Treatment

Your team of specialists in gastroenterology, medical oncology, surgery, radiation oncology, radiology and pathology will work together to assess your best course of stomach cancer treatment. Your treatment will be tailored to your specific type of stomach cancer, and it may involve a combination of surgery, radiation and chemotherapy.

Gastric Cancer Surgery

Surgery is the most important treatment for gastric cancer – with the most important aspect of stomach cancer treatment being the experience of the surgeon and the multidisciplinary team. Research has repeatedly shown that survival outcomes are better in patients who are treated by experienced surgeons.

There are two main types of stomach cancer surgery: partial gastrectomy and total gastrectomy.

Partial Gastrectomy: The surgeon might remove:

• The part of the stomach that has cancer
• Part of the esophagus or part of the small intestine
• Nearby lymph nodes and other tissues
• The spleen, which is an organ in the upper abdomen (stomach) that filters the blood and removes old blood cells.

Total Gastrectomy: The surgeon might remove:

• The entire stomach
• Nearby lymph nodes
• Parts of the esophagus and small intestine
• Other tissues near the tumor
• Perhaps the spleen.

The surgeon then connects the esophagus directly to the small intestine and makes a new "stomach" out of tissue from the intestine.

Medical Oncology/Chemotherapy

Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Adjuvant chemotherapy (after surgery) is administered in certain circumstances when the patient is at high risk for recurrence.

Chemotherapy can be utilized prior (neo-adjuvant) to the surgical procedure to shrink the tumor. It can also be used concurrently with radiation for a cure in certain gastric cancer patients who are not surgical candidates. Stage 4 patients are often treated with chemotherapy or targeted therapies to prolong survival and control symptoms.

Medical oncologists at WellStar believe in a personalized approach to stomach cancer therapy – often guided by characteristics of the tumor and condition of the patient.

Radiation

Radiation therapy in stomach cancer is used for cure and improving symptoms. Patients who are not surgical candidates can still potentially have curative use through radiation and chemotherapy.

At WellStar, radiation administered by radiation oncologists in consultation with medical oncologists and surgeons. And several innovative radiation therapies are offered, including two found to be extremely effective against difficult cases of gastric cancer:

• Intensity Modulated Radiation Therapy (IMRT) allows modulation of radiation across the tumor, while sparing healthy surrounding tissue.