Treatment for stomach cancer

About treatment for stomach cancer

Stomach cancer can be treated with:

surgery
chemotherapy
radiotherapy
chemotherapy and radiotherapy (chemoradiation)
immunotherapy
targeted therapy

The treatments can be given alone or together.

Your treatment for stomach cancer depends on:

the stage of the cancer of the cancer
your general health
your personal choices.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

Call the Macmillan Support Line for free on 0808 808 00 00.
Chat to our specialists online.
Visit our stomach cancer forum to talk with people who have been affected by stomach cancer, share your experience, and ask an expert your questions.

Preparing for treatment

Maintaining your weight

After being diagnosed with stomach cancer, you may be referred to a dietitian. You may have difficulty eating and have lost weight. A dietitian can:

give you support and advice on eating well
help you stop losing weight.

This helps you prepare for treatment.

Prehabilitation

Research suggests that making certain lifestyle changes before your treatment can help you cope better with side effects and improve your recovery.

Your healthcare team may suggest things you can do to improve your general health before treatment. This is sometimes called prehabilitation. It can help reduce the risk of complications such as blood clots. It can also help you to recover faster.

Prehabilitation can include:

stopping smoking (if you smoke) at least 2 weeks before surgery or radiotherapy
maintaining or gaining weight if you have lost weight due to difficulty eating
doing gentle physical activity, such as regular short walks
drinking less alcohol.

Treating early-stage stomach cancer

The treatment you are offered will depend on your individual situation. The cancer multidisciplinary team will meet and discuss the treatment options available to you. Your doctor will talk to you more about these.

Endoscopic mucosal resection (EMR)

If you have a very early stage stomach cancer, you may be offered a treatment to remove the cancer using an endoscope. This is called an endoscopic mucosal resection (EMR), or an endoscopic sub-mucosal dissection (ESD). Your doctor or surgeon may offer you this treatment if the tumour is very small and is only affecting the inner layer of the stomach.

Your cancer doctor will talk to you about the treatment options that might be best in your situation.

Surgery

If you have stomach cancer that has not spread, you may be offered surgery to remove the cancer. The operation you have depends on where the cancer is in the stomach. You may have a total gastrectomy, where all of the stomach is removed. Or you may have a partial gastrectomy, where part of the stomach is removed. Nearby lymph nodes may also be removed. This is a major operation. You need to be well enough to have it.

Chemotherapy

Chemotherapy is also used to treat stomach cancer. You may have chemotherapy before and after surgery to reduce the risk of the cancer coming back. It may sometimes be given with radiotherapy, this is called chemoradiation.

Treating stomach cancer that has spread

Sometimes, surgery is used to relieve the symptoms of stomach cancer that has spread. For example, it may be used if the cancer is causing an obstruction (blockage).

Chemotherapy may be used to treat stomach cancer that has spread. It may be given on its own when an operation is not possible.

Sometimes, immunotherapy or a targeted therapy drug such as trastuzumab is given. This may be at the same time as chemotherapy. These are used to treat stomach cancer that has spread and where surgery has not been possible. They may not be suitable for everyone. Your cancer doctor or specialist nurse can explain whether trastuzumab may help you.

If the cancer has spread and you decide not to have chemotherapy, you might have treatment to control your symptoms. You will usually meet doctors or nurses who specialise in symptom control. This is called palliative or supportive care.

If you are having problems with symptoms, you can talk with a member of the palliative care team at any time during treatment.

References

Below is a sample of the sources used in our stomach cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Lordick F, Carneiro S, Cascinu T, Fleitas K, Haustermans G, Piessen A, et al. Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2022;33(10): 1005–1020. Available from www.doi.org/10.1016/j.annonc.2022.07.004 [accessed July 2023].

National Institute for Care and Health Excellence. Oesophago-gastric cancer: assessment and management in adults NICE guideline [NG83]. 2018. Available from www.nice.org.uk/guidance/ng83 [accessed July 2023].

Cancer Information Development team

Author

Dr Chris Jones

Reviewer

Speciality Registrar in Clinical Oncologist and Clinical Lecturer in Clinical Oncology

Date reviewed

Reviewed: 01 November 2024

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Next review: 01 November 2027

The language we use

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