Treatment Option For Stomach Cancer
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment.
Once your cancer has been diagnosed and staged, there is a lot to think about before you and your doctors choose a treatment plan. The main treatments for stomach cancer are:
• Biological therapy
Trastuzumab (Herceptin) is a biological therapy sometimes used for people with adenocarcinoma of the stomach that has spread. It only works if their cancer cells have receptors for Herceptin (HER2 positive cancer). You have Herceptin in combination with chemotherapy such as capecitabine or fluorouracil and cisplatin.
• Chemoradiation
Doctors may use a combination of chemotherapy and radiotherapy to treat stomach cancer. This is called chemoradiation. However this treatment is not used routinely.
• Chemotherapy
Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally). A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.
The goal of chemotherapy can be to destroy cancer remaining after surgery, slow the tumor’s growth, or reduce cancer-related symptoms. It also may be combined with radiation therapy. Currently, there is no single standard chemotherapy treatment regimen that is used worldwide. However, most chemotherapy treatments are based on the combination of at least two drugs, fluorouracil (5-FU, Adrucil) and cisplatin (Platinol). Newer drugs similar to 5-FU, such as capecitabine (Xeloda), and similar to cisplatin, such as oxaliplatin (Eloxatin), appear to work equally well. Other drugs commonly used include docetaxel (Docefrez, Taxotere), epirubicin (Ellence), irinotecan (Camptosar), and paclitaxel (Taxol).
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
• Radiation therapy
Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. Patients with stomach cancer usually receive external-beam radiation therapy, which is radiation given from a machine outside the body. Radiation therapy may be used before surgery to shrink the size of the tumor or after surgery to destroy any remaining cancer cells.
Side effects from radiation therapy include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Stomach Cancer Treatment Option.
• Surgery
The amount of surgery you have will depend on the stage of your cancer. You are likely to have a CT scan and laparoscopy to help your specialist decide if surgery is an option for you. But your doctor may not be able to tell you exactly what stage your cancer is until after surgery. After surgery, specimens from the operation are sent to the lab where a pathologist looks at them under a microscope. This gives the most accurate measure of the cancer stage. Depending on the stage of the cancer, you might have
- Surgery to remove the cancer
If it is possible to try to cure your stomach cancer, you will have all or part of your stomach removed. How much is removed will depend on where in the stomach the cancer is. During your operation, your surgeon will examine the stomach and surrounding area. The lymph nodes around your stomach and part of the omentum (sheet of connective tissue that holds the stomach in place) will be removed. These will be sent to the laboratory and checked to see if they contain cancer cells. - Surgery to relieve symptoms
Even if your stomach cancer cannot be cured with surgery, you may need an operation to relieve symptoms and try to give you a better quality of life for longer. If the tumour is blocking the entrance or exit to your stomach you are likely to have a tube (called a stent) into the area, along with chemotherapy. Or you may have bypass surgery, where part of the stomach above the blockage is attached directly to the small bowel. Sometimes laser surgery is used to reduce the size of a tumour that is blocking the entrance to the stomach.
• Targeted therapy
Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells. Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. As a result, doctors can better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them.
A patient with later-stage cancer whose stomach tumor has too much of the protein HER2, called HER2-positive cancer, may benefit from receiving trastuzumab (Herceptin) with chemotherapy. For patients whose tumor has grown while receiving initial chemotherapy, the drug called ramucirumab (Cyramza) was approved in 2014 as an additional treatment. Ramucirumab is a type of targeted therapy called an anti-angiogenic. It is focused on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor.
Often the best approach uses 2 or more of these treatment methods.
You will want to weigh the benefits of each treatment against the possible risks and side effects. Your treatment options depend on many factors. The location and the stage (extent of spread) of the tumor are very important. In choosing your treatment plan, you and your cancer care team will also take your age, general state of health, and personal preferences into account.
It is important to have a team of doctors with different specialties involved in your care before plans for treating your stomach cancer are made. Most likely, your team will include:
- A gastroenterologist: a doctor who specializes in treatment of diseases of the digestive system.
- A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy.
- A radiation oncologist: a doctor who treats cancer with radiation therapy.
- A surgical oncologist: a doctor who treats cancer with surgery.
It is important that you understand the goal of your treatment — whether it is to try to cure your cancer or to keep the cancer under control or relieve symptoms — before starting treatment. If the goal of your treatment is a cure, you will also receive treatment to relieve symptoms and side effects. If a cure is not possible, treatment is aimed at keeping the cancer under control for as long as possible and relieving symptoms, such as trouble eating, pain, or bleeding.
How your treatment is planned?
As with many cancers, the main treatment options are surgery, chemotherapy and radiotherapy. You may have surgery with chemotherapy or radiotherapy, or on its own. Your doctors will plan your treatment taking into account- How far your cancer has grown or spread (the stage)
- Your general health
- Your age and level of fitness