Stomach Cancer Treatment in India

Introduction

Receiving a diagnosis of stomach cancer, also called gastric cancer, brings many questions and concerns. Understanding the available treatment options is a vital step in managing your stomach cancer treatment journey. Several factors are considered for a treatment plan, such as the exact location, cancer stage, and your overall health and fitness level.

Key Factors Influencing Stomach Cancer Treatment Plan

Treating stomach cancer isn’t a one-size-fits-all approach. A multidisciplinary team (MDT) of dedicated doctors will carefully tailor your recommended treatment plan to your circumstances. This team typically includes surgeons, medical oncologists (experts in chemotherapy and drug therapies), radiation oncologists (radiotherapy specialists), pathologists, radiologists, specialist nurses, dietitians, and other professionals.

Several key factors guide their recommendations and hence influence the stomach cancer treatment plan for an individual. The stage of the cancer is often the most significant factor, as early-stage cancers are treated differently from those that are locally advanced or have spread elsewhere. Also, tumour characteristics (Biomarkers) influence treatment options.

For instance, if your cancer is HER2-positive, targeted drug therapies may be an option, and high PD-L1 levels might mean immunotherapy could be effective. Further, the exact location of cancer, the patient’s medical history, the patient’s age and overall health and fitness affect the treatment choices. Moreover, the type of hospital, geographical location, and the patient’s financial condition while opting for a particular treatment plan for stomach cancer. Personal preferences and treatment goals are also crucial parts of the decision-making process.

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Treatment Options For Stomach Cancer

Stomach cancer treatment depends significantly on the stage of the cancer when it’s diagnosed. For cancers found at an early stage, the primary aim is often a complete cure. If the cancer is diagnosed at a more advanced stage, the focus usually shifts towards controlling its growth, effectively managing symptoms to maintain comfort and function, extending life, and preserving the best possible quality of life.

Surgery

Surgery frequently plays a central role in treating stomach cancer with two main objectives: Curative Intent and Palliative Care.

Several types of surgical procedures can be used for stomach cancer treatment:

• Endoscopic Resection (EMR/ESD): This is only suitable for very small, very early-stage cancers confined strictly to the innermost layer of the stomach lining done with an endoscope.

• Partial (Subtotal) Gastrectomy: This involves removing only the part of the stomach containing the cancer, along with nearby lymph nodes. It’s often used for cancers in the lower section of the stomach. The remaining portion of the stomach is then reconnected to the small intestine.

• Total Gastrectomy: This procedure involves removing the entire stomach and nearby lymph nodes. It’s typically necessary if the cancer is large, affects multiple parts of the stomach, or is located in the upper part near the oesophagus. After removing the stomach, the surgeon connects the oesophagus directly to the small intestine.

These operations can be performed either through traditional open surgery (one large incision) or using minimally invasive techniques like laparoscopy or robotic-assisted surgery (several small incisions). The choice depends on tumour factors and the surgeon’s experience.

Chemotherapy

Chemotherapy, a systemic treatment, uses powerful anti-cancer drugs to kill cancer cells or stop them from growing and dividing. It is typically administered either orally or intravenously in cycles, allowing the body to recover. Chemotherapy is used in several different settings for stomach cancer:

• Neoadjuvant Chemotherapy: This is given before surgery to shrink the tumour so that it is easier for the surgeon to remove it entirely and attack any microscopic cancer cells that might have already spread beyond the stomach.

• Adjuvant Chemotherapy: This is given after surgery to kill any cancer cells that might have been left behind, reducing the risk of the cancer returning.

• Perioperative Chemotherapy: It is advised both before and after surgery (e.g., the FLOT regimen).

• Primary/Palliative Chemotherapy: This is used as the main treatment when the cancer is too advanced for surgery (unresectable) or has spread to distant parts of the body (metastatic). The goal is to control the cancer’s growth, relieve symptoms, and help patients live longer.

Common chemotherapy drugs used include fluoropyrimidines (like 5-FU or capecitabine), platinum-based drugs (like cisplatin or oxaliplatin), and taxanes (like paclitaxel or docetaxel). Often, combinations of these drugs are used for greater effectiveness.

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Radiotherapy

Radiotherapy (radiation therapy) uses high-energy rays or particles to precisely damage and destroy cancer cells in a specific, targeted area of the body. Unlike chemo, it is a localized treatment, but for stomach cancer, it’s often given together with chemotherapy.

Radiotherapy might be used:

• After Surgery: Usually with chemo, to kill any remaining microscopic cancer cells in the surgical area and nearby lymph nodes, reducing the risk of local recurrence. This is considered particularly if the surgical removal was difficult or if many lymph nodes contained cancer.

• Before Surgery: Less commonly given to shrink the tumour.

• As Palliative Treatment: Effectively shrinking tumours that cause symptoms like pain, bleeding, or blockage, thereby improving quality of life in advanced stages.

Radiotherapy is typically given using a machine outside the body (External Beam Radiotherapy—EBRT). Treatment involves careful planning (simulation) using CT scans to map the target area precisely. This allows the radiation beams to specifically target the tumour while minimizing exposure to nearby healthy organs. Daily treatment sessions are usually given over several weeks.

Targeted Therapy

Targeted therapies are drugs designed to identify and attack specific molecules involved in cancer cell growth and survival. They work differently from standard chemo and often require specific laboratory tests (biomarker tests) on the tumour tissue to determine if a patient is likely to benefit.

Key examples in stomach cancer targeted therapy include:

• HER2 Inhibitors: Around 10-20% of stomach cancers are HER2-positive. For these, drugs like Trastuzumab (Herceptin) added to chemotherapy, or Fam-trastuzumab deruxtecan (Enhertu) used later, can be very effective for advanced disease.

• VEGF/VEGFR Inhibitors: Drugs like Ramucirumab (Cyramza) target the formation of new blood vessels (angiogenesis) that tumours need to grow. It’s used for advanced cancer, often after other treatments.

• Other Targets: Drugs targeting rare NTRK gene fusions or CLDN18.2 protein expression are options for smaller, specific groups identified through testing.

Immunotherapy

Immunotherapy for stomach cancer helps the body’s immune system recognise and fight cancer cells more effectively. The main type used are immune checkpoint inhibitors. These drugs block proteins (like PD-1/PD-L1) that cancer cells sometimes use to hide from the immune system, thereby “releasing the brakes” on immune cells.

Eligibility often depends on biomarker testing:

• PD-L1 Expression: High levels of PD-L1 protein on tumour cells can predict a better response.
• MSI-H/dMMR Status: Cancers with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR) often respond well.

Drugs like Nivolumab (Opdivo) and Pembrolizumab (Keytruda) are used mainly for advanced stomach cancer, sometimes combined with chemotherapy or used alone for specific biomarker-positive tumours. While effective, immunotherapy can cause side effects where the immune system attacks healthy tissues, requiring careful monitoring.

Palliative Care

Palliative care is specialised medical care focused on providing relief from the symptoms (like pain, nausea, fatigue) and stress of a serious illness. Its goal is to improve the quality of life for both the patient and their family. Importantly, palliative care is appropriate at any stage of the disease and can be given alongside treatments aimed at cure or control. It involves a team approach to managing symptoms and providing emotional, social, and practical support.

Managing the Treatment Journey: Side Effects and Support

Why is India the best option for Stomach Cancer Treatment?

The hospitals in India follow a multi-disciplinary treatment approach and have all the available stomach cancer treatment modalities. Here, globally acclaimed surgeons and oncologists, trained at the finest institutions, perform sophisticated treatments, from intricate robotic surgeries to precision chemotherapies. World-class hospitals, gleaming with advanced diagnostic tools and state-of-the-art facilities, stand ready. Yet, this exceptional level of care comes at a significantly lower cost compared to many Western nations. India offers not just medical excellence, but a beacon of accessible, high-quality treatment, making the journey towards recovery a more manageable and hopeful path. It’s a fusion of skill, technology, and value, dedicated to winning the fight against stomach cancer.

Stomach Cancer Treatment Cost

The cost stomach cancer treatment ranges from Rs. 3 lakhs to Rs. 8 lakhs, depending on various factors, such as the stage and grade of the cancer, the hospital and location, and the patient’s medical history.

On average, the diagnostic test costs around Rs. 20,000 to Rs. 60,000. The stomach cancer surgery costs between Rs. 2,00,000 and Rs. 5,00,000, depending on the procedure. Various therapies might also be included in the stomach cancer treatment plan, such as chemotherapy, which ranges between Rs. 20,000 to Rs. 40,000 per cycle. With Targeted Therapy or Immunotherapy, total costs can easily escalate to ₹20 lakhs₹40 lakhs or significantly higher over the course of treatment.

Best Hospital for Stomach Cancer Treatment in India

India offers excellent options for stomach cancer treatment across numerous top-tier hospitals.

List of best hospitals for stomach cancer treatment in India:

• Tata Memorial Hospital (Mumbai)
• AIIMS (New Delhi)
• CMC (Vellore)
• Kidwai Memorial Institute (Bengaluru)
• Adyar Cancer Institute (Chennai)
• Rajiv Gandhi Cancer Institute (New Delhi)
• Apollo Hospitals (Various locations)
• Fortis Healthcare (Various locations)
• Max Healthcare (Various locations)
• Medanta Hospital (Various locations)
• HCG Cancer Centre, Ahmedabad
• Amrita Institute of Medical Sciences (AIMS), Kochi

Best Doctors for Stomach Cancer Treatment in India

India has highly skilled specialists for treating stomach cancer across renowned institutions.

List of best doctors for stomach cancer treatment in India:

• Prof. Shailesh V. Shrikhande
• Dr. Deep Goel
• Dr. Rajesh Mistry
• Dr. Surender Kumar Dabas
• Dr. Vikas Goswami
• Dr. Ashok Vaid
• Dr. Ajith Pai
• Dr S. Rajasundaram
• Dr. P. Jagannath
• Dr. Pradeep Jain

How Can Cancer Rounds Help You?

Are you considering stomach cancer treatment in India? Cancer Rounds provides expert guidance and logistical support. We connect you with highly regarded pituitary specialists and premier hospitals, managing the entire process from consultation scheduling through surgery and post-operative follow-up. Our dedicated services extend to international patients, covering travel, accommodation, and visa facilitation. We also assist in obtaining crucial second opinions and provide detailed, personalized cost estimates for your treatment plan.

FAQs Related to Stomach Cancer

Q1. What are the main treatments for stomach cancer?

The main stomach cancer treatments include surgery, chemotherapy, and radiation therapy, often used together. Targeted therapy and immunotherapy can also be used.

Q2. How should I choose the best stomach cancer treatment plan for me?

The best treatment plan is personalized based on your cancer stage, tumour location, biomarkers (like HER2/PD-L1), and medical history alongside your treatment goals. Always consult the top stomach cancer doctor for the best treatment plan.

Q3. How does the stage of stomach cancer affect treatment options?

Early-stage stomach cancer is often curable with surgery, chemotherapy or radiation therapy. Later stages typically involve combination therapies and focus on controlling the cancer.

Q4. What are the common side effects of stomach cancer treatment?

Common side effects of stomach cancer treatment depend on the therapy (surgery, chemo, radiation) but commonly include fatigue, nausea, appetite loss, and digestive changes.

Q5. Can stomach cancer be cured with treatment?

Stomach cancer is curable to a great extent if diagnosed and treated at early stages (Stage 0/I), often with surgery. But for later stages, stomach cancer treatment controls the cancer and maintains the quality of life.