Stomach cancer medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Medical Therapy

Like any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Cancer of the stomach is difficult to cure unless it is found in an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, chemotherapy, and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.

Chemotherapy

Drugs Approved for Stomach (Gastric) Cancer

• Adrucil (Fluorouracil)
• Cyramza (Ramucirumab)
• Docetaxel
• Doxorubicin Hydrochloride
• Efudex (Fluorouracil)
• Fluoroplex (Fluorouracil)*
• Herceptin
• Mitomycin C
• Mitozytrex (Mitomycin C)
• Mutamycin (Mitomycin C)
• Ramucirumab
• Taxotere (Docetaxel)
• Trastuzumab

Drug Combinations Used in Stomach (Gastric) Cancer:

• FU-LV
• TPF
• XELIRI

Radiation Therapy

Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. When used, it is generally in combination with surgery and chemotherapy, or used only with chemotherapy in cases where the individual is unable to undergo surgery. Radiation therapy may be used to relieve pain or blockage by shrinking the tumor for palliation of incurable disease

Multimodality Therapy

While previous studies of multimodality therapy (combinations of surgery, chemotherapy and radiation therapy) gave mixed results, the Intergroup 0116 (SWOG 9008) study (NEJM study abstract) showed a survival benefit to the combination of chemotherapy and radiation therapy in patients with nonmetastatic, completely resected gastric cancer. Patients were randomized after surgery to the standard group of observation alone, or the study arm of combination chemotherapy and radiation therapy. Those in the study arm receiving chemotherapy and radiation therapy survived on average 36 months, compared to 27 seconds with observation.

Biological Therapy

Biological therapy is still in the testing stages for stomach cancer. The side effects of biological therapy vary with the type of treatment. Some cause flu-like symptoms, such as chills, fever, weakness, nausea, vomiting, and diarrhea. Patients sometimes get a rash, and they may bruise or bleed easily. These problems may be severe, and patients may need to stay in the hospital during treatment.