Stomach Cancer Treatment - GO.CARE Blog
Stomach Cancer Treatment
Author: Hào Nghiêm
Review Date: August 5, 2018 | Last Modified: January 13, 2019
Stomach Cancer Treatment

Definition

1. What is Stomach Cancer Treatment?

Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.

Treatment of stomach cancer depends to a large degree on where the cancer started in the stomach and how far it has spread.

2. What is the purpose of Stomach Cancer Treatment?

For early stages, the purpose of stomach cancer treatment is to cure the disease. In advanced cases, when a cure is unlikely, the purpose is to reduce pain and restore some quality of life (called palliative treatment).

Candidates

1. When is Stomach Cancer Treatment needed?

Once you are diagnosed with with stomach cancer, it’s advisable to seek treatment as soon as possible.

2. Who are eligible for Stomach Cancer Treatment?

There are many treatment options for stomach cancer. Eligibility for each type depends on the type of cancer you have, your current stage, general health, whether the cancer has spread, and probably your preferences.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Cost

In the U.S., for patients without health insurance, stomach cancer treatment typically costs up to $50,000 or more for surgery and tens of thousands for chemotherapy and radiation. Costs can reach $200,000 or more, depending on the case. According to a study published in the Journal of Gastrointestinal Cancer Research, it costs about $20,100 to add chemoradiotherapy, a combination of chemotherapy and radiation, after surgery for localized gastric cancer.

Preparation

1. What should I do before Stomach Cancer Treatment?

Talk to your cancer care team about the things that worry you. Learn as much as you can about the cancer, your treatment plan, and how you might feel during treatment.

Here are some tips to help you get ready for treatment:

  • Stock your pantry and freezer with your favorite foods so you won’t need to shop as often. Include foods you know you can eat even when you’re sick.
  • Cook in advance, and freeze foods in meal-sized portions.
  • Talk to your friends or family members about ways they can help with shopping and cooking, or ask a friend or family member to take over those jobs for you. Be sure to tell them if there are certain foods or spices you have trouble eating.
  • Talk to your cancer care team about any concerns you have about eating. They can help you make diet changes to help manage side effects like constipation, weight loss, or nausea.

Preparation for stomach cancer surgery

If you smoke, it’s important to try to give up or cut down before your operation. This will help reduce the risk of problems such as getting a chest infection. It will also improve wound healing after the operation.

A dietitian will give you advice on eating well to help you to get ready for the operation. If you’ve had problems eating and have lost weight, you may need extra help and support with this.

Let the nurses know as soon as possible if you think you might need help when you go home after your operation. This may be because you live alone or are a carer for someone else. The staff can help you make arrangements in plenty of time.

2. What should I do after Stomach Cancer Treatment?

Immediately after surgery

You can’t eat or drink and will take fluids through a drip. When you can drink again, start with sips of water. This is usually within 24 to 48 hours.

You’ll gradually build up what you can drink and eat. Most people are able to eat small amounts within a week or so. Some people need a feeding tube to help them maintain their nutrition. It can go into the small bowel or into a vein (a drip).

You’re likely to go home with a feeding tube in place. You keep the tube in for 4 to 6 weeks whether or not you’re using it, just in case you have any problems. You’ll see the dietitian most days while you’re in hospital. You can contact them once you get home if you have any problems.

We need vitamin B12 to make blood. The stomach produces a substance called intrinsic factor that lets us absorb it from our food. Removal of all or part of the stomach means you can‘t do this anymore. So, you’ll need to have regular injections of vitamin B12. You usually have them 3 monthly. You’ll have regular blood tests to see if you need them more often. You could have your first injection before you leave the hospital. Then you’ll get these injections from your GP.

Your nurses and physiotherapists help you to move around as soon as possible. They check you’re doing your breathing and leg exercises. This helps you recover. You might be sitting in a chair within 12 hours of your operation. The day after, you’ll be walking around your bed. And within a few days you’ll be able to walk along the hospital corridor.

During the first few days after your operation

You’ll start to feel better. The drips and drains will come out, you’ll start eating and can move about better. You’ll begin to feel like you’re making progress. Most people go home about 10 to 14 days after the operation.

You’ll need help when you first go home. The dietitian will talk to you and your family about what to eat. It can take some time to find what works for you.

You’re likely to feel very tired for several weeks and sometimes months after your surgery. It helps to do a bit more every day.

Try:

  • Sitting for less time each day
  • Walking around the house a bit more each day
  • Building up to walking outside
  • What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.
  • Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about.You’ll have follow up appointments to check your recovery and fix any problems. They’re also your opportunity to raise any concerns you have.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Procedure

1. How long does Stomach Cancer Treatment last?

Chemotherapy is often given in cycles, each usually lasting about three weeks.

Radiotherapy often involves having treatment sessions five days a week. Each session will only last a few minutes. How long you’ll need to have radiotherapy for will depend on how it’s used. Radiotherapy used after surgery to help prevent stomach cancer coming back usually lasts five weeks. If it’s being used to control symptoms of advanced stomach cancer, it may only last one or two weeks.

Surgery for Stomach Cancer procedure may take over 2-3 hours to perform. Laparoscopic surgery takes 30 to 60 minutes longer than the more common ways of removing the stomach (open surgery). If you have stomach cancer surgery, you’ll usually need to stay in hospital for around two weeks. You’ll also need several weeks at home to recover.

2. How is the procedure of Stomach Cancer Treatment?

Surgery

Gastroesophageal junction cancer that has not spread requires surgery to remove the part of the esophagus or stomach where the tumor is located. The goal of surgery is to remove all of the cancer and a margin of healthy tissue, when possible. Nearby lymph nodes are typically removed as well.

The goal of surgery for cancer in the body of the stomach is also to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include:

Removing early-stage tumors from the stomach lining. Very small cancers limited to the inside lining of the stomach may be removed using endoscopy in a procedure called endoscopic mucosal resection. The endoscope is a lighted tube with a camera that’s passed down your throat into your stomach. The doctor uses special tools to remove the cancer and a margin of healthy tissue from the stomach lining.

Removing a portion of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer.

Removing the entire stomach (total gastrectomy). Total gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system.

Removing lymph nodes to look for cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells.

Surgery to relieve signs and symptoms. Removing part of the stomach may relieve signs and symptoms of a growing tumor in people with advanced stomach cancer. In this case, surgery can’t cure advanced stomach cancer, but it can make you more comfortable.

Radiation therapy

Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. The energy beams come from a machine that moves around you as you lie on a table.

In gastroesophageal junction cancer, as well as in cancer of the stomach body, radiation therapy can be used before surgery (neoadjuvant radiation) to shrink a tumor so that it’s more easily removed. Radiation therapy can also be used after surgery (adjuvant radiation) to kill any cancer cells that might remain in the area around your esophagus or stomach.

In gastroesophageal junction cancer, radiation and chemotherapy are typically administered at the same time (chemoradiotherapy), most often before surgery.

Radiation therapy to your stomach can cause diarrhea, indigestion, nausea and vomiting. Radiation therapy to your esophagus can cause pain on swallowing and difficulty swallowing. To avoid this side effect, you may be advised to have a feeding tube placed in your stomach through a small incision in your abdomen until your esophagus heals.

In cases of advanced cancer, radiation therapy may be used to relieve side effects caused by a large tumor.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. These drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach.

Chemotherapy can be given before surgery (neoadjuvant chemotherapy) to help shrink a tumor so that it can be more easily removed. This type of treatment is also used after surgery (adjuvant chemotherapy) to kill any cancer cells that might remain in the body. Chemotherapy is often combined with radiation therapy. This type of treatment may be used alone in people with advanced stomach cancer to help relieve signs and symptoms.

The side effects depend on which drugs are used.

Targeted drugs

Targeted therapy uses drugs that attack specific abnormalities within cancer cells or that direct your immune system to kill cancer cells (immunotherapy). The drugs used to treat stomach cancer include:

  • Trastuzumab (Herceptin) for stomach cancer cells that produce too much HER2
  • Ramucirumab (Cyramza) for advanced stomach cancer that hasn’t responded to other treatments
  • Imatinib (Gleevec) for a rare form of stomach cancer called gastrointestinal stromal tumor
  • Sunitinib (Sutent) for gastrointestinal stromal tumors
  • Regorafenib (Stivarga) for gastrointestinal stromal tumors

Several targeted drugs are being studied for treatment of gastroesophageal junction cancer, but only two of these drugs — ramucirumab and trastuzumab — have been approved for this use.

Targeted drugs are often used in combination with standard chemotherapy drugs. Tests of your cancer cells can tell your doctor whether these treatments are likely to work for you.

Supportive (palliative) care

This type of treatment is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.

3. What happens after the procedure?

After stomach surgery

After a big operation, you wake up in the intensive care unit or a high dependency recovery unit. You usually move back to the ward within a day or so.

In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist also keep an eye on your progress.

You have dressings over your wounds. Most people have 1 or 2 wounds after open surgery. After a couple of days your nurse changes the dressings and cleans your wounds.

Your stitches or clips stay in for at least 10 days. The nurse usually takes them out before you leave. You can go home with the stitches in if your wound’s still healing and you’re otherwise well. The practice, district or hospital nurse then takes them out. This could be at home or you might need to go back to hospital.

Before you go home, the nurse gives you information about how to care for the wound. You may have:

  • Drips to give you blood transfusions and fluids usually through a vein in your neck
  • Wound drains to drain any blood or fluid
  • A chest drain to help your lung expand if you’ve had your stomach and part of your food pipe removed (oesophagogastrectomy)
  • A nasogastric tube down your nose and into your stomach to drain it and stop you feeling sick
  • A tube into your bladder (catheter) to measure how much urine you pass
  • A small tube into a artery to check your blood pressure

You might also have an oxygen mask on.

Electronic pumps can control any medicine you have through your drip.

It’s normal to have pain for the first week or so. Your doctor and nurses give you painkillers to help.

Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA).

Or you might have painkillers through a small thin tube that is put into your back. This tube is connected to a pump that gives you a constant dose of painkiller. This is called an epidural.

You get painkillers to take home. Follow the instructions your nurse gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.

After stomach cancer treatment

For some people with stomach cancer, treatment can remove or destroy the cancer. For other people, the cancer might never go away completely. Some people may get chemotherapy, targeted therapy or other treatments to try and help keep the cancer in check.

If you have completed treatment

Your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you are having and may do exams and lab or imaging tests to look for signs of stomach cancer or treatment side effects. Almost any cancer treatment can have side effects. Some last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.

Most doctors recommend careful follow-up, with a physical exam and review of symptoms every 3 to 6 months for the first few years, then at least yearly after that. Lab tests might also be done. Scans are not usually needed at each visit, but should be done if there are any suspicious symptoms or physical findings.

If you have had surgery

Your health care team may suggest that you meet with a nutritionist, who can help you adjust to changes in your eating habits.

People who have had surgery — especially if they had the upper part of their stomach removed (in either a subtotal or total gastrectomy) — will probably need to have their vitamin blood levels tested regularly and might need tvitamin supplements, which could include B12 injections. (The pill form of vitamin B12 isn’t absorbed if the upper part of the stomach has been removed.)

If part or all of your stomach has been removed

You might need to eat smaller amounts of food more often. Your doctor or nutritionist may also recommend that you stay upright for some time after eating. Your health care team can help you adjust your diet if you are having problems eating.

Moreover, some patients with stomach cancer have problems with nausea, diarrhea, sweating, and flushing after eating. This is called dumping syndrome. When part or all of the stomach is removed, the food that is swallowed quickly passes into the intestine, leading to these symptoms after eating. These symptoms often get better over time.

Some people may need nutritional supplements to help make sure they get the nutrition they need. Some people may even need a feeding tube, usually called a jejunostomy tube (or J-tube), put into the small intestine. This is done through a small hole in the skin over the abdomen during a minor operation. A J-tube allows liquid nutrition to be put directly into the small intestine to help prevent weight loss and improve nutrition. Less often, the tube may be placed into the lower part of the stomach instead. This is known as a gastrostomy tube or G-tube.

Eating a diet rich in fruits and vegetables and staying at a healthy weight are linked with a lower risk of stomach cancer, but we don’t know if these types of changes affect the risk of cancer progressing or coming back. However, we do know that they can have positive effects on your health that can extend beyond your risk of cancer.

Tobacco use has clearly been linked to stomach cancer, so not smoking might help reduce your risk.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Complications & Side Effects

1. What complications could arise from Stomach Cancer Treatment?

Possible risks and complications that may arise after Surgery for Stomach Cancer are:

  • Excessive bleeding
  • Excessive diarrhea
  • Infection within the surgical wound
  • Malnutrition
  • Partial paralysis of the stomach (gastroparesis)
  • Ulcer disease
  • Incisional hernia

2. What are the possible side effects of Stomach Cancer Treatment?

Chemotherapy

Side effects may include:

  • Tiredness
  • Nausea and vomiting
  • Nerve damage (peripheral neuropathy)
  • Hair loss
  • Diarrhoea
  • Anaemia (a lack of red blood cells)
  • Weight loss
  • Skin changes – such as redness, swelling and a tingling sensation in the palms of the hands and/or soles of the feet

The side effects you experience after having chemotherapy will depend on the type of chemotherapy and the number of treatment sessions you need.

Radiotherapy

You may experience the following side effects after having radiotherapy:

  • Tiredness
  • Nausea
  • Diarrhoea
  • Irritation and darkening of your skin where the treatment takes place
  • These side effects will usually improve within a few weeks of treatment finishing.

Trastuzumab

Trastuzumab can cause side effects, including heart problems. Other side effects of trastuzumab may include:

  • An initial allergic reaction to the medication, which can cause nausea, wheezing, chills and fever
  • Diarrhoea
  • Tiredness
  • Aches and pains

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Please choose the best hospitals and clinics that provide Stomach cancer treatment in Asia to get the most suitable healthcare for your condition.

GO.CARE  does not provide medical advice, diagnosis or treatment.

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