Stomach Cancer

Gastric cancer treatment depends on the type and the stage or spread of the cancer. Your age and general state of health are also of important consideration by the doctor in determining the treatment modality. Treatment involves surgery, chemotherapy, and radiation therapy. Surgery is the most common treatment for gastric cancer. Three kinds of surgeries are used to treat gastric cancer. The type of surgery depends on where the cancer is located and how deep the cancer cells have invaded the area in the stomach. The three types of surgery for gastric cancer are:

• Endoscopic mucosal resection: This is done only when the cancer is detected at an early stage, where the chance of it spreading to the lymph nodes is very low. In this procedure, cancerous tissue is removed from the stomach using an endoscope, a long flexible tube with a camera at the end. During the procedure, an endoscope is passed through the mouth into the stomach and surgical tools are also passed through it to remove the cancerous tissue. The surgery is done using these tools and does not involve any cuts on the body.
• Subtotal gastrectomy: In this surgery, a part of the stomach is removed. This surgery is primarily used when the cancer is only in the lower part of the stomach or the upper part of the stomach. During the procedure, only part of the stomach is removed, and sometimes a part of the esophagus is removed along with it. Nearby lymph nodes may also be removed. The remaining part of the stomach is then reattached.
• Total gastrectomy: In this surgery, the whole stomach is removed along with nearby lymph nodes, and a new stomach is recreated by the small intestine. This is usually done when the cancer has spread to the whole of the stomach. Sometimes nearby organs are also removed if the cancer has spread to them.

Chemotherapy and radiation may also be given after the surgery to kill the few cancer cells that may be left after the surgery and to prevent the recurrence of the disease.

Possible complications of surgery for stomach cancer include bleeding, formation of blood clots, and damage to nearby organs. You may also develop frequent heartburn, abdominal pain (especially after eating), and vitamin deficiencies.

After the surgery, follow-up is very important since the recurrence of the disease is a possibility. In case of any suspicion, the doctor will ask for certain tests to confirm any findings. Absorption of vitamin B12 occurs through the upper part of the stomach. If the upper part of the stomach is removed by surgery vitamin B12 levels are closely monitored and vitamin B12 injections are given when required. The doctor may refer you to a nutritionist to plan your diet and you may need to eat smaller meals more often as the size of the new stomach may be small.