Targeted Therapy For Stomach Cancer
Newer drugs work differently from standard chemotherapy drugs by targeting certain receptors on cancer cells and not normal cells. For example, in some stomach cancers, the cells have too much of a protein called HER2 on their surfaces. A drug called trastuzumab destroys these cancers by neutralizing this receptor. It is usually given along with standard chemotherapy drugs to help treat more advanced stomach cancers.
Depending on the stage of your stomach cancer, we may recommend a combination of treatments.
How Long Is Recovery After Stomach Cancer Surgery
There are several surgical procedures that might be used to treat stomach cancer, depending on the size, location and spread of the tumor. The surgery that is used, along with the patients age and overall health, will impact recovery time. For example, some patients undergo surgery to remove the entire stomach a procedure that will likely require a longer recovery period and more complex postoperative care than a partial gastrectomy, which involves removing only a portion of the stomach and can sometimes be performed endoscopically.
With this said, any type of stomach cancer surgery is a significant and complex operation. Many patients who undergo a partial gastrectomy remain in the hospital for around three to five days following the procedure, while a total gastrectomy may require an inpatient stay of a week or so. Once discharged, most patients need to rest as much as possible and avoid strenuous activities for several weeks.
Maintaining Your Weight Without A Stomach
Consuming enough calories to return to your favorite activities will happen over time. Nutritious, high calorie, low sugar foods provide the best bang for the bite. Calories are your bodys first priority.
You will not be able to eat the same quantity of food as you did before your surgery, so it is important to get the calories in smaller amounts of high calorie foods, Farma suggested.
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Surgery For Stomach Cancer
Surgery is often part of the treatment for stomach cancer , if it can be done. If the cancer hasn’t spread to other parts of the body, surgery offers the best chance to try to cure the cancer.
Surgery can be done for two main reasons:
- Surgery to remove the cancer: Surgery may be done to remove the cancer and part or all of the stomach, as well as some nearby lymph nodes and other structures, depending on the location and stage of the cancer. The surgeon will try to leave behind as much normal stomach as possible. Sometimes other organs will need to be removed as well.
- Palliative surgery: If the cancer is too widespread to be removed completely, surgery might still be done to help prevent bleeding from the tumor or prevent the stomach from being blocked by tumor growth. This type of surgery can prevent or relieve symptoms, but it is not expected to cure the cancer.
Removing Part Of The Stomach
Your surgeon may remove up to two thirds of your stomach if the cancer is at the lower end of your stomach. This is called a subtotal or partial gastrectomy. How much the surgeon removes depends on the position of the cancer. The surgeon will also remove part of the sheet of tissue that holds the stomach in place .
The surgeon joins your small bowel to the remaining part of your stomach.
The duodenum is the first part of your small bowel which connects to the stomach. The surgeon reconnects the far end of the duodenum to the small bowel.
You have a smaller stomach afterwards. The valve between your oesophagus and stomach will still be there.
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Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.
How Will You Handle Food After Stomach Surgery
Normally, your stomach holds food and kicks off digestion. Foods then pass from the stomach to the duodenum, the first part of your small intestine. If these things donât happen, food isnât digested as well.
Also, if the valve that controls how food exits your stomach into your small intestine is removed, food will pass through your system quicker and you wonât absorb as many nutrients as before.
As you recover, youâll probably find that a smaller or absent stomach means that you feel full faster. Your body may process some foods differently. Sugar, for example, can cause something called dumping syndrome, where extra water is drawn into your stomach or small intestine and food speeds through your digestive system.
Symptoms include cramping and diarrhea. They can start within 20 minutes of eating. People who werenât lactose intolerant before surgery may become so. Fat may be harder to digest, too.
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Having Another Type Of Cancer
Your risk of developing stomach cancer is increased if you’ve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma .
For men, the risk of getting stomach cancer is increased after having prostate cancer, bladder cancer, breast cancer or testicular cancer. For women, the risk of developing stomach cancer increases after having ovarian cancer, breast cancer or cervical cancer.
Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- The stage of the cancer .
- The patients general health.
When gastric cancer is found very early, there is a better chance of recovery. Gastric cancer is often in an advanced stage when it is diagnosed. At later stages, gastric cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.
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Targeted Drug Therapy For Treating Stomach Cancer
Targeted drugs are designed to work on the unique genetic, biological and molecular structures of stomach cancer cells.
Trastuzumab is a drug that targets a certain protein called HER2, which is found to varying degrees in stomach cancer cells. When given with standard chemotherapy, trastuzumab can help some patients with advanced stomach cancer live longer than those treated with chemotherapy alone.
Other types of targeted drug therapies work by preventing the cancer from forming new blood vessels. This stunts the tumors growth and prevents it from spreading. These agents may be given alone or with chemotherapy to patients with advanced stomach cancer.
Surgery To Ease Your Symptoms
If your stomach cancer has spread beyond your stomach, it may not be possible to remove it using surgery.
However, if your stomach has been significantly affected by cancer it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and feeling very full after eating.
If your stomach is blocked, there are a few options:
- stenting a stent is a plastic or wire mesh tube inserted through the oesophagus using an endoscope under local anaesthetic after being inserted, the stent will be expanded and open up the stomach
- partial or total gastrectomy to remove the blockage and improve your symptoms
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How Do You Live Without A Stomach
There are a number of different organs that we can live without. However, many people are surprised to learn that you can live without a stomach. However, with a little help, the body is able to adapt to bypass the stomachs main function which is to store and break down food ready to pass it to the intestines. Heres what you need to know about how you can live without a stomach.
What To Know About Stomach Cancer Surgery
If your doctor has recommended surgery to treat stomach cancer, you may have many questions. , is a Johns Hopkins surgical oncologist who specializes in stomach cancer. He has performed many surgeries to treat patients with various stages of stomach cancer.
Duncan answers some common questions patients have about what to expect after surgery and how to eat for a smoother recovery.
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What Is The Prognosis For People Who Have Stomach Cancer
The outlook for stomach cancer depends on the stage of cancer. People in the early stages of stomach cancer have a much better prognosis than those at a later stage. The 5-year survival rate for stomach cancer may be as high as 70% or as low as 6% .
Speak with your provider for a more accurate assessment of your prognosis. The type of cancer you have, its spread, your health and how your cancer responds to treatment all shape your prognosis.
What Are Stomach Cancer Treatments
Many treatments can fight stomach cancer. The one you and your doctor choose will depend on how long you’ve had the disease or how much it has spread in your body, called the stage of your cancer:
Stage 0. This is when the inside lining of your stomach has a group of unhealthy cells that may turn into cancer. Surgery usually cures it. Your doctor may remove part or all of your stomach, as well as nearby lymph nodes — small organs that are part of your body’s germ-fighting system.
Stage I. At this point, you have a tumor in your stomach’s lining, and it may have spread into your lymph nodes. As with stage 0, you’ll likely have surgery to remove part or all of your stomach and nearby lymph nodes. You might also get chemotherapy or chemoradiation. These treatments can be used before surgery to shrink the tumor and afterward to kill any cancer that’s left.
Chemotherapy uses drugs to attack cancer cells. Chemoradiation is chemo plus radiation therapy, which destroys cancer cells with beams of high energy.
Stage II. Cancer has spread into deeper layers of the stomach and maybe into nearby lymph nodes. Surgery to remove part or all of your stomach, as well as nearby lymph nodes, is still the main treatment. You’re very likely to get chemo or chemoradiation beforehand, and you might get one of them after, too.
You usually have surgery to remove your entire stomach, along with chemo or chemoradiation. This can sometimes cure it. If not, it can at least help with symptoms.
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Can You Feel A Tumor In Your Stomach
Your provider may be able to feel a mass in your stomach during a physical exam depending on how advanced the cancer is. More often, however, symptoms involve recognizing sensations in your stomach. Your stomach may frequently feel swollen, full or painful. The pain may start as mild and then get more intense as the disease progresses.
How Stomach Cancer Spreads
There are 3 ways stomach cancer can spread:
- directly the cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum
- through the lymphatic system the lymphatic system is a series of glands located throughout your body, similar to the blood circulatory system the glands produce specialised cells needed by your immune system to fight infection
- through the blood which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver
Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer.
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Why Radiation Therapy Is Used To Treat Stomach Cancer
- Targeted radiation can shrink tumors and destroy cancer cells in nearby lymph nodes, reducing the likelihood that the cancer will spread.
- Radiation therapy can shrink a tumor so that partial or full removal becomes possible.
- Radiation therapy after surgery can kill microscopic remnants of the cancer that are too small to be detected and removed in follow-up surgeries.
- As with chemotherapy and surgery, radiation can also be used for symptom relief by easing stomach pain, reducing or stopping internal bleeding and helping you regain your appetite.
Age Diet And Stomach Disease Can Affect The Risk Of Developing Gastric Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for gastric cancer include the following:
- Having any of the following medical conditions:
- Eating a diet high in salted, smoked foods and low in fruits and vegetables.
- Eating foods that have not been prepared or stored properly.
- Being older or male.
- Having a mother, father, sister, or brother who has had stomach cancer.
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Whats Life Like After A Gastrectomy
This is major surgery, so itâll take some time for you to feel better. Your hospital stay will depend on the type of gastrectomy performed.
For the first few days, you wonât be able to eat any food. Then youâll be on a clear liquid diet. This gives your digestive tract a chance to heal. Instead, youâll be fed through an IV in your vein or a catheter that goes into your belly. After about a week, you should be ready to start a light diet again.
Because your stomach is smaller now, be prepared to make some changes to how you eat:
Small meals throughout the day. Six small meals will be easier for you to digest than three large ones.
Drink and eat at different times. Have fluids 1 hour before or after meals instead of during them.
Watch your fiber intake. High-fiber foods like beans, lentils, and whole grainscan fill you up too fast. Add them back slowly.
Go easy on dairy. After this surgery, many people canât digest lactose, the sugar in milk. If youâre one of them, youâll have gas, bloating, and diarrhea after you have dairy foods.
Take a supplement. Some nutrients like iron, calcium, and vitamins B12 and D are harder for your body to absorb from food after a gastrectomy. Your doctor may do blood tests to check these levels. If theyâre low, you may need to start taking a supplement.
What Type Of Surgery Do I Need
The type of surgery you need for cancer of the stomach depends on:
- the stage and type of your cancer
- where it is in your stomach
An operation to remove stomach cancer is major surgery. You have it under general anaesthetic, so you are in a deep sleep.
Most people need surgery to remove all or part of their stomach. You wont need a stoma .
For very small, early cancers your doctor might be able to remove part of the lining of your stomach. Your surgeon removes this using a long flexible tube . The procedure is called an endoscopic mucosal resection .
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Work With A Dietitian
Your doctor will be a key resource about how to adjust your diet. But it’s a great idea to work with a dietitian, too.
Dietitians can offer advice that’s tailored to your needs. They can suggest strategies on how to eat during and after treatment. If you don’t already have a dietitian on your treatment team, ask your doctor for a recommendation.
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Stomach And Esophageal Cancer Surgery
Surgery offers the best chance for cure and is known as a gastrectomy. If part of the stomach is removed, its called a subtotal or partial gastrectomy and if the entire stomach is removed, its called a total gastrectomy. Both surgeries involve removal of surrounding lymph nodes. The surgeons at the Saint Johns Cancer Institute have extensive experience in performing this surgery using minimally invasive techniques resulting in shorter hospital stays and quicker recovery times.
Partial, or subtotal, gastrectomy
A part of the stomach is removed leaving a portion of the stomach to be connected to the small intestine
Total gastrectomy
The whole stomach is removed and the esophagus is directly connected to the small intestine. Despite having no stomach patients eat smaller meals and can live a normal life. The surrounding lymph nodes are removed and examined for cancer.
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How Can I Prevent Stomach Cancer
Treat stomach infections. If you have ulcers from an H. pylori infection, get treatment. Antibiotics can kill the bacteria, and other drugs will heal the sores in the lining of your stomach to cut your risk of cancer.
Eat healthy. Get more fresh fruits and vegetables on your plate every day. Theyâre high in fiber and in some vitamins that can lower your cancer risk. Avoid very salty, pickled, cured, or smoked foods like hot dogs, processed lunch meats, or smoked cheeses. Keep your weight at a healthy level, too. Being overweight or obese can also raise your risk of the disease.
Donât smoke. Your stomach cancer risk doubles if you use tobacco.
Watch aspirin or NSAID use. If you take daily aspirin to prevent heart problems or NSAID drugs for arthritis, talk to your doctor about how these drugs might affect your stomach.
Show Sources
American Cancer Society: “Can Stomach Cancer Be Found Early,” “Treatment Choices by Type and Stage of Stomach Cancer,” “Chemotherapy for Stomach Cancer,” “Radiation Therapy for Stomach Cancer,” “Targeted Therapies for Stomach Cancer.”
Mayo Clinic: “Stomach Cancer.”