In 2015, approximately 97,915 Americans were living with stomach cancer. Although it only accounts for 1.5 percent of new cancer cases in the U.S. per year, stomach cancer is poised to kill more than 10,000 people in 2018 alone. [1]

The condition occurs when DNA changes develop in cells in the stomach, causing those cells to mutate and divide rapidly. These cells don’t die like they should, and they can develop into tumors that invade nearby structures and spread to distant parts of the body.

Some common symptoms of stomach cancer include:

• feeling bloated or overly full after eating
• fatigue
• persistent heartburn
• severe indigestion
• unexplained, persistent nausea and/or vomiting
• stomach pain
• unintentional weight loss

Treatment for stomach cancer varies depending on a number of factors, including where in the stomach it originated, and the stage or severity of the cancer. [2]

Learn about five of today’s most common treatments for stomach cancer by reading on below.

1. Surgery

Surgery for stomach cancer is typically used in combination with other treatments. For people with stages 0, I, II, or III of the disease and who are healthy enough for it, surgery can be quite effective. [3]

The primary goal of stomach cancer surgery is to remove as much of the cancer as possible along with all or part of the stomach and nearby lymph nodes. However, even if the cancer is advanced and widespread, palliative surgery may be performed to ease symptoms.

Several types of surgery are available for treating stomach cancer. A few of the most common types include:

• Endoscopic resection: The least invasive type of surgery, endoscopic resection is reserved for the earliest stages of stomach cancer. Rather than making incisions, tools are inserted through the throat and into the stomach and manipulated to remove the cancer.
• Subtotal or partial gastrectomy: This type of surgery is used to remove the bottom portion of the stomach.
• Total gastrectomy: The entire stomach is removed with this type of surgery.
• Lymph node removal: If stomach cancer cells spread to nearby lymph nodes, this surgery may be required.
• Feeding tube placement: For patients who can’t take in enough calories due to stomach cancer, surgery to place a feeding tube may be needed.

Stomach surgery is typically difficult. Complications may include blood clots and bleeding.

2. Chemotherapy

Chemotherapy refers to the use of anti-cancer drugs, delivered either intravenously or through pills, that attack cancer cells to treat various forms of cancer. These drugs are delivered throughout the body, and they affect all rapidly dividing cells. Therefore, they also attack other quickly dividing cells, including hair follicles, bone marrow, and the lining of the mouth and intestines. As a result, side effects of this treatment may include loss of appetite, diarrhea, mouth sores, bleeding and bruising, fatigue and shortness of breath, increased risk of infection, nausea and vomiting, and hair loss. [4]

This treatment is given in cycles that include periods of rest. It works to shrink and slow the growth of tumors, and it is often used in combination with radiation. In that case, it is referred to as chemoradiation. Even in stomach cancers that have metastasized, or spread, to other organs, chemo can relieve symptoms by shrinking existing tumors and slowing their growth.

Pre-surgical chemotherapy, or neoadjuvant chemotherapy, is used to shrink existing tumors for easier removal. Post-surgical chemo, or adjuvant chemo, is used to kill remaining cancer cells that were too small to be easily removed through surgery.

3. Targeted Therapies

Standard chemotherapy drugs don’t always effectively treat stomach cancer. In such cases, targeted therapies are often viable alternatives. These refer to the use of drugs that target specific differences in cancer cells as opposed to normal cells. [5] Most people are aware that cancer cells divide rapidly, but they have other characteristics that distinguish them from healthy cells. Targeted drugs zero in on cells with these differences to treat stomach cancer.

A few examples of targeted therapies that are commonly used to treat stomach cancer include the following:

• Ramucirumab: This drug targets the VEGF protein, which tells the body to produce new blood vessels. Cancer requires new blood vessels to keep growing, and this drug effectively binds to VEGF receptors to prevent this from happening.
• Trastuzumab: Approximately one out of every five cases of stomach cancer involve cells that contain too much of a protein called HER2. This drug targets the HER2 protein to zero in on and kill cancerous cells.

4. Immunotherapy

Immunotherapy involves the use of medicines that improves the immune system’s ability to find and kill cancer cells. The body’s immune system relies on “checkpoints,” molecules on immune cells, to start immune responses. This is how the immune system normally prevents itself from attacking healthy cells. However, cancer cells often use these checkpoints to avoid being attacked. Recently, new drugs that target and inhibit these checkpoints have been developed and are being used to effectively treat stomach cancer. [6]

One example of such a medication is pembrolizumab. This drug targets the PD-1 protein that is found on immune cells called T-cells. In blocking this protein, the drug boosts the immune system’s response to cancerous cells to shrink them and slow their growth. This medication is typically delivered intravenously every five weeks.

Side effects of this treatment may include the following:

• shortness of breath
• itchy skin
• fever
• feeling weak and tired
• cough
• skin rash
• constipation and/or diarrhea
• loss of appetite
• muscle and joint pain

5. Radiation Therapy

Like most other stomach cancer treatments, radiation therapy is typically used in conjunction with other treatments. Radiation therapy involves the use of high-energy particles or rays to kill cancerous cells in targeted areas of the body. [7]

It is commonly used in the following ways:

• Before surgery: When used before surgery, radiation shrinks tumors for easier removal.
• After surgery: Radiation therapy is also commonly performed following surgery to remove small remaining cancer cells. When used with chemo, it can delay or even prevent recurrence.
• Palliative: This therapy may be used on a palliative basis for advanced, untreatable cases of stomach cancer to slow its growth and to ease symptoms.

A form of radiation therapy called beam radiation therapy is commonly used to treat stomach cancer. This method focuses radiation on cancer using a machine that is outside of the body — much like getting a regular X-ray. Today, computers are used to carefully target cancerous cells and to limit damage to nearby tissue. The process is painless and typically only takes about five minutes, and it’s usually administered five days a week over the course of several weeks or months.

Common side effects of radiation therapy for stomach cancer include the following:

• low blood cell counts
• diarrhea
• nausea and vomiting
• fatigue
• skin problems in area where radiation was targeted, including peeling, blistering, and redness

Sources

1. “Cancer Stat Facts: Stomach Cancer.” gov, National Cancer Institute, 2018, seer.cancer.gov/statfacts/html/stomach.html.
2. Mayo Clinic Staff. “Stomach Cancer.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 May 2018, mayoclinic.org/diseases-conditions/stomach-cancer/symptoms-causes/syc-20352438.
3. The American Cancer Society medical and editorial content team. “Surgery for Stomach Cancer.” org, American Cancer Society, 15 Dec. 2017, www.cancer.org/cancer/stomach-cancer/treating/types-of-surgery.html.
4. The American Cancer Society medical and editorial content team. “Chemotherapy for Stomach Cancer.” org, American Cancer Society, 14 Dec. 2017, https://www.cancer.org/cancer/stomach-cancer/treating/chemotherapy.html.
5. The American Cancer Society medical and editorial content team. “Targeted Therapies for Stomach Cancer.” org, American Cancer Society, 15 Dec. 2017, https://www.cancer.org/cancer/stomach-cancer/treating/targeted-therapies.html
6. The American Cancer Society medical and editorial content team. “Immunotherapy for Stomach Cancer.” org, American Cancer Society, 15 Dec. 2017, https://www.cancer.org/cancer/stomach-cancer/treating/immunotherapy.html.
7. The American Cancer Society medical and editorial content team. “Radiation Therapy for Stomach Cancer.” org, American Cancer Society, 15 Dec. 2017, https://www.cancer.org/cancer/stomach-cancer/treating/radiation-therapy.html.