Radiation therapy offers pain-free treatment options to manage stomach cancer while maintaining quality of life.
The stomach is part of the digestive system where food is processed into liquid and passed into the small intestine to absorb nutrients.
Stomach cancer is also called gastric cancer and typically originates in the stomach’s mucosa, or inner lining. It tends to grow very slowly and while there are pre-cancerous changes to the lining before the cancer starts, they rarely cause symptoms and therefore go undetected. Later stage symptoms include stomachache, difficulty swallowing, nausea, vomiting, unexplained weight loss and bloating.
Two out of three people diagnosed with stomach cancer are over the age of 70. Approximately 13,000 men and 8,000 women will be diagnosed with stomach cancer in the United States every year.
Patients with long-term inflammation of the stomach such as pernicious anemia are at a higher risk of developing stomach cancer. Exposure to helicobacter pylori infection can also cause stomach inflammation and peptic ulcers and increase the risk. Additional risk factors include poor diet, obesity, lack of physical activity, smoking, and family history.
Surgery holds the best possible cure for stomach cancer and is therefore the most common treatment. That said, chemotherapy, targeted therapy and radiation therapy may also be recommended.
Depending on the stage of the cancer and the location of the tumor, a surgeon may choose to remove the affected portion of the stomach lining, perform a partial gastrectomy to remove a portion of the stomach or a total gastrectomy to remove all of the stomach. Nearby lymph nodes are also often removed during partial or total gastrectomies as well as parts of the esophagus, intestines, pancreas and other nearby organs to help prevent further spreading of the disease.
Chemotherapy uses drugs circulated through the blood stream to destroy cancer cells. It may be used as the primary treatment in cases where stomach cancer has spread to distant sites and can alleviate symptoms and help prolong life. It can also be used after surgery (adjuvant treatment) to destroy any cancerous cells left behind and prevent recurrence of the cancer. In some stages of stomach cancer, chemotherapy can be used before surgery (to shrink the size of the tumor to make the surgery less complicated. Chemotherapy can also be administered after the surgery.
Targeted therapy uses drugs to seek and attack molecules and cellular activity that the cancer depends on to survive and grow. Approximately 20% of stomach cancer patients have too much of a growth-promoting protein called HER2 on the surface of the cancer cells. Trastuzumab is a monoclonal antibody that targets HER2 on the surface of cancer cells. By interfering with the protein, it slows or stops the cancer’s growth.
Radiation uses high-powered x-rays to destroy cancerous tumors and cells. In cases of stomach cancer, External Beam Radiation Therapy or EBRT may be recommended after surgery to kill any remaining cancerous cells left behind. In advanced cases of the disease, radiation may be used to successfully manage the patient’s quality of life by helping to alleviate bleeding, pain and trouble eating.
3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT) are two forms of External Beam Radiation Therapy. During 3D-Conformal treatments, a device called a “multi-leaf collimator” will shape the individual radiation beams to “conform” to the shape of your tumor according to the data and instructions it receives from the system computer. IMRT uses thousands of radiation “beamlets” from many different angles to deliver a single dose of radiation. The intensity of the “beamlets” can change during the treatment session to modulate the dose, so that the tumor receives a very precise high dose of radiation, while minimizing damage to surrounding, normal tissue.
Before each session, a Radiation Therapist will carefully position you on the treatment table using a body immobilizer for precise body placement. Image guidance will be used to confirm the location of the tumor before the therapy begins. During your treatment sessions, the radiation delivery system will revolve around you, delivering the radiation according to the plan set by your Radiation Oncologist. Each treatment session lasts from 10 to 30 minutes. If radiation is your primary form of treatment, you will be scheduled for five sessions a week for six to seven weeks. If it is used in adjuvant to surgery, you will be treated for four to five weeks. The sessions are pain-free and require no sedation so you can return to your normal activities right away.