Stomach Cancer and Chemotherapy

Stomach cancer and chemotherapy. Chemotherapy is a treatment with cytostatics. These are drugs that kill cells or inhibit cell division. These drugs spread through your body through the blood.

The doctor will advise you whether chemotherapy is appropriate in your situation. He/she does this based on your age, condition, and function of heart and kidneys.

Chemotherapy combined with surgery
If you are being treated for stomach cancer, you will often receive chemotherapy before and after surgery.

Neo-adjuvant chemotherapy
Usually, you get 3 chemo drugs. These must ensure that the outlook after surgery is better. This is called neoadjuvant chemotherapy. Neoadjuvant means: for another treatment.

Surgery
After that, you will be given a surgery: The surgeon will remove your stomach completely or completely. The surgery preferably takes place between 3 and 6 weeks after the last chemotherapy.

Do you have a tumor at the outlet of the stomach and it complicates the passage of food to the intestines? Then your doctor may advise starting immediately with the surgery.




Adjuvant chemotherapy, sometimes with irradiation
After surgery, you usually get 3 more chemotherapy. Sometimes with irradiation. The combination of chemotherapy and radiation is called chemoradiation.

This treatment is called adjuvant chemotherapy or chemoradiation. Adjuvant means: in addition to another treatment. The additional treatment is preferably started 6 to 12 weeks after the surgery.

The purpose of this is:

• Remaining any remaining cancer cells after surgery
• Destroy very small, invisible metastases (micrometastases)

Chemoradiation instead of chemotherapy
Your doctor may advise adjuvant chemoradiation instead of chemotherapy if:

• The chemotherapy for the surgery (neoadjuvant) does not work well with you
• The stomach cancer has T-stage 3 or 4 and N-stage 2 or 3 or if the tumor can not be removed in its entirety

Commonly used stomach cancer drugs
Commonly used combinations of cytostatics in stomach cancer are:

• EOF: epirubicin, oxaliplatin, and 5-fluorouracil
• EOX: epirubicin, oxaliplatin, and capecitabine
• DOC: docetaxel, oxaliplatin, and capecitabine

Chemotherapy as palliative treatment
Do you have stomach cancer and are you in good condition? Then you can get palliative chemotherapy. This cure consists of oxaliplatin + 5-fluorouracil or capecitabine. This treatment aims at inhibiting the disease and reducing complaints.

If you have HER2-positive stomach cancer, the targeted drug trastuzumab can be added to chemotherapy. If a combination of chemotherapy and targeted therapy is not suitable for you, you can only be treated with capecitabine.

Side effects of chemotherapy in stomach cancer
Whether and how much you get from the side effects of chemotherapy depends on others on:

• the types of medicine
• how much medicine you get

You may experience the following side effects:

• hair loss
• nausea and vomiting
• bowel complaints
• increased risk of infection and bleeding
• fatigue

Are you nauseous or do you care a lot? Then you can usually get medications here. Ask your doctor for this. If you have finished chemotherapy, the side effects are usually less.

Most complaints usually disappear a few weeks after treatment. But you can stay tired for a long time. The doctor or nurse will give you advice on how to minimize the side effects.

*Image source : Wikimedia Commons

References :

1. National Cancer Institute
2. Kanker.nl
3. American Cancer Society