What is surgery?

Surgery is an important treatment for stomach cancer. Even if the cancer has spread outside the stomach, it might still be possible to remove it. This is major surgery and some people may not be physically well enough to have it. Most people will need chemotherapy as well as surgery.

You may have surgery to remove all or part of the stomach. During the operation, the surgeon also removes an area of healthy tissue and some nearby lymph nodes. This is to try to make sure that all the cancer cells are gone. If the cancer has spread, the surgeon may also remove part of some nearby organs.

Your doctor will talk to you about the benefits and risks of the operation. If you’re not sure about anything, it’s important that you ask. You can also discuss any concerns you have about the operation.

If you do decide to have the surgery, your medical team will give you advice about the best way to prepare for it.

Surgery for stomach cancer

Surgery is an important treatment, especially for early stomach cancer. It should only be carried out by specialist surgeons. It isn’t available in all hospitals, so you may need to go to a different hospital to have it done.

Even when the cancer has spread outside the stomach to the surrounding area, it may still be possible to remove it. This involves major surgery and some people may not be physically well enough to have it. You need to talk to your surgeon about the benefits and risks of this operation before making a decision about it.

Most people need treatment with chemotherapy as well as an operation. Sometimes, surgery may be the only treatment that’s needed. This is usually when stomach cancer is diagnosed at the earliest possible stage. Or it may be because having chemotherapy and surgery would be too intensive and hard to cope with.

The operation you have depends on where the cancer is in the stomach and its size. You may have all or part of the stomach removed. The surgeon also takes away an area of healthy tissue around the cancer to try to make sure all the cancer cells are gone. They also remove nearby lymph nodes and the fatty tissue called the omentum that covers the stomach and the front of the bowel.

Depending on the position of the cancer and how far it has spread, the surgeon may remove part of some nearby organs. This may include the lower part of the gullet (oesophagus), the upper part of the small bowel (duodenum) and occasionally the spleen or part of the pancreas.


Before surgery to remove part or all of your stomach

Having part or all of your stomach removed is major surgery. You’ll need to have tests to make sure you’re physically well enough. These are usually done a few days to two weeks before your operation at a pre-assessment clinic. They include tests on your heart and lungs.

A member of the surgical team and a specialist nurse will talk to you about the operation. You may see the doctor who gives you the anaesthetic (the anaesthetist) at a clinic or when you’re admitted to hospital.

If you smoke, it’s important to try to give up or cut down before your operation. This will help reduce the risk of problems, such as getting a chest infection. It will also improve wound healing after the operation. Your GP can give you advice and we also have more information on giving up smoking.

A dietician will give you advice on eating well in preparation for the operation. If you’ve had problems with eating and have lost weight, you may need extra help and support with your diet.

Let the nurses know as soon as possible if you think you might need help when you go home after your operation. This may be because, for example, you live alone or are a carer for someone else. The staff can help you make arrangements in plenty of time.

Many hospitals now follow what’s called an enhanced recovery programme. This aims to reduce your time in hospital and speed up your recovery. It involves you more in your care. For example, you’ll be given information about exercises you can do to help you get fitter before surgery. And any arrangements needed for your return home will be put in place in advance. Your doctor will tell you if an enhanced recovery programme is suitable for you and if it’s available – not all hospitals have one.

You’ll usually be admitted to hospital the morning of your operation. The nurses will give you special elastic stockings (TED stockings) to wear during and after the operation. They help prevent blood clots forming in your legs.

One of the most important things you can do before surgery is make sure you’ve asked all the questions you want to and discussed any concerns with your nurse or doctor.


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After your operation

The nurses and doctors will monitor you carefully after your operation. You may be in hospital for 10–14 days.