Stomach Cancer (cont.)
Treatment methods
The choice of treatment depends mainly on the size and place of the tumor,
the stage of disease, and your general health. Treatment for stomach cancer may
involve surgery, chemotherapy, or radiation therapy. Many people have more than
one type of treatment.
Your doctor can describe your treatment choices and the expected results. You
and your doctor can work together to develop a treatment plan that meets your
needs.
Cancer treatment is either local therapy or systemic therapy:
- Local therapy: Surgery and radiation therapy are local therapies. They remove
or destroy cancer in or near the stomach. When stomach cancer has spread to
other parts of the body, local therapy may be used to control the disease in
those specific areas.
- Systemic therapy: Chemotherapy is systemic therapy. The
drug enters the bloodstream and destroys or controls cancer throughout the body.
Because cancer treatments often damage healthy cells and tissues, side effects
are common. Side effects depend mainly on the type and extent of the treatment.
Side effects may not be the same for each person, and they may change from one
treatment session to the next.
Before treatment starts, your health care team will explain possible side
effects and suggest ways to help you manage them. NCI provides helpful booklets
about cancer treatments and coping with side effects. These include Chemotherapy
and You, Radiation Therapy and You, and Eating Hints for Cancer Patients.
At any stage of disease, supportive care is available to relieve the side
effects of treatment, to control pain and other symptoms, and to ease emotional
concerns. Information about such care is available on NCI's Web site at
http://www.cancer.gov/cancertopics/coping, and from Information Specialists at
1-800-4-CANCER or LiveHelp (http://www.cancer.gov/cis).
You may want to talk to your doctor about taking part in a clinical trial, a
research study of new treatment methods. The section on "The Promise of Cancer
Research" has more information about clinical trials.
You may want to ask your doctor these questions about treatment:
- What is the stage of the disease?
- What are my treatment choices? Which do you
suggest for me? Why?
- Would a clinical trial (research study) be a good choice
for me?
- Will I have more than one kind of treatment?
- What are the expected
benefits of each kind of treatment?
- What are the risks and possible side effects
of each treatment? What can we do to control my side effects? How else can I
take care of myself during treatment?
- How will treatment affect my normal
activities? Am I likely to have eating or other problems?
- Whom should I call if
I have problems during treatment?
- What is the treatment likely to cost? Does my
insurance cover this treatment?
- How often should I have checkups?
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Surgery
Surgery is the most common treatment for stomach cancer. The type of surgery
depends on the extent of the cancer. There are two main types of stomach cancer
surgery:
- Partial (subtotal) gastrectomy: The surgeon removes the part of the stomach
with cancer. The surgeon also may remove part of the esophagus or part of the
small intestine. Nearby lymph nodes and other tissues may be removed.
- Total gastrectomy: The doctor removes the entire stomach, nearby lymph nodes, parts of
the esophagus and small intestine, and other tissues near the tumor. The spleen
also may be removed. The surgeon then connects the esophagus directly to the
small intestine. The surgeon makes a new "stomach" out of tissue from the
intestine.
It is natural to be concerned about eating after surgery for stomach
cancer. During surgery, the surgeon may place a feeding tube into your small
intestine. This tube helps you get enough nutrition while you heal. Information
about eating after surgery is in the "Nutrition" section.
The time it takes to heal after surgery is different for each person. You may
be uncomfortable for the first few days. Medicine can help control your pain.
Before surgery, you should discuss the plan for pain relief with your doctor or
nurse. After surgery, your doctor can adjust the plan if you need more pain
relief.
Many people who have stomach surgery feel tired or weak for a while. The
surgery also can cause constipation or diarrhea. These symptoms usually can be
controlled with diet changes and medicine. Your health care team will watch for
signs of bleeding, infection, or other problems that may require treatment.
You may want to ask your doctor these questions about surgery:
- What kind of surgery do you recommend for me?
- Will you remove lymph nodes?
Will you remove other tissue? Why?
- How will I feel after surgery?
- Will I need a
special diet?
- If I have pain, how will you control it?
- How long will I be in the
hospital?
- Am I likely to have eating problems? Will I need a feeding tube? If
so, for how long? How do I take care of it? Who can help me if I have a problem?
- Will I have any lasting side effects?
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Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells. The drugs enter the
bloodstream and can affect cancer cells all over the body.
Most people who receive chemotherapy have it after surgery. Radiation therapy
may be given along with chemotherapy.
Anticancer drugs for stomach cancer are usually injected into a blood vessel.
But some drugs may be given by mouth. You may have your treatment in a clinic at
the hospital, at the doctor's office, or at home. Some people may need to stay
in the hospital during treatment.
The side effects of chemotherapy depend mainly on the specific drugs and the
dose. The drugs affect cancer cells and other cells that divide rapidly:
- Blood cells: These cells fight infection, help blood to clot, and carry
oxygen to all parts of your body. When drugs affect your blood cells, you are
more likely to get infections, bruise or bleed easily, and feel very weak and
tired.
- Cells in hair roots: Chemotherapy drugs can cause hair loss. Your hair
will grow back, but it may be somewhat different in color and texture.
- Cells
that line the digestive tract: Chemotherapy can cause poor appetite, nausea and
vomiting, diarrhea, or mouth and lip sores. The drugs used for stomach cancer
also may cause a skin rash or itching. Your health care team can suggest ways to
control many of these side effects.
You may want to ask your doctor these questions about chemotherapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the
drugs work?
- When will treatment start? When will it end?
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Radiation therapy
Radiation therapy (also called radiotherapy) uses high-energy rays to kill
cancer cells. It affects cells only in the treated area.
The radiation comes from a large machine outside the body. Most people go to
a hospital or clinic for treatment. Treatments are usually 5 days a week for
several weeks.
Side effects depend mainly on the dose of radiation and the part of your body
that is treated. Radiation therapy to the abdomen may cause pain in the stomach
or the intestine. You may have nausea and diarrhea. Also, your skin in the
treated area may become red, dry, and tender.
You are likely to become very tired during radiation therapy, especially in
the later weeks of treatment. Resting is important, but doctors usually advise
patients to try to stay as active as they can.
Although the side effects of radiation therapy can be distressing, your
doctor can usually treat or control them. Also, side effects usually go away
after treatment ends.
You may want to ask your doctor these questions about radiation therapy:
- Why do I need this treatment?
- When will the treatments begin? When will they
end?
- How will I feel during treatment?
- How will we know if the radiation
treatment is working?
- Are there any lasting effects?
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