Surgery is the most common treatment for stomach cancer. The goal of surgery is to remove the entire tumor and any cancer cells that may have spread (metastasized) to nearby tissue. Depending on the stage of the cancer, surgery may be the only treatment that you need. You may have surgery before or after another treatment.

Your doctor may recommend an open (traditional) approach or a minimally invasive laparoscopic procedure, which uses smaller incisions and involves less recovery time. At Stanford Health Care, our team is skilled at robot-assisted techniques. The surgeon controls the operating tools with the assistance of a specially designed robot, allowing us to make procedures more precise.

Types of stomach cancer surgery include:

Cancer drugs destroy cancer cells or help your body fight them. You may need them along with other treatments. They include:

You may receive cancer medications by mouth (orally) or as an injection or infusion (intravenously, or IV). In some cases, we may recommend receiving cancer medications using a method called hyperthermic intraperitoneal chemotherapy, or HIPEC. With HIPEC, doctors apply high-dose chemotherapy directly to the surgical site, after removing the tumor.

At Stanford Health Care, we have the most experienced HIPEC team in Northern California. We specialize in this advanced treatment, which involves fewer side effects than intravenous chemotherapy. 

External radiation

Most commonly, doctors use external radiation (external beam therapy) to treat stomach cancer. This painless treatment uses a machine to send high levels of radiation directly to the cancer cells, which destroys them. Our team is skilled at using several types of external radiation therapy:

• 3D conformal radiation therapy (3D-CRT): With this method, 3D images help the doctor better target the tumor. We create the images using a computed tomography (CT) or magnetic resonance imaging (MRI) machine. Your doctor can aim the beams of radiation from many different angles to match the exact shape of the cancer.
•  Intensity-modulated radiation therapy (IMRT): IMRT is similar to 3D-CRT, but the doctor can adjust how much radiation you get from each beam. In certain situations, this adjustment enables the doctor to avoid nearby healthy cells to reduce the risk of side effects.

Our team offers advanced genetic testing and counseling to assess your risk, and your family’s risk, of stomach cancer. We use the latest technology to look at many genes at once, allowing us to identify inherited cancer conditions and gene mutations that increase the risk of cancer.

We combine this information with your family history and medical background to create a customized plan for you and your family. This plan may include preventive care and screenings that can detect cancer earlier, when it’s easier to treat. Genetic testing also helps us develop treatment plans and manage disease.

To achieve the best possible outcome, your care team may recommend combining surgery with other treatments such as radiation therapy or chemotherapy. You may receive additional treatment in one of two ways:

• Neoadjuvant therapy: This treatment occurs before surgery to make it easier and more effective. Undergoing chemotherapy before surgery, for example, may shrink a tumor and make removal more successful.
• Adjuvant therapy: This treatment occurs after surgery to reduce the risk of the cancer coming back. Chemotherapy or radiation therapy after surgery can destroy remaining cancer cells.