Factors influencing the patient’s treatment plan include the type and stage of the cancer, the patient’s general health and other contributing factors.  For most patients, a cancer care team will be established to diagnose and plan all aspects of the patient’s treatment. The team is typically headed up by a medical oncologist and may also include:  

• Radiation oncologist
• Surgeon
• Pathologist
• Gastroenterologist
• Dietician
  

The treatment of stomach cancer will depend on a variety of factors. In most cases, patients may receive a combination of the following treatments:

• Surgery. Surgical removal of cancerous tissue. Surgery is considered the only way to possibly cure stomach cancer.  Curative surgery is performed for stages 0, I, II, and III. These tumors are resectable, meaning they can be surgically removed.  In the later stages, stomach cancer surgery is palliative, meaning it is done to relieve the patient of symptoms, not necessarily cure the cancer. The following types of surgery may be used:
  
  
• • Endoscopic mucosal resection. Surgical removal of a tumor or portion of an organ through an endoscope. This procedure is performed in the early stages of cancer and when there is little risk of the cancer spreading to the lymph nodes or surrounding tissues.
    
    
  • Subtotal or partial gastrectomy. Removal of the cancerous part of the stomach and in some cases, the first section of the small intestine. This type of surgery is can allow the patient to eat with less difficulty than when the entire stomach is removed.
    
    
  • Total gastrectomy. The entire stomach is removed because the cancer is in the middle and upper parts of the stomach. The nearby lymph nodes, parts of the esophagus, small intestine and any other cancerous tissue near the tumor also may be removed. After total gastrectomy, individuals can only eat very small amounts of food at a sitting as they will fill up quickly.
    
    
  In the event that the stomach is blocked but the tumor cannot be removed through the above surgeries, the following procedures may be performed:
  
  
• • Endoluminal stent placement. A stent (a thin, flexible tube) is inserted to keep a passage open that may have been blocked by a tumor, such as the opening connecting the esophagus to the stomach or a major blood vessel in the stomach.
    
    
  • Endoscopic laser surgery. An endoscope with a laser attached is inserted into the body and the tumor is cut out with the laser beam.
    
    
  • Electrocautery. An electrical current is sent to create heat that removes lesions or controls bleeding.
    
    
• Chemotherapy. The use of powerful drugs to control the growth of cancer cells by killing them or preventing cell division. This method can be used in addition to surgery to prevent a return of cancer cells or before surgery to make a tumor smaller. In addition, chemotherapy may be used as primary treatment for cancer that has spread to distant organs.
  
  
• Radiation therapy. Use of high energy x-rays to destroy or shrink cancer cells  External beam radiation is the type of radiation typically used for stomach cancer. Research indicates that radiation therapy, particularly when combined with chemotherapy, can be effective in preventing stomach cancer from retuning after surgery.
  
  
• Biological therapy (also called immunotherapy).  This treatment is used to stimulate the immune system to fight the cancerous cells or, in some cases, directly attack the cancer.
  
  
• Clinical trials. A physician may recommend participation in a clinical trial that will test new experimental treatments. Experimental therapies may include new chemotherapy drugs or a variety of combined treatments.
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• Comfort (palliative) care. Patients have the option of receiving treatment for their symptoms without treating the cancer. Stage IV stomach cancer is generally treated with palliative chemotherapy and/or radiation therapy and other treatments because metastasis is extensive. Surgery is palliative at this stage, to stop bleeding, prevent blockages or shrink a tumor.