Non-Curative Treatments

In North America, gastric cancer is often diagnosed at very advanced stages. Sometimes, the cancer is so advanced that cure is not possible. This may occur when the disease involves organs that cannot be removed with surgery or when disease has spread to other parts of the body far away from the stomach (i.e. liver, lungs, bone, brain).

In these situations the goals of treatment are to alleviate symptoms (i.e. pain, difficulty swallowing, obstruction, bleeding) and to extend life. These treatments will not cure the cancer. In general, one or more of the following types of treatment may be recommended by your healthcare team.

Surgical/Procedural Intervention

The typical indication for surgical or procedural interventions is obstruction, or a blockage due to the cancer. Symptoms might include difficulty swallowing, sensation of food getting stuck, and nausea, vomiting and pain. If the tumor is located in the upper part of your stomach near the esophagus, a stent can be used to open up the blockage and allow food and liquid to pass through more easily. If the cancer is located in the lower part of your stomach surgery can be performed to “bypass” the segment that is blocked and allow food and liquid to pass through more easily through a new connection. Sometimes, it may even be possible to remove the segment that is blocked and reconnect the remaining intestine.

Radiation Therapy

The typical indication for radiation is bleeding. Cancerous tissue can bleed easily and this blood is lost through the gastrointestinal tract; however, you may not notice any obvious blood in your stools. You may notice dark or black stools. Tests on the stool can be performed to determine whether microscopic blood is present. Your blood work may show anemia, which is a low hemoglobin level. Not all anemia requires treatment and this will need to be discussed with your healthcare team.

Radiation causes fibrosis or hardening of the tissues and may reduce the likelihood or severity of bleeding. If your healthcare team feels that radiation will be helpful then a referral would be sent to a Radiation Oncologist.


The typical indication for chemotherapy is to extend life. It may also help with certain symptoms by shrinking the cancer. The response to chemotherapy is different for everyone; however expected extension of life is usually by a few weeks-months. Different types of chemotherapy can be used in this setting. A discussion with the Medical Oncologist will help you weigh the risks and benefits of chemotherapy.

Supportive Care

Supportive care from other services becomes important during this time. This may involve input from the Dietitian, Social Worker, Spiritual Care, Palliative Care, Pain Service, and Home Care Nursing. Referrals to these services will depend on your individual needs and can be facilitated by your healthcare team.