Treatment and drug options for gastric cancer include:
- Chemotherapy: this consists of anti-cancer drugs given by mouth or injected into a vein, targeting cells that divide rapidly. They enter the bloodstream and spread to all body regions. Chemotherapy is given before surgery to shrink tumors, to slow cancer growth, or to shrink cancer.
- Radiation therapy: high-energy beams focus on a specific area of the body to kill cancer cells. Radiation therapy is used to shrink tumors, kill remnants after surgery, or to slow the growth of cancer. It can be used in addition to chemotherapy. External beam radiation is most typically used for stomach cancer treatment.
- Immunotherapy: this includes medications that stimulate the immune system to find and destroy cancer cells. They turn on or off molecules on the immune cells themselves to attack cancer cells.
- Surgery: this involves the removal of cancer, portions or all of the stomach, and neighboring lymph nodes. It is one of the treatments of choice for patients with Stages 0,1,2, or 3. Often, surgery is done with other treatments.
Surgical options include:
- Endoscopic resection, done while passing an endoscope (flexible tube with small video camera attached) down the throat and into the stomach. Tools passed through the endoscope allow tumor removal.
- Partial gastrectomy is done when the cancer is limited to the lower or upper part of the stomach, removing a section of the stomach along with a segment of esophagus or duodenum, the first part of the small intestine.
- Targeted Cell Therapy: Drugs that act on specific cells that may not be affected by chemotherapy as in cells that have an overabundance of growth-promoting proteins on cancer cell surfaces (HER2 +)
The specific therapy that you select with your physician depends on cancer staging or how much – and where – the cancer has spread in your body along with any lymph node involvement. Lymph nodes are the germ-fighters in your body.
Stage 0: Precancerous cells are found in your stomach lining. Surgical removal of these cell areas typically cures the disease. A portion of the stomach or entire stomach removal with neighboring lymph nodes may be advised.
Stage I: A tumor is part of your stomach's lining, with or without spread into the lymph nodes. In addition to surgical removal of part, or all, of your stomach and nearby lymph nodes, chemotherapy or chemo radiation is advised.
Chemotherapy involves drugs that attack cancer cells and shrink tumors. Chemoradiation is chemotherapy along with radiation, which directs beams of high energy to destroy the cancer cells remaining.
Stage II. Deeper stomach layers and possible nearby lymph nodes are involved. Surgery is the key treatment with chemotherapy and/or chemoradiation pre-surgery and post-surgery is typical.
Stage III. Cancer may be in all layers of the stomach, and spread to nearby organs like the spleen or colon. It may be smaller but involving many lymph nodes.
Surgical removal of the entire stomach is advised along with chemotherapy and radiation if tolerated.
Stage IV. In this last stage, cancer has distant spread to the liver, lungs, or brain. A cure is unlikely. Treatment goals here are for symptomatic relief.
It's much harder to cure, but a doctor can help manage it, and give some relief from symptoms with surgery, radiation, and targeted therapy along with stent insertion.