Receiving a diagnosis of stomach cancer, also known as gastric cancer, can be a disorienting experience. Symptoms like persistent indigestion, unexplained weight loss, and fatigue are often initially mistaken for minor ailments, making the confirmation of a malignancy feel sudden and overwhelming. Beyond the physical toll, the diagnosis brings significant emotional weight and uncertainty about the future. However, the landscape of gastric cancer care has evolved significantly, offering more precise and effective options than ever before.

Treatment is critical to halt the progression of the disease, alleviate painful symptoms, and extend survival. In early stages, the goal is often curative, aiming to remove or destroy all cancer cells. In more advanced stages, treatment focuses on controlling the disease, maintaining quality of life, and prolonging time with loved ones. Because stomach cancer varies biologically from person to person, influenced by genetic markers and the tumor’s location, treatment plans are highly personalized (National Cancer Institute, 2023).

Overview of treatment options for Stomach Cancer

The management of stomach cancer typically involves a combination of surgery and systemic medication. While surgical removal of part or all of the stomach (gastrectomy) is the primary method for curing localized cancer, medications are almost always required to support this process.

Systemic therapy serves three main roles: “neoadjuvant” therapy is given before surgery to shrink the tumor; “adjuvant” therapy is administered after surgery to kill any remaining microscopic cells; and palliative therapy is used for advanced cancer to control growth. The treatment plan often combines chemotherapy, targeted drugs, and immunotherapy. Clinical experience suggests that combining these modalities often yields better outcomes than using any single approach alone.

Medications used for Stomach Cancer

Chemotherapy remains the backbone of treatment. Commonly used drugs include fluoropyrimidines (such as 5-fluorouracil or capecitabine), platinums (like oxaliplatin or cisplatin), and taxanes (such as paclitaxel). These are often given in combination regimens. Patients typically undergo cycles of treatment, with rest periods in between to allow the body to recover.

Targeted therapy is used when specific proteins are driving the cancer’s growth. For example, if the tumor overexpresses the HER2 protein, doctors may prescribe trastuzumab. Another targeted option is ramucirumab, which focuses on cutting off the tumor’s blood supply.

Immunotherapy has become a vital tool, particularly for advanced cases. Drugs like nivolumab or pembrolizumab are checkpoint inhibitors that help the immune system recognize and attack cancer cells. These are often used when chemotherapy alone has not been effective or in combination with it. Studies show that for certain genetic profiles, adding immunotherapy can significantly improve survival rates (American Cancer Society, 2024).

How these medications work

Chemotherapy drugs work by targeting fast-dividing cells. Since cancer cells divide uncontrollably, these drugs disrupt their reproductive cycle, causing them to die. However, they can also affect healthy fast-growing cells, leading to common side effects.

Targeted therapies work differently by “locking on” to specific molecular targets associated with cancer. Trastuzumab, for instance, blocks the HER2 receptors on the surface of cancer cells, effectively shutting down the signals that tell the cell to grow and divide. Ramucirumab binds to a receptor involved in blood vessel formation, starving the tumor of the nutrients it needs to expand.

Immunotherapy does not attack the cancer directly. Instead, it blocks proteins (like PD-1 or PD-L1) that cancer cells use to hide from the immune system. By removing this “mask,” the medication unleashes the body’s own white blood cells to find and destroy the tumor (Mayo Clinic, 2023).

Side effects and safety considerations

Chemotherapy often causes fatigue, nausea, vomiting, hair loss, and infection risk (due to low white blood cells). Platinum drugs and taxanes commonly cause neuropathy (tingling).

Targeted therapies have different side effects; trastuzumab requires heart monitoring due to potential muscle weakening. Immunotherapy can cause the immune system to attack healthy organs, leading to inflammation in the lungs, colon, or liver.

Pregnant women should usually avoid these systemic therapies due to fetal risks. Patients must seek immediate medical care for fever (infection), severe abdominal pain, or uncontrolled vomiting. Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. American Cancer Society. https://www.cancer.org
2. Mayo Clinic. https://www.mayoclinic.org
3. National Cancer Institute. https://www.cancer.gov
4. National Comprehensive Cancer Network. https://www.nccn.org