Stomach Cancer

At the University of Chicago Center for Gastrointestinal Oncology, our cancer specialists have many years of experience treating stomach cancer (also known as gastric cancer). Our treatment team is highly respected, bringing together specialists from our cancer and digestive disease programs--two programs ranked among the best in the nation by U.S.News & World Report.

Team Approach to Care

Our stomach cancer treatment team is comprised of specialists from a variety of disciplines--including gastroenterology, surgical oncology, medical oncology, radiation oncology, nutritional care, and others. These specialists work together to provide a comprehensive treatment plan tailored to the unique needs of each patient.

Diagnosis

A thorough diagnosis helps our physicians determine the best treatment plan. Here, our physicians offer a variety of diagnostic services to evaluate suspected stomach cancer. In addition to routine tests, our physicians can offer:

  • Esophogastroduodenoscopy (upper endoscopy): An endoscope--a thin, flexible tube--is inserted into the mouth and down into the upper gastrointestinal tract. The endoscope has a light source and camera at its tip, allowing the physician to see inside the stomach. The physician can also insert small tools into the endoscope to remove a tissue sample for testing in the lab.
  • Endoscopic ultrasound (EUS): In endoscopic ultrasound, the endoscope is fitted with a special device--called a transducer--that emits and detects sound waves as they bounce off tissue. The transducer sends this data to a computer to create an image of the tissue. EUS is very effective at visualizing the individual layers of the gastrointestinal tract--aiding in the detection and staging of cancerous lesions.
  • Laparoscopy: Laparoscopy is performed immediately before a planned gastrectomy.
  • CT scans: These non-invasive scans allow physicians to more accurately stage stomach cancers.

Treatment

Our cancer experts determine an individualized treatment plan based on the stage of the cancer, the size and location of the tumor, if the tumor has spread to other organs or lymph nodes, and other factors such as overall health.

Treatment for stomach cancer typically involves a combined approach of treatment types, including surgery, chemotherapy, and/or radiation therapy. Not all patients will receive each type of treatment.

Surgery

Many patients with stomach cancer can benefit from surgery. The most common surgeries performed for the condition include:

  • Subtotal gastrectomy: The surgeon removes the cancerous area of the stomach, typically located in the lower part of the stomach and the surrounding lymph nodes. In some instances adjacent organs(pancreas, spleen, colon, etc.) may need to be partially or completely removed in order to effectively eliminate the cancer.
  • Total gastrectomy: The entire stomach is removed, often along with parts of organs near the tumor, such as the esophagus or small intestine. The surgeon will then create a new stomach out of tissue from the small intestine.

At the Center for Gastrointestinal Oncology, some early stage stomach cancers can be treated using minimally invasive techniques. In a minimally invasive procedure, surgeons use specially designed thin instruments to completely remove tumors of the stomach through small incisions, minimizing the side effects associated with more conventional open techniques. Recovery is typically quicker, and there is minimal scarring.

Mitchell Posner and Ed Robinson Ed Robinson (at right, pictured here with surgeon Mitchell Posner, MD) was diagnosed with advanced stomach cancer in 2005 and had successful treatment at the medical campus. Today, he leads a robust life with his family and friends, works full time, and volunteers in his community. » Read Robinson's inspirational story

When it comes to surgery for stomach cancer, it's important to choose a surgeon who is very experienced at performing these types of procedures. Studies show that patients treated at hospitals that perform a high volume of major cancer operations--such as gastrectomies--fare far better than those treated at hospitals that do fewer cases. Here, our surgeons have many years of experience performing gastrectomies and other types of major gastrointestinal surgeries. Each year, our cancer surgeons perform dozens of procedures to treat stomach cancer.

Chemotherapy

Chemotherapy is a treatment that uses medicine to kill cancerous cells. For stomach cancer, chemotherapy is typically given to patients whose cancer is more advanced and has spread to lymph nodes and other organs. The drugs help slow the progression of the disease, and can help relieve symptoms such as pain, nausea, and bloating associated with the cancer. Some patients will receive chemotherapy after surgery to help treat any cancer cells that went undetected and therefore could not be removed during surgery.

Here, our medical oncologists are conducting clinical trials of new drugs for stomach cancer. These medicines are experimental and are not widely available at other hospitals.

Radiation Therapy

Radiation therapy (RT) uses high-energy radiation rays to treat cancer cells. Radiation therapy slows the progression of cancer growth. At the University of Chicago Comprehensive Cancer Center, RT is most often administered after surgery to kill any remaining cancer cells that could not be removed with surgery. RT can also relieve pain and other problems associated with stomach cancer.

Here, our radiation oncologists use a special type of RT--called intensity modulated radiation therapy (IMRT)--to treat stomach cancer. IMRT is highly precise and can "shape" the radiation beam more closely to the cancerous tissue, thus sparing nearby healthy tissue. With IMRT, higher levels of radiation can be focused on certain areas of the tumor, with lower levels of radiation being delivered to more sensitive areas closer to healthy tissue. University of Chicago radiation oncologists were the first in the Chicago area to offer this advanced type of radiation therapy.

Nutritional Care

People who have stomach cancer have special nutritional needs. At the University of Chicago Center for Gastrointestinal Oncology, our stomach cancer treatment team includes an experienced nutritionist who works with patients to develop eating plans tailored to the nutritional needs of each patient.

Palliative Care

Physician in clinic with patient

Our experts understand that symptoms associated with stomach cancer--such as pain and difficulty eating--can be very troubling. In addition to treatments designed to destroy cancerous tissue, our physicians offer palliative therapy, or treatments aimed at lessening symptoms, though not likely to cure disease.

Palliative therapy options offered at the Center for Gastrointestinal Oncology include:

  • Stent placement, which involves the insertion of an expandable, metal tube to relieve obstructions of the stomach and allow the patient to continue eating.
  • Specialized nutritional care, to ensure that patients receive adequate nutrition
  • Individualized pain management, to help keep patients comfortable
  • Individual or group counseling to provide patients and their families with a better understanding of their disease.

Pain Control

Many patients in the advanced stages of stomach cancer will experience pain. We're dedicated to helping patients keep cancer pain under control. Our oncologists and anesthesiologists (pain control physicians) work together to determine the best pain management strategy--from oral medicines to powerful nerve blocks.