Surgery is a common treatment of all stages of gastric cancer. The following types of surgery may be used:

• Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor.
  • The spleen may be removed.
    • The spleen is an organ that makes lymphocytes, stores red blood cells and lymphocytes, filters the blood, and destroys old blood cells.
    • The spleen is on the left side of the abdomen near the stomach.
• Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor.
  • The spleen may be removed.
  • The esophagus is connected to the small intestine so the patient can continue to eat and swallow.

If the tumor is blocking the stomach but the cancer cannot be completely removed by standard surgery, the following procedures may be used:

• Endoluminal stent placement: A procedure to insert a stent (a thin, expandable tube) in order to keep a passage (such as arteries or the esophagus) open.
  • For tumors blocking the passage into or out of the stomach, surgery may be done to place a stent from the esophagus to the stomach or from the stomach to the small intestine to allow the patient to eat normally.
• Endoluminal laser therapy: A procedure in which an endoscope (a thin, lighted tube) with a laser attached is inserted into the body.
  • A laser is an intense beam of light that can be used as a knife.
• Gastrojejunostomy: Surgery to remove the part of the stomach with cancer that is blocking the opening into the small intestine.
  • The stomach is connected to the jejunum (a part of the small intestine) to allow food and medicine to pass from the stomach into the small intestine.

Endoscopic mucosal resection is a procedure that uses an endoscope to remove early-stage cancer and precancerous growths from the lining of the digestive tract without surgery.

• An endoscope is a thin, tube-like instrument with a light and a lens for viewing.
• It may also include tools to remove growths from the lining of the digestive tract.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

• When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). (See Chemotherapy for more information)
• A type of regional chemotherapy being studied to treat gastric cancer is intraperitoneal (IP) chemotherapy.
  • In IP chemotherapy, the anticancer drugs are carried directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.
• Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment used during surgery that is being studied for gastric cancer.
• After the surgeon has removed as much tumor tissue as possible, warmed chemotherapy is sent directly into the peritoneal cavity.

Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.

• Chemoradiation given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
• Chemoradiation given before surgery, to shrink the tumor (neoadjuvant therapy), is being studied.

Radiation therapy

Targeted therapy

Immunotherapy