According to the National Cancer Institute, almost all stomach cancers, also called gastric cancers, are adenocarcinomas, arising from the glandular inner lining of the stomach. NCI estimates put the total number of new cases of stomach cancer in the United States in 2009 at over 20,000 with more than half that number resulting in death. Treatment options, according to the American Society of Clinical Oncology (ASCO), depend on the site and size of the stomach cancer, the extent of spread and the health condition of the patient. There are several options that may be combined.
Surgery
In early stages of the cancer, when it is still confined to the lining of the stomach, surgery is done to remove the cancer and nearby lymph nodes. One option, endoscopic mucosal resection, involves the use of a long flexible tube, an endoscope, to visualize and remove the layer of cancer cells. This, according to the American Cancer Society (ACS), is done in very early stages, when the chances of spread to the lymph nodes are very low. In later stages, removal of part or all of the stomach, a surgical procedure called gastrectomy, is the treatment of choice. During this procedure, nearby lymph nodes are also removed for further investigation to determine extent of spread. A new "stomach" is usually fashioned out of parts of the intestine in those cases needing total gastrectomy, where the whole stomach is removed.
Radiation Therapy
Radiation therapy, the use of high powered radiation to destroy cancer cells, is also used in the treatment of stomach cancer. External beam radiation therapy is the type of radiation therapy used in stomach cancer, according to ASCO. Here, the source of radiation is placed outside the body. Radiation therapy can be used before surgery as neoadjunct therapy, to shrink the tumor and improve the outcome and ease of surgery. It can also be used after surgery, as adjunct therapy, with or without chemotherapy, to reduce the likelihood of recurrence of cancer. According to the ACS, radiation therapy can also help in advanced cases of stomach cancer to relieve pain and bleeding from inoperable cancers, as palliative treatment.
Chemotherapy
Chemotherapy is the use of drugs that destroy cancer cells or stop them from growing and spreading. Chemotherapy is used in stomach cancer, according to the ACS, mainly in cases when the cancer has spread to other organs. It can also be used after surgery as adjuvant treatment to prevent recurrence of cancer.
5-fluorouracil, usually in combination with leucovorin, may be used alone with or without radiation therapy. Other drugs used in stomach cancer, usually in combinations, are doxorubicin, epirubicin, etoposide, cisplatin and methotrexate. Others, which might help include paclitaxel, docetaxel, irinotecan, capecitabine and oxaliplatin.
Other Treatments
Pain relievers like morphine can be given to relieve pain and discomfort in stomach cancer. Multivitamins, food supplements and other drugs for symptomatic relief may also be used to reduce or prevent effects of the cancer or adverse effects from the different modes of treatment.
