Stomach Cancer

Surgery is often the main treatment option for stomach cancer. For many patients, surgery is combined with chemotherapy and immunotherapy given before and after the operation. Whenever possible, we use small incisions and a small tube (laparoscope) with a camera on its end to see inside your abdomen while performing surgery. Surgery may allow us to remove the tumor or to accurately determine the stage of your cancer before nonsurgical treatment.

Some very early stomach cancers can be removed through an endoscope, without any incisions.

A partial gastrectomy surgically removes part of your stomach. A total gastrectomy removes your entire stomach. Nearby lymph nodes are always removed at the same time to check for cancer spread, and nearby organs may also be removed if the cancer has grown into them. If your entire stomach is removed, your esophagus is connected to your small intestine so that you can continue to eat. Our nutrition team will help you adjust to eating smaller, more frequent meals.

When a tumor creates a blockage, your doctor may insert an expanding metal scaffolding device, called a stent, through a small lighted endoscope, to open the blockage and relieve symptoms such as nausea and vomiting.

Our medical oncologists routinely combine the newest chemotherapy drugs, which kill or slow the growth of cancer cells, with standard drug regimens to achieve a better response, fewer side effects, and improved quality of life.

For cancers that can be removed, chemotherapy is typically given both before and after surgery to shrink the tumor and lower the chance it returns. For cancer that has spread to other organs, chemotherapy is usually combined with immunotherapy or targeted therapy based on your tumor’s test results.

For many patients whose cancer can be removed, immunotherapy is now given together with chemotherapy before and after surgery, followed by immunotherapy alone. Immunotherapy helps your immune system recognize and attack cancer. For advanced cancer, immunotherapy may be combined with chemotherapy, or occasionally given by itself, depending on the results of tests on your tumor.

Radiation uses focused high-energy beams to kill cancer cells. For stomach cancer, radiation is most often used to relieve symptoms such as bleeding or pain, or in select situations after surgery or when surgery isn’t an option. Your care team will discuss whether radiation is right for you.

Depending on your tumor’s test results (for example HER2, claudin 18.2, or PD-L1), your oncologist may combine targeted therapy, which attacks specific features of cancer cells, with immunotherapy and chemotherapy to help control advanced stomach cancer and help you live longer.