypass procedures that help food pass into the small intestine, placement of a feeding tube to support nutrition, or endoscopic approaches such as tumor ablation or stent placement to relieve blockages.
Chemotherapy for Stomach Cancer
Chemotherapy is often included in a personalized stomach cancer treatment plan. If surgery is an option, chemotherapy is typically given before and after the procedure to help shrink the tumor and reduce the risk of the cancer returning. When surgery is first, chemotherapy may follow to target any remaining cancer cells that cannot be seen.
In some cases, chemotherapy is combined with radiation therapy after surgery, especially if the cancer cannot be fully removed or if lymph node involvement is a concern.
For cancers that cannot be removed with surgery, chemotherapy may be used first to try to shrink the tumor, sometimes making surgery possible later. If the cancer has spread to other parts of the body, chemotherapy can help slow its growth, ease symptoms, and support quality of life.
The specific combination of chemotherapy drugs varies based on whether it’s early-stage or advanced-stage stomach cancer.
Radiation Therapy
Radiation therapy uses high-energy beams to treat cancer in a specific area. It may be given with chemotherapy before surgery to shrink the cancer, after surgery to treat any remaining cancer cells (often called chemoradiation), or to help control symptoms such as pain, bleeding, or difficulty eating when surgery is not an option.
Targeted Therapy for Stomach Cancer
If a genetic mutation is identified through biomarker tests, specific targeted therapy drugs can be used to slow cancer cell growth.
HER2-positive cancers have excessive HER2 protein expression. This mutation can be treated with drugs like trastuzumab, often combined with chemotherapy, or other HER2-targeted therapies if the cancer continues to grow.
Other targeted therapy treatments focus on blocking the cancer’s blood supply, which helps slow tumor growth. In some cases, tumors may have high levels of a protein called CLDN18.2, which can be treated with a targeted therapy along with chemotherapy. A small number of stomach cancers also have NTRK gene changes, which can be treated with targeted oral medications known as TRK inhibitors.
Immunotherapy for Stomach Cancer
Immunotherapy helps the immune system recognize and attack cancer cells. PD-1 and PD-L1 inhibitors block these proteins from binding which turns on the immune system’s ability to identify cancer cells. Immunotherapy is usually used in combination with chemotherapy and sometimes with targeted therapy.
Stomach Cancer Clinical Trials in Colorado
As part of RMCC’s commitment to bringing the most advanced treatments for stomach cancer to our patients, we participate in clinical research trials through the Sarah Cannon Research Institute. Our team will discuss whether a clinical trial is a good fit for your diagnosis, based on prior treatments and biomarker results.
Caring for Your Nutritional Needs During Stomach Cancer Treatment
Stomach cancer and its treatments can make it harder to eat, tolerate meals, and maintain weight, but nutrition is an important part of treatment and recovery. RMCC’s supportive care program provides oncology nutrition services to help patients manage side effects, maintain strength, and improve day-to-day well-being during treatment. In some cases, temporary nutrition support (including IV nutrition) may be discussed if you are unable to meet your needs by mouth.
