What to know about chemotherapy for stomach cancer

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Doctors often use chemotherapy alongside other treatments to treat stomach cancer. This helps make other treatments more effective. Doctors use chemotherapy with different treatment goals, depending on whether a person has had surgery for the disease.

Before and after surgery

Chemotherapy before surgery helps make tumors smaller. Doctors call this neoadjuvant treatment, which may help:

• make surgery easier by reducing the amount of tissue surgeons need to remove
• people with stomach cancer live longer
• stop tumors from coming back

Healthcare professionals may administer chemotherapy with radiation therapy, known as chemoradiation. Radiation therapy uses beams of energy to destroy cancer cells.

Learn about the differences between chemotherapy and radiation therapy.

After surgery

Chemotherapy after surgery to remove stomach cancer is known as an adjuvant treatment. The aim of this treatment is to destroy remaining areas of cancer that are too small to see. It also helps if surgeons cannot completely remove cancer during surgery.

This can help stop cancer from coming back. Healthcare professionals may give people radiation therapy with chemotherapy after surgery.

Advanced cancer

If surgeons cannot remove the cancer, or if it has spread, chemotherapy may be the main treatment for stomach cancer. It can help control and improve symptoms and help someone live longer by helping shrink the cancer and slowing its growth.

Healthcare professionals may sometimes give a person targeted medicines with chemotherapy. These are drugs that target specific changes in cells that cause cancer. They work differently from chemotherapy drugs and often have different side effects. They may work when chemotherapy is ineffective.

Healthcare professionals usually give people chemotherapy for stomach cancer by injecting chemotherapy into the veins via an IV line or catheter or giving chemotherapy orally.

Health experts call this systemic chemotherapy. Drugs enter the bloodstream and circulate to treat cancer cells anywhere in the body. They then can reach stomach cancer that has spread to other organs.

Types of stomach cancer chemotherapy drugs include:

• capecitabine (Xeloda)
• cisplatin
• docetaxel
• doxorubicin
• epirubicin
• fluorouracil (5-FU)
• irinotecan
• leucovorin
• oxaliplatin (Eloxatin)
• paclitaxel
• trifluridine or tipiracil

Read more about common cancer medications.

Healthcare professionals can give people combinations of two or three of these drugs. Which drugs they give depends on:

• the stage of the cancer
• a person’s overall health
• if an individual has chemotherapy in combination with radiotherapy for their treatment

Combinations of three drugs can have more side effects. Healthcare professionals may also give people one drug to minimize side effects.

Learn how chemotherapy affects the body.

A person’s individual side effects of chemotherapy for stomach cancer depend on the following:

• the type of chemotherapy drugs
• the drug dosage
• how long treatment lasts

Different chemotherapy drugs have different side effects, which can include:

• nausea
• vomiting
• appetite loss
• hair loss
• diarrhea
• constipation
• mouth sores
• increased likelihood of infections
• easier bleeding or bruising
• fatigue
• shortness of breath

Read more about chemotherapy side effects.

Healthcare professionals can sometimes help people reduce side effects. This may include medications for nausea or vomiting.

These side effects typically go away after a person finishes chemotherapy. However, some side effects of specific chemotherapy drugs may last after treatment, such as:

• nerve damage or neuropathy, where people have symptoms in their hands or feet such as:
  • pain
  • burning or tingling sensations
  • weakness
  • sensitivity to heat or cold
• hand-foot syndrome, people develop redness or discoloration in their hands and feet that can progress to:
  • painful sores
  • blistering
  • calluses
  • peeling skin

Some chemotherapy drugs can cause heart damage if a person uses them for a long time or in high doses. Healthcare professionals therefore carefully control how a person takes them. They will stop treatment if someone shows any signs of heart damage.

Read more about the long-term side effects of chemotherapy.

The following are answers to some questions people frequently ask about stomach cancer.

How aggressive is stomach cancer?

How aggressive a stomach cancer is depends on several factors, including the cancer’s stage, if it has spread, and a person’s overall health. Different types of stomach cancer can also grow and spread at different rates.

What is someone’s life expectancy with stomach cancer?

A person’s life expectancy with stomach cancer depends on various factors. The National Cancer Institute (NCI) gives the 5-year relative survival rate for different stages of stomach cancer, varying from 7% to 75%.

How treatable is stomach cancer?

Healthcare professionals can usually treat early stage stomach cancers. Treatment for advanced stomach cancer usually focuses on controlling cancer growth, helping people live longer, and relieving symptoms.

Chemotherapy for stomach cancer can destroy cancer cells and help stop them from growing. Healthcare professionals may use it alongside surgery or other treatments to make them more effective. It can help make a person’s cancer smaller before surgery or destroy microscopic cancer cells after surgery to help stop cancer from coming back.

It can also help to control and improve a person’s symptoms of advanced stomach cancer if the disease has spread or is not removable.

Chemotherapy often has side effects, but healthcare professionals may be able to help reduce them.