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 then 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
  • after surgery at the same time as radiotherapy (called chemoradiation) but in a clinical trial
  • to control the cancer and relieve symptoms when 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 they can go home with.

Chemotherapy

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 to remove the cancer
  • before surgery to shrink a cancer that’s too large to remove – this sometimes works well enough to make an operation possible
  • occasionally, in combination with radiotherapy (chemoradiation), after surgery – this is for people who didn’t have chemotherapy before surgery and is normally given as part of a clinical trial
  • to help control the cancer and improve symptoms if an operation to remove it isn’t possible.

Perioperative chemotherapy

The most common use of chemotherapy with surgery is perioperative chemotherapy. This shrinks the cancer 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 your operation, and again after it.

Advanced cancer

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. Some people have a targeted therapy drug called trastuzumab (Herceptin®) with chemotherapy.


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. A cycle often takes three weeks. 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) in your arm, or a soft plastic tube called a central line or PICC line. A central line goes into a vein in your chest and a PICC line is put into a vein above the bend in your arm.

If you have a central or PICC line, your nurse will show you how to look after it. These lines are designed to stay in until all your chemotherapy treatment is over. Some people are also given a course of chemotherapy tablets called capecitabine to take at home. Or you may have a chemotherapy drug called fluorouracil through a small pump attached to your central or PICC line. You can go home with this in.


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. Other drugs such as irinotecan and docetaxel can also be used.

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.


Back to Chemotherapy explained

Your feelings

You may experience difficult feelings while having chemotherapy treatment. Talking these over can be helpful.

Where can you have chemotherapy?

You usually have chemotherapy in a chemotherapy day unit or clinic. If your treatment is more complex, you may need to stay in hospital.