Treatment options for stomach cancer
A team of health professionals will discuss the best treatment for you. This depends on factors such as your cancer stage and grade. You might have one or more treatments. These include surgery, chemotherapy, targeted and immunotherapy cancer drugs and radiotherapy.
Deciding what treatment you need
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).
Most people are referred to a specialist MDT. You might go to a different hospital if there isn't a specialist MDT at your local hospital.
The team usually includes:
- a specialist surgeon
- cancer specialists (oncologists) who treat cancer with cancer drugs (medical oncologist) and radiotherapy (clinical oncologist)
- a specialist cancer nurse (also called a clinical nurse specialist)
- a pathologist who examines any cancer or tissue the surgeon removes
- a radiologist who looks at your scans and x-rays
- an endoscopist who looks inside your food pipe and stomach using a flexible tube
- a dietitian who offers support and advice about eating and drinking
- a palliative care doctor who specialises in controlling cancer symptoms
Your treatment depends on:
- where the cancer is in your stomach
- how far it has grown or spread (the stage)
- the type of cancer
- how abnormal the cells look under a microscope (the grade)
- whether the cancer has spread to another part of the body (this spread is also called secondary cancer)
- your general health and level of fitness
The MDT will discuss your treatment, its benefits and possible side effects with you. This is a good time to ask any questions you might have. You then sign a consent form.
Treatment overview
The main treatments are:
- surgery
- chemotherapy
- targeted or immunotherapy cancer drugs
- radiotherapy
You might have one or more of these treatments depending on the stage of your cancer. You may have other treatments, such as a stent, to control symptoms.
Surgery
You might have surgery if your stomach cancer hasn't spread. Doctors remove:
- cancer from the lining of the stomach (endoscopic mucosal resection or endoscopic submucosal dissection)
- all or part of your stomach (a partial or total gastrectomy)
You may have surgery with other treatments, such as chemotherapy. And some people have surgery to relieve the symptoms of advanced cancer.
Chemotherapy
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream.
You might have chemotherapy before and after surgery. Or you might have chemotherapy as your main treatment if your cancer has spread and you can't have surgery.
Chemotherapy for advanced cancer can relieve symptoms. It can also control the cancer and improve your quality of life for a time.
Radiotherapy
Radiotherapy uses high energy rays to destroy cancer cells.
You might have radiotherapy combined with chemotherapy (chemoradiotherapy). Or you might have radiotherapy to control the symptoms of advanced cancer.
Targeted and immunotherapy cancer drugs
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. These are called immunotherapy.
You might have targeted or immunotherapy cancer drugs as part of your treatment for advanced stomach cancer.
Other treatments to relieve symptoms
The cancer might block the entrance to your stomach or bowel. This can cause pain, sickness and make you feel very unwell.
Your doctor might recommend:
- a tube called a stent that goes into your stomach to allow food to pass through
- laser therapy which uses hot beams of light to burn away cancer cells causing the blockage
Clinical trials to improve treatment
Your doctor may ask if you’d like to take part in a clinical trial.
Doctors and researchers do trials to:
- improve treatment
- reduce the side effects of treatment
- develop new treatments
Treatment by stage
High grade dysplasia
The main treatment is endoscopic surgery to remove the lining of your stomach. You have the abnormal areas in the lining of your stomach removed through a tube called an endoscope. You might have an endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD).
Stage 1
Surgery is the main treatment.
You might have surgery to remove all or part of the stomach. If your cancer is stage 1B, you might have chemotherapy before and after surgery.
For very small, early stage cancers you may have endoscopic surgery. You don't usually need any other treatment.
Stage 2 and 3
You usually have surgery to remove all or a part of your stomach. And have chemotherapy before and after surgery.
If you haven't had chemotherapy before surgery, you might have:
- chemotherapy combined with radiotherapy (chemoradiotherapy) after surgery
- chemotherapy on its own after surgery
Your doctor will discuss your options with you.
Stage 4
Treatment aims to control the cancer and maintain a good quality of life. You might have:
- chemotherapy
- radiotherapy
- symptom control, for example treatment to help you swallow food
- targeted or immunotherapy cancer drugs
Getting a second opinion
Some people like to get an opinion from a second doctor. This is before they decide on their treatment. Most doctors are happy to refer you to another NHS specialist if you would find this helpful.
