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Treatments


Treatments for adenocarcinoma of the stomach and gastric (digestive) tract are based on your diagnosis and exact case. Your doctor will review recommendations with you. You will be an informed partner in your treatment planning. Options include:

  • Surgery

    Adenocarcinoma is typically treated with surgery to remove any cancerous glandular tissue. Some surrounding tissue is also removed. Minimally invasive surgery techniques can reduce healing time and minimize potential infection. Surgery is the only curative treatment for gastric cancer. Chemotherapy is often done first before surgery of the stomach and gastric tract.

    • Subtotal gastrectomy: A subtotal gastrectomy is the removal of roughly 80% of your stomach. Total gastrectomy sometimes is needed afterward. Chemotherapy would be done before the surgery, and sometimes after surgery to kill any remaining cancer cells. Patients undergoing total gastrectomy can still often maintain strong gastrointestinal function after the recovery period.

    • Endoluminal stent placement: A stent (a thin, expandable tube) is inserted into the esophagus to prop the passageway open to the stomach; or a stent is placed from the stomach leading to the small intestine. By opening up any blocked passages, you will be able to eat and receive proper nutrition.

    • Gastrojejunostomy: This surgery removes the part of the stomach with cancer that is blocking areas leading into your small intestine. The jejunum is part of the small intestine. If it is blocked by cancer, food and medicine cannot easily pass from the stomach into the small intestine.

    • Endoluminal laser therapy: An endoscope is a thin, lighted tube. It has a laser attached to it. An endoscope is inserted into the blocked area. We use the laser in place of a scalpel to remove the blockage.

    • Gastrectomy: This is a more complex surgery for much more advanced tumors. A surgeon will remove your stomach and attach your esophagus to the small intestine. You would receive a prescription for medicine to help manage post-surgery discomfort and to lessen symptoms. You would be able to eat small amounts of food at a time. Additional support services would be offered as part of your care and nutrition plan.

    • Lymphadenectomy: Regional lymph nodes are often removed during stomach surgery because cancer may have spread.

    • Radical surgical resection: Available for resectable, or able to be removed by surgery, primary adenocarcinomas. This involves the removal of the tumor’s blood supply, lymph nodes, and sometimes adjacent structures during surgery.

    • Surgical bypass of obstructing lesion: Available when a radical surgical procedure would be a risk for a certain patient, based on the tumor or a medical history.

    • Endoscopic surgery: Many gastric cancer surgeries are performed with a minimally invasive approach. The surgeons insert an endoscope (a flexible thin tube with a tiny attached camera and a powerful light) through the mouth and esophagus. An endoscope has a channel through which the doctor inserts tools to collect suspicious tissue or to provide treatment. He or she can then see a magnified view of the tumor and can operate with small instruments to remove it.

    • Laparoscopic surgery: The surgeon will make three or more very small (5-10 mm) incisions in your abdomen called access ports. The laparoscope and its tiny surgical instruments are inserted through these ports. The surgeon then uses the laparoscope, which transmits a picture of the abdominal organs on a video monitor, to see fine details inside the digestive tract and stomach. Laparoscopic surgery offers you less pain and often less recovery time than a traditional open surgery.

  • Radiation Therapy

    Radiation therapy is often combined with surgery and/or chemotherapy for treating adenocarcinoma. Advanced radiation therapies make use of image-guided approaches in modern radiation therapy machines. You might receive radiation therapy before surgery to shrink the tumor or after surgery to destroy any remaining cancer cells.

  • Chemotherapy

    Chemotherapy uses medicines to destroy cancer cells. It is delivered through an intravenous (IV) tube placed into a vein with a needle, or as pills to swallow. Chemotherapy is often combined with other forms of treatment.

    • Intravenous (infusion) chemotherapy is offered at our Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami. This is a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, or Deerfield Beach locations.

    • Some chemotherapy drugs used for adenocarcinoma, stomach or gastric cancers include:

      • Cisplatin (Platinol)
      • Fluorouracil (5-FU, Adrucil)
      • Capecitabine (Xeloda)
      • Docetaxel (Docefrez, Taxotere)
      • Epirubicin (Ellence)
      • Irinotecan (Camptosar)
      • Oxaliplatin (Eloxatin)
      • Paclitaxel (Taxol)

  • Targeted Therapy

    Targeted therapy focuses on treating specific genes, proteins, or the tissue environment that contributes to cancer growth. Target therapies block the growth and spread of cancer cells. This approach can help decrease any potential damage to healthy cells.

    • Anti-angiogenesis therapy is an example of a targeted therapy. It helps stop or slow down the cancer cell’s ability to create new blood vessels. This helps to “starve” the tumor.

  • Immunotherapy

    Immunotherapy, also called biologic therapy, helps boost the body's natural defenses to fight cancer. Immunotherapies can be part of a clinical trial. Your doctor will discuss this option if you are a good candidate for this approach.

  • Palliative Care

    Many therapies are offered to help reduce symptoms and side effects before or after treatment. Ask your doctor about palliative cancer options for your stomach cancer and your treatment plan. These therapies and options can increase your quality of life during and after treatment.

  • Clinical Trials

    Newer treatments may be available through clinical trials. These are studies of the most promising new therapies. Talk with your doctor about if a clinical trial is an option for you.