Low Dose Chemotherapy for Advanced Stomach Cancer

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According to the World Health Organization 2008 stomach cancer is not as common in the United States as it is in other countries such as Japan and China. People that live in regions that use smoke, salt or pickling for food preservation may be at higher risk of the disease. Americans can avoid foods that may be a risk factor.

Treatment varies according to the advancement of the disease. High doses of chemotherapy have been the treatment for advanced cancer. Researchers are testing a newer treatment using low dose chemotherapy for advanced stomach cancer.


The onset of cancer may require surgery to remove any signs of cancer. Endoscopy- a scope that is placed down the esophagus into the stomach, is used to remove just the tumors.

Partial or full stomach removal may be necessary to remove all of the cancer. Radiation and chemotherapy treatments are often used before and after surgery.


Prior to surgery radiation is used to reduce the size of the tumors. Radiation used after surgery can eliminate cancer cells that were left behind.

Metronomic Chemotherapy

Chemotherapy is used before and after surgery to reduce the size of tumors. It is also used for advanced cancer cases where surgery is not an option. The protocol has been to deliver as high a dose as possible of chemotherapy drugs to kill the cancer cells. Research has found that low dose chemotherapy can be more affective.

Metronomic chemotherapy can deliver as little as one tenth of the traditional dose. It keeps symptoms down and allows for more frequent treatments that deliver a steady flow of the drug. Treatments can be given within days of each other rather than weeks as in traditional chemotherapy.

Another reason that the treatment can be more affective is that it attacks the endothelial cells of the stomach that feed nutrients to the tumor. Rather than trying to kill the tumor with the drug, it kills the nutrient producer at a much lower dose.

Cancer cells mutate and become resistant to chemotherapy. Endothelial cells do not mutate which means that the low dose of chemotherapy can still be affective on the cells. It is a round-about-way of getting to the cancer cells and cutting off their food supply.


The drug that works against the blood supply of the tumor is an angiogenesis inhibitor which means it blocks the growth of blood vessels. Only one drug has been approved for the metronomic treatment but others are being investigated.

Researchers are hopeful that the low dose chemotherapy for advanced stomach cancer will become a maintenance therapy. Initial treatment using higher doses of chemotherapy can be used, followed by the metronomic chemotherapy.

Survival rates using low dose chemotherapy are still being studied.


The research is promising in the treatment of advanced stomach cancer and low dose chemotherapy. If the use of new drugs can destroy the path for cancer cells to feed, it can keep the disease from spreading


CNN.com Health Library: Metronomic chemotherapy: Low-dose chemotherapy for advanced cancers


Globcan 2008: Stomach Cancer Incidence and Mortality Worldwide 2008 Summary


Mayo Clinic: Stomach Cancer


Cancer Treatment Centers of America: Metronomic Chemotherapy for Stomach Cancer