Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers


Stomach cancer can form anywhere in the stomach and may spread to nearby lymph nodes, the bean-shaped organs that help your body fight infections.

Almost all stomach cancers are a type called adenocarcinoma, which begins in the glandular cells lining the inside of your stomach. It can take years for stomach cancer to develop. Often precancerous changes occur first, but these changes often go undetected because they may not cause symptoms.

We will discuss the treatment options and develop a plan that is right for you. Standard treatment options for stomach cancer include surgery, chemotherapy, radiation therapy, and targeted therapy.


Surgery removes the cancer and part or all of your stomach, depending on how advanced the cancer is. We will talk with you about your surgery options, which depend on what part of your stomach is affected and how much the cancer has spread into surrounding areas. The types of surgery used to treat stomach cancer include:

  • Endoscopic mucosal resection. For some very early-stage cancers, the tumor may be removed from the stomach lining using a thin, flexible tube (endoscope) that we guide down the throat and into your stomach.
  • Subtotal (partial) gastrectomy. We remove part of your stomach and nearby lymph nodes, sometimes along with the first section of the small intestine (duodenum) or part of the esophagus. We then attach the remaining part of your stomach to your small intestine or esophagus. This type of surgery is typically used for cancers in the lower part of the stomach, although it is sometimes used to treat cancers in the upper portion of the stomach.
  • Total gastrectomy. If the cancer has spread throughout the stomach, your entire stomach and nearby lymph nodes are removed. We may also remove your spleen and parts of your esophagus, small intestine, and other tissues near the tumor. We connect your esophagus to your small intestine and use a piece of intestine to create a new stomach pathway that can store food before moving it into your intestinal tract. Following a gastrectomy, you will be able to eat only a small amount of food before getting full, which will require you to eat more often.

It takes time to recover from surgery, so you will likely be in the hospital for at least a week. Until you are able to eat on your own, you may receive nutrients through an intravenous (IV) line or feeding tube. In some cases, surgery cannot be used to remove the tumor. For advanced tumors blocking the stomach, the following procedures may be used:

  • Stent placement. We may place a mesh tube called a stent into the narrowed or blocked passage from your esophagus to your stomach or from your stomach to your small intestine. The stent keeps the passage open and allows you to eat normally.
  • Laser therapy. Through the end of an endoscope, we aim a laser beam at the cancer. The laser vaporizes the cancer cells and unblocks your stomach.
  • Gastrojejunostomy. If the tumor is blocking the passage from your stomach into your small intestine, we may remove the part of the stomach containing the tumor. The remaining stomach is connected to a section of small intestine called the jejunem.

Surgery Side Effects

After surgery, we will watch you closely for side effects. The chance of developing side effects and their severity depends on the extent of surgery. We will talk with you about potential side effects of your stomach surgery and how we plan to manage them. Possible side effects of stomach cancer surgery include:

  • Infection
  • Bleeding or blood clots
  • Leakage where your stomach connects to your esophagus or small intestine or where your esophagus connects to your small intestine if your entire stomach is removed
  • Vitamin deficiencies
  • Heartburn
  • Abdominal pain after eating

One particular side effect known as dumping syndrome causes nausea, cramps, diarrhea, and dizziness after eating. Dumping syndrome occurs when food enters your small intestine too quickly. The symptoms of dumping syndrome usually go away within a few months after surgery, but they can be permanent in some cases. We will talk with you about ways to prevent these problems with eating choices and possibly medication.

After surgery to remove part or all of your stomach, you may develop vitamin deficiencies because your stomach absorbs certain vitamins, such as vitamin B12. We may prescribe vitamin supplements to help with this side effect.


You will likely receive chemotherapy drugs to kill cancer cells. Chemotherapy drugs can be delivered intravenously or as a pill. Known as systemic chemotherapy, these drugs enter the bloodstream and attack stomach cancer cells throughout the body. Chemotherapy is generally given in an outpatient setting. Chemotherapy may be used to help relieve symptoms of advanced stomach cancer, such as eating problems and bleeding.

For less advanced cancers, chemotherapy may be used before surgery to make the tumor easier to remove or after surgery to kill any remaining cancer cells in the body. Radiation therapy is often given in combination with chemotherapy. Chemotherapy may also be used in combination with targeted therapy to treat certain stomach cancers.

Chemotherapy Side Effects

Chemotherapy can cause a variety of side effects, the severity of which depends on the type and dose of the drug as well as the length of time it is given. You may experience one or more of the following common side effects of chemotherapy:

  • Hair loss
  • Nausea and vomiting
  • Loss of appetite
  • Mouth sores
  • Diarrhea
  • Fatigue
  • Low blood cell counts

We have effective methods for preventing and managing chemotherapy side effects. For example, without enough healthy blood cells, you are at higher risk for infections, bleeding, and severe fatigue. We may give you medications to boost your blood counts, antibiotics to treat and prevent infections, and transfusions of red blood cells and platelets.

Additional References:

Radiation Therapy

Radiation therapy uses high-energy radiation, such as X-rays, to kill cancer cells. The most common type used for stomach cancer is external-beam radiation therapy, which delivers radiation from a machine outside the body. Radiation may be used before surgery to shrink the tumor or to kill cancer cells left in the body after surgery. Often chemotherapy is given along with radiation. For advanced stomach cancers that cannot be removed with surgery, radiation therapy may ease symptoms such as pain and trouble eating.

Side effects 

Radiation therapy to your abdomen and possibly other parts of your body can cause a variety of problems. Possible side effects include:

  • Skin changes, such as redness and dryness
  • Nausea and vomiting
  • Indigestion or heartburn
  • Diarrhea
  • Fatigue

Side effects of radiation therapy are often worse at higher doses and when chemotherapy is given at the same time, but problems typically go away soon after treatment ends. We can help manage the side effects of radiation therapy so that they do not interfere with your quality of life.

Targeted Therapy

Targeted therapy is a relatively new approach to treating cancer. It involves the use of drugs that target specific parts of the cancer cell that help it survive and grow. In about 1 in 5 cases, stomach tumors make too much of a protein called HER2. The HER2 protein is found in high numbers on the surface of these stomach cancer cells and helps the tumor survive and grow.

A drug that targets HER2 turns off the signal that tells the cancer to grow. Chemotherapy is given at the same time as HER2-targeted therapy. If your stomach cancer tests positive for HER2, we will talk with you about this treatment option. Other targeted drugs that block the growth and spread of cancer may be used to treat a rare type of stomach cancer called gastrointestinal stromal tumor (GIST).

Side effects 

Because targeted drugs take aim specifically at cancer cells, they cause less collateral damage to healthy cells. But HER2-targeted therapy is not without side effects, which may include:

  • Fever
  • Diarrhea
  • Fatigue and weakness
  • Nausea and vomiting
  • Cough
  • Headache
  • Low blood counts

We will watch you closely for these and other side effects. Notify us as soon as you notice symptoms.

Clinical Trials

We’re always looking for new and better ways to treat stomach cancer. Clinical trials are research studies that test new treatments and procedures. We can talk about available clinical trials that may be right for you.

Additional References:

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