Stage 0 (Carcinoma in Situ)
Stage I Gastric Cancer
Stage II Gastric Cancer
Stage III Gastric Cancer
Stage IV Gastric Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage 0 is usually surgery (total or subtotal gastrectomy).

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 gastric cancer ¹.

Treatment of stage I gastric cancer may include the following:

• Surgery (total or subtotal gastrectomy).
• Surgery (total or subtotal gastrectomy) followed by chemoradiation therapy.
• A clinical trial of chemoradiation therapy given before surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I gastric cancer ².

Treatment of stage II gastric cancer may include the following:

• Surgery (total or subtotal gastrectomy).
• Surgery (total or subtotal gastrectomy) followed by chemoradiation therapy.
• Chemotherapy given before and after surgery.
• A clinical trial of surgery followed by chemoradiation therapy testing new anticancer drugs.
• A clinical trial of chemoradiation therapy given before surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II gastric cancer ³.

Treatment of stage III gastric cancer may include the following:

• Surgery (total gastrectomy).
• Surgery followed by chemoradiation therapy.
• Chemotherapy given before and after surgery.
• A clinical trial of surgery followed by chemoradiation therapy testing new anticancer drugs.
• A clinical trial of chemoradiation therapy given before surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III gastric cancer ⁴.

Treatment of stage IV gastric cancer that has not spread to distant organs may include the following:

• Surgery (total gastrectomy).
• Surgery followed by chemoradiation therapy.
• Chemotherapy given before and after surgery.
• A clinical trial of surgery followed by chemoradiation therapy testing new anticancer drugs.
• A clinical trial of chemoradiation therapy given before surgery.

Treatment of stage IV gastric cancer that has spread to distant organs may include the following:

• Chemotherapy as palliative therapy to relieve symptoms and improve the quality of life.
• Endoluminal laser therapy or endoluminal stent placement to relieve a blockage in the stomach.
• Radiation therapy as palliative therapy to stop bleeding, relieve pain, or shrink a tumor that is blocking the stomach.
• Surgery as palliative therapy to stop bleeding or shrink a tumor that is blocking the stomach.
• A clinical trial of new combinations of chemotherapy as palliative therapy to relieve symptoms and improve the quality of life.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV gastric cancer ⁵.

Glossary Terms

Treatment that combines chemotherapy with radiation therapy. Also called chemoradiotherapy.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

An operation to remove all or part of the stomach.

The use of an intensely powerful beam of light to kill cancer cells.

A part of the body that performs a specific function. For example, the heart is an organ.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal cells are found in the inside lining of the mucosal (innermost) layer of the stomach wall. These abnormal cells may become cancer and spread into nearby normal tissue.

Stage I is divided into stage IA and stage IB, depending on where the cancer has spread. In stage IA, cancer has spread completely through the mucosal (innermost) layer of the stomach wall. In stage IB, cancer has spread completely through the mucosal (innermost) layer of the stomach wall and is found in up to 6 lymph nodes near the tumor, or has spread to the muscularis (middle) layer of the stomach wall.

Cancer has spread (1) completely through the mucosal (innermost) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor, or (2) to the muscularis (middle) layer of the stomach wall and is found in up to 6 lymph nodes near the tumor, or (3) to the serosal (outermost) layer of the stomach wall but not to lymph nodes or other organs.

Stage III is divided into stage IIIA and stage IIIB depending on where the cancer has spread. In stage IIIA, cancer has spread to (1) the muscularis (middle) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor, or (2) the serosal (outermost) layer of the stomach wall and is found in 1 to 6 lymph nodes near the tumor, or (3) to organs next to the stomach but not to lymph nodes or other parts of the body. In stage IIIB, cancer has spread to the serosal (outermost) layer of the stomach wall and is found in 7 to 15 lymph nodes near the tumor.

Cancer has spread (1) to organs next to the stomach and to at least one lymph node, or (2) to more than 15 lymph nodes, or (3) to other parts of the body.

A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to keep the structure open.

An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.