Chemotherapy is the administration of cancer-fighting medication (cytotoxic drugs) to destroy cancer cells. It can be administered by itself or alongside surgery, radiotherapy, or targeted therapy drugs.

Chemotherapy for stomach cancer can be given:

  • Before and after surgery to remove the tumor
  • Before surgery to reduce the size of the tumor if it is too big
  • In combination with radiotherapy
  • To help control the cancer and improve symptoms if an operation has not been possible.

Perioperative chemotherapy

The most common use of chemotherapy with surgery is perioperative chemotherapy. This reduces the size of the tumor and makes surgery more effective and also reduces the risk of the cancer coming back. This treatment normally consists of three cycles of chemotherapy before the operation and then again after it.

Advanced cancer

If the cancer has spread to other parts of the body (metastatic), chemotherapy is the main treatment. It can help you live longer and reduce your symptoms. Some people are given a targeted therapy drug called trastuzumab before chemotherapy.

How is the chemotherapy administered?

Chemotherapy is usually given on an outpatient basis, which means you can go home the same day. Chemotherapy is normally given as part of a course consisting of several treatment sessions (or cycles) and lasting for a few months.

You may be given chemotherapy drugs through a vein (intravenously) or in tablet form. Stomach cancer is normally treated with a combination of both.

Your chemotherapy nurse will give you the drugs intravenously using an injection or infusion (drip). The drugs are given through a small tube (line) in your arm, or a central line or PICC line. If you have a central line or a PICC line, your nurse will show you how to take care of it. These lines are designed to stay in place throughout the treatment.

Some people are also given a treatment of chemotherapy tablets to take while a home, called capecitabine. Or you may have a chemotherapy drug called fluorouracil through a small pump attached to your intravenous line; this can go home with you.

The drugs used

Normally, a combination of drugs is given. Possible treatments include:

  • ECX, made up of epirubicin, cisplatin, and capecitabine tablets.
  • EOX, made up of epirubicin, oxaliplatin, and capecitabine.
  • ECF, made up of epirubicin, cisplatin, and fluorouracil (5FU).

Sometimes only two of these drugs are given together.

Other drugs such as irinotecan and docetaxel may also be used.

With ECF chemotherapy, fluorouracil is given using a small pump that allows people to continue their treatment as outpatients.