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Gastric Cancer

Treating Stomach Cancer

Summary & Participants

Gastric cancer, more commonly known as stomach cancer, is one of the most common cancers in the world. Learn more about this cancer and what treatments are available.

Medically Reviewed On: July 16, 2008

Webcast Transcript

DAVID ILSON, MD: In patients that have had potentially curative surgery, particularly in patients with stage III disease that have had complete surgeries and removal of the cancer, chemotherapy and radiation after surgery has preventive benefit in terms of reducing the risk of recurrence. In that situation, the standard chemotherapy that's used is a drug called 5-FU, or fluorouracil. That's given by itself and in combination with radiation for a period of four to five months after surgery.

ANNOUNCER: Once the cancer spreads to other organs, it is the most advanced disease or stage IV. Surgery is generally no longer a treatment option.

DAVID ILSON, MD: For patients with stage IV disease, that is identified metastatic disease, the role of surgery is not clear, because even if we remove the primary stomach cancer, we're leaving behind a distant cancer in the liver or other organs.

ANNOUNCER: Doctors will instead prescribe a combination of chemotherapy medications.

JOHN MACDONALD, MD: The FDA approved a regimen for gastric cancer, which is one of a number of regimens that are out there, but using a combination of a drugs called docetaxel, cisplatin and 5-FU. There's another regimen that uses a combination of a drug called irinotecan and cisplatin, which is also helpful now.

ANNOUNCER: Alternative chemotherapies are being studied for treating advanced cancer, including oral versions of 5-FU and substituting cisplatin with oxaliplatin.

DAVID ILSON, MD: Oxaliplatin is currently the subject of trials comparing it to the older drug, cisplatin. Oxaliplatin may have some benefits in terms of side effects compared to cisplatin.

ANNOUNCER: Studies have found that oxaliplatin can cause less nausea and fatigue than cisplatin. But all combinations of chemotherapy drugs may carry a variety of side effects.

DAVID ILSON, MD: The problem is that combination therapy has more side effects, and the side effects start to overlap. Side effects like nausea, lowering of the blood counts, diarrhea become more intense with combination treatment. So as we become more aggressive with chemotherapy, then we have to limit the use of such treatments to fit patients that are going to be able to tolerate side effects.

ANNOUNCER: Although there is no cure for advanced stomach cancer, treatments can sometimes slow its progress and provide relief.

DAVID ILSON, MD: In general, we always have to offer patients hope. And even in the situation of advanced or metastatic disease, sometimes patients have very gratifying and very symptom-relieving responses to chemotherapy and sometimes those responses to treatment, again, may last six months, a year or longer. And even though the survival that we achieve sometimes is not long, those are periods of time in which patients can have good quality of life and function and participate in family events, so we always have to approach patients with hope and optimism.

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