Stomach Cancer Treatment

At MD Anderson, we customize your stomach cancer treatment to ensure the highest chances for successful treatment while focusing on your quality of life. Our treatments include targeted therapy, immunotherapy, chemotherapy, advanced radiation therapy and state-of-the-art surgery.

A stomach cancer patient’s treatment plan often involves more than one type of therapy. A group of experts including oncologists, radiation oncologists and surgeons work together to determine the best treatment plan for you. This team approach – coupled with extraordinary skill and the latest technology – means you receive the best possible care with the least impact on your body.

Stomach cancer treatments

If you are diagnosed with stomach cancer, your doctor will discuss the best options to treat it. This will depend on several factors, including the type and stage of the cancer, the location of the tumor and your general health.

One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.

Stomach cancer surgery

Surgery is the most common treatment for stomach cancer. Sometimes surgery is performed to cure the cancer. However, in some cases of advanced stomach cancer, surgery may be performed to treat symptoms and not necessarily cure the disease. This is known as palliative surgery.

Surgical techniques for stomach cancer may include:

Endoscopic mucosal resection: A thin tube (an endoscope) equipped with surgical tools is inserted down the throat and into the stomach, allowing doctors to remove certain types of early, non-invasive stomach cancers.

Gastrectomy: The goal of a gastrectomy is to completely remove the stomach cancer and affected nearby lymph nodes (tissues that filter infection and disease) while preserving as much stomach function as possible. There are several types of gastrectomy including:

• Partial (wedge) gastrectomy: The cancerous part of the stomach is locally removed. This method is typically used to treat stomach cancers with low likelihood of lymph node spread.
• Subtotal (distal) gastrectomy: The cancerous part of the stomach, nearby lymph nodes and a margin of healthy tissue is removed. In some cases, parts of the esophagus or small intestine that are near the tumor may also be removed.
• Total gastrectomy: The entire stomach, nearby lymph nodes and sometimes the spleen, parts of the esophagus, intestines, pancreas and other organs where the cancer has spread, are removed. The esophagus is reconnected to the small intestine allowing patients to continue to eat and swallow.
• Robotic gastrectomy: Surgeons use surgical robots to perform a minimally-invasive gastrectomy through small abdominal incisions. Robotic gastrectomy can be used to perform partial, subtotal or total gastrectomy with minimized pain and quicker recovery.

Endoluminal stent placement: When a stomach cancer tumor is blocking the stomach but cannot be removed completely, an endoluminal stent placement may help a patient eat normally. A thin, expandable tube is placed between the stomach and esophagus or small intestine to keep the passageway open.

Many times, surgery is combined with chemotherapy and radiation. If all three therapies are needed, MD Anderson's standard approach is to give chemotherapy and radiation before surgery (neoadjuvant chemoradiation therapy). This helps kill cancer cells and shrink the stomach tumor before surgery, and it is often better tolerated and more successful. 

Stomach cancer surgery is delicate and challenging. Studies have shown that patients do better when their surgeons have a higher level of experience, and MD Anderson surgeons are among the most experienced in the country. MD Anderson's skilled surgeons use specialized procedures to treat stomach cancer while helping you retain as much of the stomach as possible. However, if surgical removal of part of all of the stomach is unavoidable, we have the skill and staff to help you adjust to life after surgery.

Life after stomach cancer surgery

Gastrectomy surgery may require you to change how you get nutrients. Some patients may have a feeding tube inserted directly into the small intestine; others may need to take vitamin supplements as pills or shots (injections). MD Anderson dieticians will support you in meeting your nutritional requirements after stomach cancer surgery.

Following stomach cancer surgery, you may need to eat smaller, more frequent meals and avoid sugar. Abdominal discomfort, lack of appetite and diarrhea may also occur; these are usually temporary.

Chemotherapy for stomach cancer

Chemotherapy works by killing fast-growing cells, including cancer cells.

At MD Anderson, chemotherapy for stomach cancer is often given before surgery to shrink the tumor. It can also be given after surgery to kill any remaining cancer cells that were not visible during the operation. Chemotherapy may also be used (often in conjunction with other therapies) to treat more advanced stomach cancer, especially if the cancer has spread to other parts of the body. MD Anderson offers the most advanced chemotherapy regimens with the fewest side effects.

These methods include:

• Intravenous (IV) chemotherapy: Chemotherapy drugs are inserted into a vein using a needle or catheter. This is the most common type of chemotherapy.
• Intraperitoneal (IP) chemotherapy: Chemotherapy drugs are inserted into the abdominal cavity using a port.
• Hyperthermic Intraperitoneal Chemotherapy (HIPEC): In this treatment, also known as hot chemotherapy, heated chemotherapy drugs are inserted into the abdominal cavity after the tumor is removed.

Radiation therapy for stomach cancer

Radiation therapy uses focused, high-energy beams to kill cancer cells.

We use the most precise methods of radiation therapy to target the stomach cancer while limiting damage to surrounding areas. These methods include:

• Intensity-modulated radiation therapy (IMRT): Treatment is tailored to the specific shape of the stomach, while avoiding other organs.
• Stereotactic body radiation therapy (SBRT): Very high doses of radiation are targeted at the tumor using beams. SBRT is typically used in cases when stomach cancer has spread to other sites.

Immunotherapy and targeted therapies for stomach cancer

Immunotherapy
Immunotherapy recruits the patient’s own immune system in the fight against cancer. For stomach cancer, patients may be given an immunotherapy known as a checkpoint inhibitor. Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated.

Targeted therapy
Targeted therapy works by stopping or slowing the growth or spread of cancer on a cellular level.

Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.

Genetic/molecular profiling 
This type of testing classifies cancerous tumors by their genetic makeup and can help your doctor identify specific immunotherapies, targeted therapies, or clinical trials that might best treat that specific cancer.

Stomach cancer clinical trials

Since MD Anderson is one of the nation’s leading research centers, we’re able to offer top-quality, innovative treatment including clinical trials (research studies) of new treatments for every type and stage of stomach cancer.