Stomach cancer diagnosis and treatment include:
- A small camera (upper endoscopy) to look inside your abdomen. A thin tube containing a small camera is passed down your throat and into your stomach. Your doctor can use this to look for signs of cancer.
- Removal of a sample of tissue for testing (biopsy). If a suspicious area is found during an upper endoscopy, special instruments may be used to remove a tissue sample for testing. The sample is sent to a laboratory for analysis.
- Imaging test. Imaging tests used to detect colon cancer include a CT scan and a special type of X-ray exam called a barium swallow.
Determining the extent (stage) of stomach cancer
The stage of your colon cancer helps your doctor decide which treatment may be best for you. Tests and procedures used to determine the stage of cancer include:
- Blood tests. Blood tests to measure organ function may indicate that other organs in your body, such as your liver, may be affected by cancer.
- Imaging tests. Tests may include CT and positron emission tomography (PET).
- Endoscopic ultrasound. During an endoscopic ultrasound, a thin tube with a camera at the tip is passed down your throat and into your abdomen. A special ultrasound tool is used to take pictures of your abdomen. Endoscopic ultrasound helps doctors determine how deep cancer has penetrated the abdominal wall.
- Exploratory surgery. Your doctor may recommend surgery to find out if your cancer has spread beyond your abdomen, into your chest or abdomen. Exploratory surgery is usually performed laparoscopically. This means that the surgeon makes several small incisions in your abdomen and inserts a special camera that transmits the images to a monitor in the operating room.
Other staging tests may be used, depending on your situation.
Your doctor uses the information from these procedures to determine a stage for your cancer. Stomach cancer stages are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating the cancer is small and affects only the inner layers of your stomach. By stage IV, the cancer is considered advanced and may have spread to other areas of the body.
Treatment
Treatment options for stomach cancer depend on the location, stage, and aggressiveness of cancer. Your doctor also considers your overall health and your preferences when creating a treatment plan.
Surgery
The goal of surgery is to remove all of cancer and some of the healthy tissue around it.
Operations used for colon cancer include:
- Removal of part of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes the part of the stomach affected by cancer and some of the healthy tissue around it.
- Removal of lymph nodes to look for cancer. The surgeon may remove lymph nodes in your abdomen to test for cancer.
- Removal of early-stage tumors from the stomach lining. Very small cancers confined to the inner lining of the stomach can be removed by passing special instruments through the endoscope.
- Removal of the entire stomach (total gastrectomy). Total gastrectomy involves removing the entire stomach and some of the surrounding tissue. The esophagus is connected directly to the small intestine to allow food to move through your digestive tract. Total gastrectomy is most often used for stomach cancers that affect the body of the stomach and which are located in the gastroesophageal junction.
- Surgery to relieve signs and symptoms. An operation to remove part of the stomach can relieve signs and symptoms of growing cancer in people with advanced colon cancer.
Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the abdomen.
Chemotherapy may be given before surgery to help shrink cancer so that it can be removed more easily. Chemotherapy is also used after surgery to kill any cancer cells that may remain in the body. Chemotherapy is often combined with radiation therapy.
Chemotherapy is used alone or in combination with targeted drug therapy in people with advanced stomach cancer.
Radiation therapy
Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. The energy beam comes from a machine that spins around you as you lie on the table.
For colon cancer, radiation therapy may be used before surgery to shrink the cancer so that it can be more easily removed. Radiation therapy may also be used after surgery to kill any cancer cells that may remain. Radiation therapy is often combined with chemotherapy.
For advanced stomach cancer that cannot be removed with surgery, radiation therapy may be used to relieve side effects such as pain or bleeding caused by the growing cancer.
Targeted drug therapy
Targeted drug treatments focus on specific vulnerabilities within cancer cells. By blocking these vulnerabilities, targeted drug treatments can cause cancer cells to die. For stomach cancer, targeted drugs are usually combined with chemotherapy for advanced cancer or cancer that comes back after treatment.
Your doctor can test your cancer cells to see which targeted drugs might work for you.
Immunotherapy
Immunotherapy is a drug treatment that helps your immune system fight cancer. Your body’s disease-fighting immune system cannot attack cancer because cancer cells produce proteins that make it difficult for immune system cells to recognize cancer cells as dangerous. Immunotherapy works by interfering with that process.
For stomach cancer, immunotherapy may be used if the cancer is advanced, if it comes back or if it has spread to other parts of the body.
Supportive (palliative) care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of serious illness. Palliative care specialists work with you, your family, and your other doctors to provide an extra level of support that complements your ongoing care. Palliative care may be used during aggressive treatments such as surgery, radiation therapy or chemotherapy.
When palliative care is used in conjunction with all other appropriate treatments, people with cancer can 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 of people living with cancer and their families. This form of care is offered curative or along with other treatments you may receive.
