About chemotherapy for stomach cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. The drugs circulate in the bloodstream around the body.

For stomach cancer, you may have chemotherapy

• Before and after surgery
• To reduce or control symptoms in advanced cancer
• To slow an advanced cancer down

You might have your chemotherapy for stomach cancer

• As an injection
• Through a drip into the arm
• Through a pump as a slow continuous infusion
• As tablets

How you have your chemotherapy will depend on the particular drug or combination of drugs you are having. You may have a combination of drip, injections and tablets. There is information about the drugs used to treat stomach cancer in the next page of this section.

If you have stomach cancer that can be removed, you are most likely to have chemotherapy both before and after surgery. This is called peri operative chemotherapy. Chemotherapy helps to reduce the size of the cancer making it easier to remove. And it also reduces the chances of the cancer coming back.

Chemotherapy does have side effects, and not everyone is fit enough to have it. Your doctor will assess you carefully to make sure you are fit enough before you start any chemotherapy treatment.

If your cancer is thought to be too large to remove completely, your doctor may suggest chemotherapy to try to shrink it. This may help to slow down its growth. In some cases, the cancer may shrink far enough for your surgeon to be able to remove it.

If you have advanced stomach cancer, your doctor might suggest chemotherapy to try to shrink the cancer, slow it down, or relieve any symptoms that you have. This type of treatment is called palliative chemotherapy. It is usually given through a drip or chemotherapy pump and you may also have chemotherapy tablets.

If your cancer has a large amount of a protein called HER2, you may have a biological therapy called trastuzumab (Herceptin) with chemotherapy. There is information about Herceptin on the page about biological therapy for stomach cancer.

You may be asked to take part in a clinical trial. It is important for doctors to find out which treatments work best. As the aim of the treatment is to make you feel better, it is important that the chemotherapy itself does not make you feel ill and that you do not have to make too many trips to the hospital. So doctors design trials to look at the side effects of treatment, ways of giving outpatient treatment, and how the treatment makes you feel, as well as trying to find the treatment that works best.

This way of giving chemotherapy for stomach cancer is not done very often. It may be used when there are signs that cancer cells have spread onto the inside of the abdominal wall and are making your abdomen swell with fluid (ascites). A small cut is made in the wall of your abdomen and a tube called a catheter is put through. The fluid in the abdomen is drained out and a chemotherapy infusion put into the abdominal cavity through the catheter. With most of these chemotherapy drugs you need anti sickness medicines, and a drip to flush the chemo out of your system.

We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed them by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.

For detailed information about chemotherapy look at the main chemotherapy section. It explains

• What chemotherapy involves
• How chemotherapy works
• General side effects
• Living with chemotherapy

If you would like more information about chemotherapy, contact our cancer information nurses. They would be happy to help.

If you would like more information about anything to do with chemotherapy, contact one of the stomach cancer organisations. They often have free factsheets and booklets that they can send to you.