Chemotherapy for stomach cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You usually have it as a drip or an injection into a vein, or as tablets. Treatment for stomach cancer is often a combination of both.

Chemotherapy drugs also affect healthy cells. They can cause side effects, such as feeling sick or an increased risk of infection. Side effects can often be reduced and usually stop when treatment is finished.

Chemotherapy for stomach cancer may be given:

  • before and after surgery to reduce the risk of the cancer coming back
  • to shrink a cancer that’s too large to remove – this can sometimes make an operation possible
  • with radiotherapy – this is called chemo-radiation
  • to control the cancer and relieve symptoms if stomach cancer has spread to other parts of the body.

You have chemotherapy as a course of several sessions. After a session of treatment, you can usually go home the same day. Some people have chemotherapy through a small infusion pump that they can take home.

Chemotherapy for stomach cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be used on its own or along with surgery, radiotherapy or a targeted therapy drug.

Chemotherapy for stomach cancer may be given:

  • before and after surgery (peri-operative chemotherapy)
  • before surgery to shrink a cancer (neo-adjuvant chemotherapy)
  • with radiotherapy to make it work better (chemo-radiation)
  • to control the cancer and improve symptoms (palliative chemotherapy).

Peri-operative chemotherapy

When chemotherapy is used before and after surgery, it is called peri-operative chemotherapy. This treatment shrinks the tumour to make surgery more effective and reduces the chance of cancer coming back. This treatment is usually given as three cycles of chemotherapy over nine weeks before the operation, and again after it.

Neo-adjuvant chemotherapy

Chemotherapy may be given before surgery to shrink a large cancer. This sometimes works well enough to make an operation possible.

Chemo-radiation

Chemotherapy may be given in combination with radiotherapy (chemo-radiation). It may be given before surgery (neo-adjuvant) or after surgery. It would be used after for people who didn’t have chemotherapy before surgery.

Palliative chemotherapy

If the cancer has spread to other parts of the body (advanced cancer), chemotherapy is the main treatment. It can help you to live longer and reduce symptoms. You may be given the chemotherapy for up to six months.

Targeted therapy

Some people have a targeted therapy drug called trastuzumab (Herceptin®) as well as chemotherapy. You will have tests first to see if trastuzumab is a suitable treatment for you.


How chemotherapy is given

You‘ll usually have chemotherapy as an outpatient, which means you can go home on the same day. If you have it as an inpatient, you only need a short stay in hospital.

Chemotherapy is usually given as a course of several sessions (or cycles) over a few months. Your doctor or nurse will explain more about this.

You have the chemotherapy drugs given into a vein (intravenously) or as tablets. Stomach cancer is often treated with a combination of both.

The chemotherapy nurse will give you the drugs into a vein by injection or as a drip (infusion). The drugs are given to you through:

  • a small tube (cannula) into a vein in your hand or arm
  • a soft plastic tube called a central line which goes into a vein in your chest
  • a PICC line which goes into a vein above the bend in your arm.

A cannula will be removed after each treatment. A central or PICC line can stay in place until all your chemotherapy treatment is over. If you have a line, your nurse will show you how to look after it. Some people may have a chemotherapy drug called fluorouracil through a small pump attached to their central or PICC line. You can go home with this pump attached.

Some people are given a course of chemotherapy tablets called capecitabine to take at home.


Chemotherapy drugs used

Usually, a combination of drugs is used. The treatments are named after the initials of the drugs included. Possible treatments include:

  • ECX, which is made up of epirubicin, cisplatin and a tablet called capecitabine (Xeloda®)
  • EOX, which is made up of epirubicin, oxaliplatin and capecitabine (Xeloda®)
  • ECF, which is made up of epirubicin, cisplatin and fluorouracil (5FU).

Sometimes, only two of these drugs are given together.

With ECF chemotherapy, you have fluorouracil (5FU) given continuously through a small pump attached to your central or PICC line. The pump gives you a low dose of the drug continuously while you’re at home. You can carry it in a belt or a small bag. Your nurse will show you how to look after it.

If results show the cancer hasn’t responded well enough, your doctor may decide to change your treatment to different chemotherapy drugs, such as irinotecan and docetaxel.

Back to Chemotherapy explained

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.