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33

NCCN Guidelines for Patients

®

Stomach Cancer, Version 1.2016

32

NCCN Guidelines for Patients

®

Stomach Cancer, Version 1.2016

4

Overview of cancer treatments Endoscopic treatment

EMR

EMR (

e

ndoscopic

m

ucosal

r

esection) removes a

tumor with an endoscope that has a wire loop called

a snare. There is more than one method of how to do

EMR. The methods mainly differ by what devices are

used with the snare to remove the tumor.

Sometimes EMR is all that is needed to remove

a tumor. Other times, the tissue removed by EMR

helps with diagnosis but more treatment is needed.

Some tumors may be removed in multiple pieces with

EMR. However, the larger and deeper a tumor is, the

higher the risk of the tumor returning (recurrence).

Therefore, an expert endoscopist will only perform

EMR on people who are most likely to benefit.

EMR requires that you be sedated but some people

do receive general anesthesia. The procedure can

take about 1 hour to complete. EMR is generally an

outpatient procedure. However, you may stay in the

hospital for 1 or 2 days.

Figure 10.

Endoscopic resection

Stomach tumors that have not

invaded deep into the stomach wall

may be removed with endoscopic

resection. This treatment removes

tumors with tools inserted through

an endoscope.

In Part 4, the main treatment types for

stomach cancer are briefly described.

Knowing what a treatment is will

help you understand your treatment

options listed in Part 5. There is

more than one treatment for stomach

cancer. Not every person will receive

every treatment described in this

chapter.

Endoscopic treatment

Some stomach tumors and high-risk tissue may be

treated with an endoscopic resection. This treatment

removes early tumors using tools inserted through

an endoscope.

See Figure 10

. Early tumors include

those confined to the first layer of the stomach

wall (Tis and T1a scores). Doctors who perform

endoscopic resections are called endoscopists.

There are two main types of endoscopic treatment.

Both types first inject a liquid under the tumor to move

it away from other tissue. However, the tools used to

remove the tumor differ. More details on how the two

types differ are discussed next.

4

Overview of cancer

treatments

32 Endoscopic treatment

35 Surgical treatment

37 Radiation therapy

40 Chemotherapy

43 Targeted therapy

45 Clinical trials

46 Review

An endoscope is

guided into the

stomach

Fluid is injected

under the tumor

A cutting tool

removes the

tumor

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