Treatment overview

The main treatments for stomach cancer are surgery and chemotherapy. Sometimes, radiotherapy or targeted therapy treatments are used. Treatments can be used alone or in combination with each other. The treatment you have will depend on the stage of the cancer, your general health and your personal choices.

You may have surgery to try to cure the cancer or to control it for as long as possible. This is a major operation, so you need to be physically well enough to have it. The operation involves removing part or all of the stomach and nearby lymph nodes.

If the cancer has spread to other tissue or organs nearby, the surgeon may remove part of these too to make sure all the cancer is removed. This type of surgery is less common.

Sometimes, surgery is used to relieve the symptoms of the cancer, for example if it is causing a blockage (obstruction).

Chemotherapy is another important treatment for stomach cancer. Many people have chemotherapy with surgery to cure the cancer. Doctors often give chemotherapy before and after surgery to reduce the risk of the cancer coming back. It can also be given on its own when an operation isn’t possible.

Occasionally, radiotherapy is given with chemotherapy (chemoradiation). Doctors can also give radiotherapy to relieve symptoms if the cancer is advanced.

Sometimes, a targeted therapy drug called trastuzumab (Herceptin®) is given with chemotherapy to treat stomach cancer that has spread. This isn’t suitable for everyone.

If the cancer has spread and you decide not to have chemotherapy, your doctors will give you treatment to control your symptoms. You’ll usually see doctors or nurses who specialise in symptom control (palliative or supportive care).

You can see a symptom control specialist at any time during treatment if there is any problem with symptoms.

The benefits and disadvantages of treatment

Treatment can be given for different reasons and the benefits or disadvantages will depend on your individual situation. Many people are frightened by the idea of having cancer treatments, because they are worried about side effects. However, these can usually be controlled with medicines.

Your cancer doctor or surgeon will explain the benefits and disadvantages of the treatments and how successful they are likely to be for you.

If the cancer is very advanced and has spread to other parts of the body such as the lungs or bones, treatment can only control it for some time. It may also help to reduce symptoms and extend or improve the quality of your life. However, for some people in this situation, the treatment will have no effect on the cancer and they will get the side effects without any of the benefit.

If you’ve been offered treatment that aims to cure the cancer, it may be easy to agree to it. But if a cure is not possible and the aim of treatment is to control the cancer for a while, it may be more difficult to decide whether to go ahead. Making decisions about treatment in these circumstances is always difficult, and you may need to discuss it with your doctor or nurse. If you choose not to have treatment, you can still be given supportive (palliative) care to control symptoms.

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Staging and grading

Knowing how far the cancer has grown (stage) and how slow or fast growing it is (grade) helps plan your treatment.