Life With Advanced Stomach Cancer: What Changes

Stomach cancer (gastric cancer) has a reputation for coming up unexpectedly. Although less common than other cancers, stomach cancer tends to be caught during advanced stages. That’s because symptoms typically surface later. In some cases, it can even metastasize, or spread, to other areas of your body before it’s discovered.

Any cancer diagnosis will impact your life in significant ways, and stomach cancer is no different. But advanced cancer diagnoses come with their own set of unique challenges and complications.

Oncologist Alok Khorana, MD, shares how you and your loved ones can tackle some of those challenges with lifestyle modifications.

Lifestyle modifications for advanced stomach cancer

Stomach cancer is an uncommon but aggressive type of cancer that can form in any part of your stomach. Most stomach cancers in the U.S. begin at the location where your stomach meets your esophagus (your gastroesophageal junction). Outside of the U.S., it’s more common in other areas of your stomach, like your:

• Stomach lining
• Stomach muscles
• Lymphatic tissues
• Connective tissues

“Usually, the cancer starts in the stomach and then spreads to regional lymph nodes,” explains Dr. Khorana. “Then, it can go farther out and spread to other organs, like the liver or lungs.”

Because of its location and importance to your digestive system, your stomach plays an integral role in your day-to-day life. If any part of your stomach is affected by cancer, it can impact your physical, mental and emotional health in many ways.

Like other cancers, your symptoms will vary based on how far it’s spread and where it’s located. But chances are, you’ll need to consider making some of the following modifications to maintain and improve your quality of life during treatment.

Increased medical attention

It’s common to work with a wide range of providers in different fields of medicine when you’re living with advanced stomach cancer.

Palliative medicine specialists, for example, help in a variety of ways. They assist you with pain management and find other strategies for making you comfortable throughout the course of your treatment while prioritizing self-care.

“Most people end up getting a combination of chemotherapy and surgery,” shares Dr. Khorana. “Chemotherapy typically happens every two weeks. Surgery is only once, but there is a prolonged recovery after surgery, which can extend for several weeks.”

Chemotherapy can be given both before and after a gastrectomy, when parts of or all of your stomach are removed to minimize the spread of cancer. Oncologists and radiologists will keep track of how your disease progresses as you go through treatment. And some treatments will vary from person to person or may need to be adjusted as the cancer evolves.

“It’s typically a period of several months where people do need very frequent appointments, typically once every other week,” says Dr. Khorana. “Progress is typically measured by looking at scans, and those are done every two to three months.”

Your oncologist can answer any questions you have at any point in the process. They’ll help you understand what options are available to you. They’ll discuss your risks and any side effects you may experience with treatment. And they’ll discuss what may be the best course of action for you and your body.

Advanced care planning

Advanced stomach cancer takes a toll and can spread quickly if it’s not caught early enough. That’s why it’s critical to talk with your family or loved ones about what’s important to you in the few days after receiving a diagnosis. You might want to go over:

• Advance directives, which are important legal documents that determine what your healthcare providers can and should do in the event of emergencies
• A living will, which tells your providers what medical care you do and don’t want when emergencies happen
• A durable power of attorney (DAP), which designates a person who can make decisions for your medical care in the event you’re unable to do so on your own

These are just a few examples. But understanding how palliative care and hospice care can be helpful throughout the entire process and at the end of your life is important to make sure your physical, emotional and mental needs are taken care of. In some cases, you may even find some benefit in working with an end-of-life doula.

Your relationship with food

Depending on where the stomach cancer is located, you may experience a variety of symptoms that directly impact your relationship with food and the kinds of food you can eat.

“If there’s difficulty swallowing, you may need to rely on a liquid diet,” illustrates Dr. Khorana. “But I would say that for most people, you can have high-calorie dense foods in smaller portions without necessarily having to switch to a liquid diet.”

The amount of food you eat and how often you eat will likely be impacted by the progress of the cancer and whether you have a partial or total gastrectomy. How well you do with chemotherapy and other treatments can also impact the way you’re able to digest and process foods. In some cases, you may experience diarrhea, nausea or vomiting and other discomforting symptoms.

“If someone has to undergo surgery for the stomach cancer, then that reduces the length of the gastrointestinal tract,” explains Dr. Khorana. “That can lead to food going through the GI tract faster than you would normally expect.”

You may not be able to eat the same way you once did, but a dietitian or nutritionist can work with you to find ways to improve your meal plans and make sure you’re getting all the nutrients you need throughout your treatment.

Your mental health and social supports

There’s a symbiotic relationship that occurs between your mental health and your physical health. Chronic illnesses can increase your risk of depression and anxiety because they may limit your ability to interact with others or do activities you once loved. A lack of activity can also lead to increased isolation and loneliness, which can have a devastating impact on your mental health, too.

This means your mental health is a top priority at every stage of diagnosis, treatment and beyond. If you’re not sure what you can do to improve your mental health, make an appointment with a therapist who can guide you through the process. Learning how to cope with emotional stress can make a big difference in how you maintain your day-to-day.

Sometimes, having someone talk to about your experiences and challenges can also have a positive impact on your well-being. Social workers can even connect you with others in the community who are dealing with the same type of challenges.

Exercise and physical activity

It’s normal to feel fatigued or have a lack of energy after a stomach cancer diagnosis and over the course of your treatments. But you should try and fight the urge to take it easy whenever possible.

“With fatigue — it sounds counterintuitive — but you actually want to stay physically active,” stresses Dr. Khorana. “Even if you can do a brief walk for four or five minutes, some type of exercise has been shown to keep people more conditioned even if they’re feeling tired.”

Building any form of exercise into your daily routine is key. If a full-blown exercise routine becomes difficult for you, try to exercise in small bursts throughout the day. You may even want to consider other forms of exercise, like walking meditation or restorative yoga. These, along with other mindfulness activities, can help you flex your mind and muscles so you can better maintain your energy levels.

Life after diagnosis

Life with advanced stomach cancer isn’t without challenges. As the cancer evolves and your treatments progress, you may need to make adjustments along the way based on how you feel. Having that understanding and allowing yourself to be flexible can benefit you and your loved ones as you continue to seek guidance and assistance from your healthcare team.