Stomach Cancer: Surgery

Your healthcare provider may advise surgery if it may help cure the cancer. At this time, surgery is the only way that stomach cancer can be cured. When cure is the goal, chemotherapy and radiation are often used along with surgery.

Surgery might be a choice for you if:

• Your cancer is thought to be resectable. This means that based on other tests, your surgeon thinks all of the cancer can be safely removed. 

• The cancer has not spread outside of your stomach.

• You’re healthy enough for surgery.

In some cases, surgery may not be able to cure the cancer. In this case, your healthcare provider may advise surgery to ease or prevent some symptoms of cancer. For instance, surgery might be done to take out part of a tumor that's blocking your stomach and making it hard for you to eat. This type of surgery is called palliative surgery.

All surgery has risks. The risks of surgery for stomach cancer include:

• Excess bleeding

• Infection

• Blood clots

• Damage to nearby organs or tissue

• Leaking of fluids where organs are reattached during surgery. (But this is rare.)

Your risks depend on your overall health, the type of surgery you need, and other factors. Talk with your healthcare provider about which risks apply most to you.

You will have side effects when all or part of the stomach is removed. They can include:

• Heartburn

• Pain in your belly (abdomen)

• Upset stomach (nausea)

• Diarrhea, especially after eating

• Vitamin deficiencies
• Changes in your diet and in the way you eat (often eating smaller meals and eating more often)

Over time, side effects may improve or go away. Talk with your healthcare provider about any changes you notice or side effects you have. There are often ways to treat or even help prevent them.

Before you have surgery, you’ll talk with your surgeon. Your surgeon may be a general surgeon, gastrointestinal surgeon, or surgical oncologist. Talk with your surgeon about:

• How much of your stomach and other organs or tissues are likely to be removed. Some surgeons try to leave behind as much of the stomach as they can. This may allow people to eat more normally after surgery. But the cancer may be more likely to return.

• Their experience with surgery for stomach cancer. You may have better results when both the surgeon and the hospital have a lot of experience treating people with stomach cancer. 

• Any questions or concerns you have.

• The risks and complications of the surgery.

• How you’ll eat after surgery.

After you've talked about all the details of the surgery, you’ll sign a consent form. This gives the surgeon permission to do the surgery.

You’ll also talk with an anesthesiologist. This healthcare provider will give you the general anesthesia. This medicine makes you sleep during surgery and keeps you from feeling pain. They also watch you closely during surgery to keep you safe. You will be asked about your health history and the medicines you take. You will also be asked to sign a consent form for the anesthesia to be given.

Before surgery, tell your healthcare team if you’re taking any medicines. These include over-the-counter medicines, prescription medicines, vitamins, herbs, and other supplements. This is to make sure you’re not taking medicines that could affect the surgery.

On the day of surgery, you’ll be taken into the operating room. Your healthcare team will include your anesthesiologist, surgeon, and several nurses. 

During a typical surgery:

• You’ll be moved onto the operating table. 

• Special stockings will be put on your legs. These are to help prevent blood clots. 

• Electrocardiogram electrodes will be put on your chest. These are to keep track of your heart rate. You will also have a blood pressure cuff on your arm.

• You’ll get anesthesia through an IV (intravenous) line in your hand or arm.

• When you’re asleep, your surgeon will do the surgery.

You’ll wake up in a recovery room. You'll be watched very closely. Once your condition is stable, you will be moved to your hospital room. You'll be given medicine to treat pain. You won’t be able to eat or drink for at least a few days after surgery. This is to give your stomach time to heal.

You may be in the hospital for several days. You may not be able to return to work or other activities for many weeks.

After any major surgery, you may have:

• Pain. This can be managed with medicine.

• Tiredness or weakness. How long it takes to recover from surgery is different for each person.

• Constipation. This can be caused by the pain medicine. It can also be caused by not moving much and from not drinking or eating as you normally would. Talk with your healthcare provider or nurse about how to prevent and treat constipation.

After this surgery you may:

• Learn how to care for and use your feeding tube, if one was placed during surgery

• Need to make changes in your diet and eat smaller meals more often

• Need to take vitamins

• Get chemotherapy or radiation after you heal from surgery

You will have follow-up visits with your surgeon and other healthcare providers. You may meet with a dietitian who will help plan your diet so you get the nutrients you need. Keep your appointments. If you have any problems or concerns, contact your healthcare team.

Talk to your healthcare team about signs of problems that you should watch for after surgery. Know how to reach them after office hours and on weekends. For instance, you may be told to contact them right away or get immediate medical care if you have any of these problems:

• Bleeding

• Redness, swelling, or fluid leaking from the cut (incision)

• Fever

• Chills

• Inability to eat

• New pain, or pain that gets worse

• Swollen or hard-feeling belly