• Chemotherapy for Stomach Cancer

    Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.
    For stomach cancer, chemotherapy is usually combined with other types of treatment, such as surgery and radiation therapy , in an attempt to:
    • Increase survival time
    • Prevent recurrence
    • Provide some symptom relief
    Chemotherapy is usually given after surgery. Research is being done to study the effects of chemotherapy given in an effort to shrink the stomach cancer before surgery.

    Chemotherapy Drugs Used for Stomach Cancer

    There are several chemotherapeutic drugs that are currently being used to treat stomach cancer. These include F-FU, cisplatin , oxaliplatin , irinotecan , capecitabine , anthracyclines, and taxanes.
    Chemotherapy agents may be given by mouth or by injection into a vein. Research is studying the effects of chemotherapy instilled directly into the abdomen, called intraperitoneal chemotherapy.

    Effectiveness of Chemotherapy for Stomach Cancer

    Chemotherapy, when given in combination with radiation after surgery, increases the survival time and increases the amount of time before recurrence. In a group of stomach cancer patients who received chemotherapy and radiation following surgery, the 3-year survival rate was 50%, versus 41% in those who received no additional treatment after surgery. Relapse (return of cancer) occurred in 43% of the chemoradiation group compared to 64% in the no treatment group.
    Chemotherapy may be helpful for more advanced stomach cancer that has already spread to organs outside of the stomach. This treatment may improve survival time by months and the quality of life. Various combinations of chemotherapy may bring about a response in up to 50% of patients; a response is defined as shrinkage of the tumor volume by 50% or more.

    Side Effects

    Chemotherapy given to treat stomach cancer may cause the following side effects:
    • Sunburn-like skin irritation
    • Nausea
    • Diarrhea
    • Fatigue
    • Nerve damage
    • Low blood counts
    • Hair loss
    • Kidney damage

    References

    Cashen AF, Wildes TM. The Washington Manual; Hematology and Oncology Subspeciality Consult. 2nd ed. Wolter Kluwers; 2008.

    Cecil Textbook of Medicine. Philadelphia, PA: WB Saunders Company; 2002: 738-741.

    Conn’s Current Therapy 2002. Philadelphia, PA: WB Saunders Company; 2002: 527-529.

    Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. Philadelphia, PA: WB Saunders Company; 1998: 733-749.

    What Is stomach cancer? American Cancer Society website. Available at: http://www.cancer.org/ . Accessed December 2002.

    What you need to know about stomach cancer. National Cancer Institute website. Available at http://www.cancer.gov/cancerinfo/wyntk/stomach . Accessed December 2002.

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