Most people will have some type of surgery as part of their stomach cancer treatment. Your treatment plan likely includes chemotherapy and possibly radiation therapy as well, each with their own benefits and risks. Knowing what to expect along the way can take away some of the uncertainty. Use this information as a starting point for a conversation with your doctor about your treatment plan. Knowing what to expect from stomach cancer treatment helps you and your doctor anticipate, prevent and manage side effects. Surgery Surgery is a main treatment for most cases of stomach cancer. The type of surgery you need will depend on the stage of the disease and the location of the tumor in the stomach. Gastrectomy is the most common surgery doctors use to treat stomach cancer. It involves removing either part or all of the stomach. The side effects of surgery will depend on how extensive it is. Total Gastrectomy Total gastrectomy removes the entire stomach. Doctors connect the bottom of the esophagus to the small intestine. The digestive tract takes several months to heal from this surgery. You can expect to lose weight for about two months afterwards. You will slowly transition to eating over a few months. However, you will always need to eat small, frequent meals. In some cases, people are not able to take in enough nourishment after a total gastrectomy. A permanent feeding tube can solve this problem. Partial Gastrectomy Partial gastrectomy removes only part of the stomach, either the top or bottom portion. Doctors reconnect the remaining stomach to either the esophagus at the top or the small intestine at the bottom. Generally, the side effects of this surgery are less severe than a total gastrectomy. Weight loss levels out more quickly and it is easier to resume normal eating. Chemotherapy Chemotherapy—or chemo—is a systemic stomach cancer treatment. These potent medicines travel throughout your body to kill cancer cells. As a result, chemo can cause side effects in different areas of the body. Because chemo kills rapidly dividing cells, some normal cells and tissues are more vulnerable to chemo’s effects than others. Examples include the cells of the hair follicles, digestive tract, and bone marrow. Doctors can use several chemo drugs in different combinations to treat stomach cancer. The side effects you experience will depend on your specific regimen and the dose of each drug. However, some common side effects cancer patients experience include nausea, vomiting, diarrhea, appetite loss, mouth sores, and hair loss. You can also have problems with blood cell counts. This can cause fatigue, increased risk of bleeding, and increased risk of infections. Keep in mind, everyone reacts differently to chemo. Your overall health and other factors can influence your experience. Talk with your doctor before treatment to understand what to expect. After starting chemo, tell your doctor about all new or changing symptoms. Sometimes chemo is the cause and your doctor may be able to adjust your regimen. However, there can be other causes that your doctor will need to explore. Radiation Therapy Radiation therapy is a local treatment for stomach cancer. It targets the tumor using high-energy X-rays or particles to destroy cancer cells. Side effects depend on the dose of radiation. They can include nausea, vomiting, diarrhea and fatigue. Skin problems at the target site can also occur, including blistering, peeling and redness. It can take a few weeks after treatment stops for side effects from radiation to resolve. If you have radiation therapy along with chemo, the side effects may be worse than taking each treatment separately. It is also possible for radiation to damage nearby organs and tissues. Ask your doctor ahead of time about the risk of these complications and how to avoid them if possible. Targeted Therapy Targeted therapy uses tumor characteristics to attack cancer cells. This is different from traditional chemo. Targeted therapy does not affect normal cells in the same way as chemo. As a result, the side effects of targeted therapy tend to be milder. Common side effects of targeted therapy for stomach cancer include nausea, vomiting, diarrhea, cough, headache, and fever and chills. For many people, the side effects get better after the first dose. Serious side effects, such as severe bleeding or heart problems, are possible but rare. Your care team needs to know if you experience these symptoms with targeted stomach cancer therapy. Immunotherapy Immunotherapy uses your own immune system to wage war against cancer. The type of immunotherapy that can treat stomach cancer targets so-called checkpoint proteins. Basically, checkpoint inhibitor therapy helps your immune system recognize cancer cells that are trying to avoid detection. Because this boosts your immune response, side effects can include fever, fatigue, itching, rash, and muscle or joint pain. Sometimes, the immune system goes into overdrive and starts attacking healthy tissues. These autoimmune reactions are less common than other side effects, but can be very serious. Always tell your doctor if new symptoms develop during immunotherapy. This includes problems during infusion of the medicine, such as having trouble breathing, itching, or feeling dizzy. Side Effect Solutions There are often ways to avoid or manage side effects from stomach cancer treatment. Talk with your doctor about each of your treatments beforehand. Learn what to expect and how your doctor plans to deal with side effects should they occur. With stomach cancer surgery, a doctor’s experience is an important consideration. Seek treatment from someone with plenty of experience treating your specific type and stage of stomach cancer.