How is Gastric Cancer Treated?

In the United States, gastric cancer often carries a poor prognosis for two main reasons:

  1. Frequently, the tumor is not detected until it has reached an advanced stage, limiting curative therapy.
  2. Only about 35% of the treatment facilities have a multidisciplinary approach where a coordinated team of specialists can offer a comprehensive treatment plan.

On average the long-term survival rate in the United States is 25% with approximately half of all gastric cancer patients dying within a year of diagnosis. At The Gastric Cancer Care Program of NewYork-Presbyterian/Columbia University Medical Center, we are committed to changing those statistics through the promotion of early detection initiatives and providing the highest quality of care through our multidisciplinary team of experts.

Treatment Options

The three main treatment options for gastric cancer are surgery, chemotherapy, and radiation. Hormonal therapy may be an option for a small percent of patients with a certain type of tumor biology. Surgery, however, remains the primary option for curative therapy.

Small early gastric cancers (less than 2cm) involving only the first two layers of the stomach wall can be cured with endoscopic removal of the abnormal tissue. Since some early cancers have minimal chance of spreading to other areas, a trained endoscopist can perform either an Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD), two procedures that remove the cancerous tissues in a non-surgical, minimally invasive way. The procedures offer a curative removal of the tumor without the need for open surgery.

Advanced gastric cancers are most commonly treated by surgery. Surgery involves removing part or all of the stomach as well as the lymph nodes, which aid in the body’s clearing of infections, toxins, and more. Subtotal distal gastrectomy, the removal of two-thirds of your distal stomach, is performed for tumors in the lower portions of the stomach. A total gastrectomy, removal of the entire stomach, is performed for tumors, which are in the upper portion of the stomach. The extent of lymph node removal during the operation depends on the depth of tumor invasion of the stomach wall. In many cases, this can be performed using minimally invasive approaches and robotic assistance.