Stomach Cancer

When you have stomach cancer, it means that cells anywhere in your stomach can grow out of control. Often, it starts in your stomach lining and can then grow deeper into your stomach walls. It can even spread to other organs.

There are four types of stomach cancer:

• Adenocarcinoma starts in the mucus-producing stomach lining. This is the most common type. 
• Carcinoid tumors start in neuroendocrine cells (type of neuroendocrine tumors). These can make hormones that can cause flushing, severe diarrhea or bad acid reflux.
• Gastrointestinal stromal tumors (GIST) start in special nerve cells in your stomach wall.
• Lymphoma starts in your immune system cells and can develop in your stomach.

The first important step is learning if you have stomach cancer — and if you do, what kind it is and if it’s spread.

What to expect at your first visit

We know that hearing you may have cancer can be stressful. That’s why from the moment you schedule your first appointment with us, we’re here to help you through each step of diagnosis, treatment, recovery and follow-up.

When you come to your appointment, your provider will take time to get to know you. They’ll answer your questions and ask a few of their own, like:

• What symptoms have you had, if any?
• How long have you had these symptoms?
• What other health conditions do you have?
• Has anyone in your family had cancer?

They’ll also do a physical exam and order some tests to help them make a diagnosis and stage the cancer, like:

• Blood tests for cancer.
• Endoscopic ultrasound.
• Upper endoscopy.
• Biopsy.
• CT scan.
• MRI.
• PET scan.
• Laparoscopy.

Second opinions for stomach cancer

A lot goes through your mind when you hear you have stomach cancer. What’s next? Will I be OK? Who can I turn to for help? You know you want the most experienced care team on your side. One that listens to you, answers your questions and offers the best treatments for your unique diagnosis. That’s why we encourage second opinions.

Our highly skilled and compassionate gastric cancer team is here to help you understand your diagnosis and what to expect from treatment, recovery and follow-up. And because we know that cancer doesn’t wait, we work to schedule your appointment as quickly as possible. A second opinion can give you peace of mind and the confidence to move forward with treatment.

Meet Our Stomach Cancer Team

No two cancers are alike. And in most cases, more than one healthcare provider will plan and oversee your treatment. So, when you come to Cleveland Clinic, you’ll have a care team of experienced providers from different specialties based on your unique needs and diagnosis. Your team may include:

• Gastroenterologists.
• Gastrointestinal surgeons.
• Oncologists.
• Radiation oncologists.
• Surgical oncologists.
• Radiologists.
• Pathologists.
• Nurse practitioners.
• Social workers.
• Dietitians.
• Care coordinators.

Your care team works closely together to confirm a diagnosis and map out a highly personalized treatment plan that keeps you at the center of your care.

Often, stomach cancer means you’ll need surgery. We want to remove all of the tumor or as much as possible, while keeping as much of your digestive tract as we can. The type of surgery you have depends on many things, including how much the cancer has spread. And we may combine surgery with other treatments to improve outcomes.

Endoscopic resection

We may be able to remove small tumors from your stomach lining while leaving your stomach intact using endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR). These minimally invasive options eliminate the need for open surgery and help you recover faster.

Gastrectomy

If endoscopic surgery isn’t an option for you, your care team may recommend a gastrectomy (also called gastric sleeve surgery). There are two types — partial (subtotal) and total. These may be done with a minimally invasive approach or an open approach, depending on the type and location of the cancer.

A subtotal surgery removes the part of your stomach affected by cancer and a small amount of surrounding tissue. A total gastrectomy removes your entire stomach and some surrounding tissue. Your surgeon will then connect your esophagus (food tube) to the middle part of your small intestine (jejunum) so that food can move through your system for digestion.

Palliative surgery

Surgery can also treat advanced cancer and tumors that don’t respond to other treatment. We may recommend surgery to remove tissue to ease your symptoms.

Chemotherapy and radiation

We may recommend chemotherapy or radiation therapy before surgery to shrink the tumor. Or you may have one or both afterward to destroy the remaining cancer cells. Some people also receive these therapies without surgery to destroy cancerous cells or relieve symptoms.

We offer a localized (given in one area only) chemotherapy option that doesn’t travel through your bloodstream — hyperthermic intraperitoneal chemotherapy (HIPEC). We inject this treatment in your abdominal cavity during surgery to treat only the area where you have cancer.

Other gastric cancer treatments

Cleveland Clinic also offers other treatment options for stomach cancer. If our testing reveals that your cancer has certain qualities, we may recommend some of the following options:

• Hormone therapy stops your body from making specific hormones that help cancer cells grow and multiply or blocks access to these hormones.
• Immunotherapy uses your body’s own immune system to find and destroy cancer cells.
• Targeted therapy sends treatment to cancer cells without hurting healthy cells.
• Palliative care provides symptom relief and offers an extra layer of comfort and support when you’re living with a serious illness.

Some people with stomach cancer need additional care to manage the effects of the disease and treatments. Your Cleveland Clinic team can prescribe medications to help lessen side effects like nausea, diarrhea, loss of appetite and weight loss.

During treatment and recovery, we keep an eye on your vitamin and mineral levels to make sure you’re getting the nutrition you need. We can provide supplements, expert guidance from our dietitians and a feeding tube if you need extra nutritional support.

Living with stomach cancer

An important part of care is a plan for having a healthy life after treatment. We’ll help you:

• Be aware of possible late or long-term side effects of the treatments you received.
• Find resources to help you live a healthy lifestyle.
• Schedule follow-up appointments and screening tests to catch cancer that comes back as early as possible.
• Get support for nutrition concerns and related needs.
• Know when to call and see your provider.

Taking the Next Step

Finding out you have stomach cancer can change your life in many ways. When you come to Cleveland Clinic, you’ll have a compassionate team of skilled providers who’ll keep your health, comfort and goals in mind as you move from diagnosis and treatment to recovery and follow-up care. And we do this with the latest therapies and tools and exceptional support that always focuses on you.