Stomach Cancer Treatment Surgery

Surgery for stomach cancer is often the most realistic hope for curing most gastric cancer, according to the American Cancer Society (2010). Even if the cancer is in an advanced stage and the stomach cancer prognosis is poor, surgery may relieve symptoms and extend the patient’s life.

Stomach Cancer Surgery: Endoscopic Mucosal Resection

For small, early-stage tumors confined to the stomach lining, the cancer surgery of choice may be an endoscopic mucosal resection. During this surgery, the surgeon passes a lighted tube with a camera (called an “endoscope”) down the throat into the stomach, and then uses special tools to remove the cancer and a small amount of surrounding healthy tissue.

Stomach Cancer Surgery: Subtotal Gastrectomy

If gastric cancer is confined to either the upper or lower part of the stomach, surgery for stomach cancer, called a subtotal (or partial) gastrectomy, may remove only part of the stomach and nearby lymph nodes. Removal of the upper stomach may also include removing part of the esophagus, and removal of the lower stomach may also include removing the first part of the small intestine. The surgeon reattaches the remaining section of stomach, meaning that eating is much easier than when the entire stomach is removed.

Stomach Cancer Surgery: Total Gastrectomy

If cancerous cells have spread throughout the stomach (and sometimes if the cancer is only in the upper part of the stomach, near the esophagus) the surgeon may perform a total gastrectomy. This cancer surgery removes the entire stomach and nearby lymph nodes, and sometimes the spleen and parts of other nearby organs, such as the esophagus, intestines and pancreas.

Stomach Cancer Surgery: Endoluminal Surgeries

Standard surgery for stomach cancer cannot completely remove all tumors. If a tumor that can’t be removed is blocking the passage into or out of the stomach, the surgeon may perform one of the following procedures:

  • Endoluminal stent placement: During this surgery, the surgeon inserts a thin, expandable tube called a “stent” that is designed to keep either the passage from the esophagus to the stomach or from the stomach to the small intestine open, letting you eat normally.
  • Endoluminal laser therapy: During this surgery, the surgeon uses an endoscope with a laser attached to clear the blocked passages to the stomach.

Stomach Cancer Surgeries for Advanced Cancers

If small, metastatic tumors have spread to the liver, radiofrequency ablation may be an option. Using ultrasound to guide the procedure, the surgeon places a thin, needle-like device into the center of a liver tumor. The tip of the device then emits electrical energy, called “radiofrequency waves” to heat and destroy the cancer cells.

Another option for metastatic cancer in the liver is a partial hepatectomy, or liver resection, to remove part of the liver.

A relatively new cancer surgery that may help if stomach cancer has spread throughout the abdomen–but not to the liver, lungs or outside the abdominal cavity–is hyperthermic intraperitoneal chemoperfusion (HIPEC). During this surgery, the surgeon starts by removing as much of the cancer as possible, and then uses a sterilized, heated chemotherapy that circulates through the abdominal cavity for 90 minutes to kill other cancer cells.

All surgeries have potential side effects, ranging from infection and bleeding to increased risk of fatality, so be sure you discuss all your options with your doctor and that you understand the potential benefits and risks.

Resources

American Cancer Society. (2010). Treating stomach cancer – Surgery. Retrieved February 16, 2011, from http://www.cancer.org/Cancer/StomachCancer/DetailedGuide/stomach-cancer-treating-surgery

Cancer Treatment Centers of America. (n.d.). Stomach cancer surgery. Retrieved February 16, 2011, from http://www.cancercenter.com/stomach-cancer/surgical-oncology.cfm

Mayo Clinic. (2009). Stomach cancer – Treatment and drugs. Retrieved February 16, 2011, from http://www.mayoclinic.com/health/stomach-cancer/DS00301/DSECTION=treatments-and-drugs

National Cancer Institute. (2010). Gastric cancer treatment option overview. Retrieved February 16, 2011, from http://www.cancer.gov/cancertopics/pdq/treatment/gastric/Patient/page4