Stomach Cancer

Many patients with stomach cancer can benefit from surgery. Surgical procedures performed for stomach cancer include:

• Subtotal gastrectomy: The surgeon removes the cancerous area of the stomach, typically located in the lower part of the stomach, as well as the surrounding lymph nodes. In some instances adjacent organs (pancreas, spleen, colon, etc.) may need to be partially or completely removed in order to effectively eliminate the cancer.
• Total gastrectomy: The entire stomach is removed, often along with parts of organs near the tumor, such as the esophagus or small intestine. The surgeon will then create a new stomach out of tissue from the small intestine.

Some early stage stomach cancers can be treated using robot-assisted and other minimally invasive techniques. During these procedures, the surgeon uses specially designed thin instruments to completely remove tumors in the stomach through small incisions. Benefits of minimally invasive surgery include less pain, quicker return to normal activities and less tissue damage than with traditional surgeries.

When it considering surgery for stomach cancer, it's important to choose a surgeon who is highly experienced at performing these types of procedures. Studies show that patients treated at hospitals that perform a high volume of major cancer operations — such as gastrectomies — fare far better than those treated at hospitals that do fewer cases. Our surgeons have many years of experience performing gastrectomies and other types of major gastrointestinal surgeries.

HIPEC: Heated Chemotherapy for Abdominal Tumors

Some patients with stomach tumors are candidates for HIPEC (hyperthermic intraperitoneal chemotherapy). In a HIPEC procedure, at the end of surgery to remove tumors, the patient's abdominal cavity is bathed in a heated, highly concentrated chemotherapy solution to eliminate residual cancer cells. UChicago Medicine is a leader in HIPEC and features a team of experts with many years of experience performing this advanced procedure.

Chemotherapy is a systemic therapy that uses medicine to kill cancerous cells. For stomach cancer, chemotherapy is typically given to patients whose cancer is more advanced and has spread to lymph nodes and other organs. The drugs help slow the progression of the disease, and can help relieve symptoms such as pain, nausea and bloating associated with the cancer. Some patients will receive chemotherapy after surgery to help treat any cancer cells that went undetected and therefore could not be removed during surgery.

Our medical oncologists are conducting clinical trials of new drugs, including immunotherapy, for stomach cancer. These experimental medicines are not widely available at other hospitals.

Radiation can be used in three different settings for stomach cancer:

• Before or after surgery, in order to eliminate tumor cells and improve the chance of cure with surgery
• As “definitive therapy” for unresectable disease
• For palliative care to help improve symptoms that the tumor may cause

Most commonly, radiation is given on consecutive days over several weeks in conjunction with chemotherapy.

UChicago Medicine radiation oncologists use advanced radiation techniques to treat stomach and other gastrointestinal cancers, including intensity-modulated radiation therapy (IMRT), which delivers high doses of radiation more precisely than conventional radiation therapy. That allows normal tissues to be better protected, enabling higher doses aimed at the tumor. We have an array of technology and tools for immobilizing and targeting tumors.

Our experts understand that symptoms associated with stomach cancer — such as pain and difficulty eating — can be troubling and uncomfortable. In addition to treatments designed to destroy cancerous tissue, our physicians offer palliative therapy. These treatments are aimed at lessening symptoms, but are often not likely to cure disease.

Palliative therapy options offered at the Center for Gastrointestinal Oncology include:

• Stent placement, which involves the insertion of an expandable, metal tube to relieve obstructions of the stomach and allow the patient to continue eating.
• Specialized nutritional care, to ensure patients receive adequate nutrition
• Individualized pain management, to help keep patients comfortable
• Counseling to provide patients and their families with a better understanding of their disease

Many patients in the advanced stages of stomach cancer will experience pain. We're dedicated to helping patients keep cancer pain under control. Our oncologists and anesthesiologists work together to determine the best pain management strategy, from oral medicines to nerve blocks.