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Surgery is the initial procedure in the treatment of many solid cancers. Surgery and other invasive procedures work by removing cancerous tissues. The main type of surgery used to treat stomach cancer is a gastrectomy.
Psychotherapy may have an important role to play in the care of patients admitted to the hospital for stomach cancer surgery. Researchers randomly divided 271 surgical patients with cancers affecting the gastrointestinal tract (esophagus, stomach, liver, pancreas, colon, or rectum) into 2 groups: 1 received usual care on the surgical ward and the other received formal psychological support in addition to usual care. Psychological interventions, which were provided both before and after surgery, consisted of emotional and cognitive support and help in planning for the future. 10 years after their surgery, patients who received psychological support were significantly more likely to be alive than those who did not receive such additional care.
A gastrectomy is the removal of all or part of the stomach. Gastrectomy is the only treatment that offers the hope of curing stomach cancer. However, it is only potentially curative if the cancer has not spread beyond the stomach; in other words, only Stages 0, I, II, or III may be cured through surgery.
Gastrectomy may also be done for palliation (symptom relief). It may help decrease bleeding or pain, even in patients with more advanced stages of stomach cancer.
There are 3 main types of gastrectomy operations:
You will be given general anesthesia before you undergo a gastrectomy. An incision is made from your breastbone down to your navel. Depending on the type of operation you are having, part or all of your stomach is removed. If the stage of your cancer is such that you may be hoping for a cure, then your surgeon will also try to remove as many lymph nodes as possible from the area around your stomach, some of the fatty tissue in your abdomen, and the spleen.
Your hospital stay will last about a week. If you develop complications, you will have to stay in the hospital longer.
Gastrectomy is the only treatment that offers any hope of a cure for stomach cancer. Survival following gastrectomy is related to the stage of the tumor and the administration of chemotherapy and radiation therapy afterwards.
In the United States, the 5-year survival rate, as reported by the American College of Surgeons, is:
The use of adjuvant therapy (chemotherapy and radiation after surgery) is expected to improve the survival. Unfortunately, most patients are found to have locally advanced disease at the time of surgery (Stage II or III).
Gastrectomy has a very high rate of complications and death; about 7%-10% of all patients die in the immediate postoperative period. It’s important to find a surgical team that has a great deal of experience with these operations.
Possible complications include the following:
Since this is a major operation, you may have the following postoperative care and medical support:
Once your stomach and/or intestines are beginning to function normally, you will be allowed to drink liquids. Over the next day or days you will progress through a soft diet to regular food, as tolerated. You may need to consult a registered dietitian for help in choosing healthful foods and eating patterns that you can tolerate. Some suggestions may include:
If you have dumping syndrome, you may need to make dietary changes, such as decreasing your intake of sugar-containing foods and increasing your protein intake. Symptoms of dumping syndrome include diarrhea, cramping, nausea, vomiting, sweating, and dizziness after eating. If you have these symptoms, contact your doctor right away.
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Hundahl SA, Phillips JL, et al. The National Cancer Data Base Report on poor survival of US gastric carcinoma patients treated with gastrectomy: Fifth Edition American Joint Committee on Cancer staging, proximal disease, and the "different disease" hypothesis. Cancer. 2000;88:921-932.
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Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. Philadelphia, PA: WB Saunders Company; 1998: 733-749.
What is stomach cancer? American Cancer Society website. Available at: http://www.cancer.org. Accessed December 2002.
What you need to know about stomach cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancerinfo/wyntk/stomach. Accessed December 2002.
9/18/2007 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116155/Gastric-carcinoma. Küchler T, Bestmann B, et al. Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial. J Clin Oncol. 2007;25:2702-2708.
Last reviewed September 2016 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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