Being diagnosed with stomach cancer can be overwhelming. Once doctors recommend surgery, patients and their families often have several questions. Will the entire stomach be removed? How will digestion change? What should patients eat after surgery? How long does recovery take?

One of the common surgical procedures used to treat stomach cancer is called a gastrectomy. It involves removing part or all of the stomach, depending on the location and extent of the cancer.

Although the word surgery can sound frightening, understanding the procedure and knowing what to expect can help patients feel more prepared. From pre-surgery investigations to dietary changes after the operation, there are several things worth knowing before undergoing a gastrectomy.

Let's understand what happens before, during and after stomach cancer surgery.

What Exactly Is a Gastrectomy?

A gastrectomy is an operation in which a surgeon removes the cancer-affected portion of the stomach. It is generally recommended when the cancer can be surgically removed and the patient's overall condition allows them to undergo the procedure.

The stomach plays an important role in digestion. It stores food, mixes it with digestive juices and gradually passes it into the small intestine. When a part or the entire stomach is removed, the digestive system needs to adjust to a different way of processing food.

There are different types of gastrectomy, and the procedure recommended depends on where the cancer is located and how far it has grown.

What Are the Different Types of Stomach Cancer Surgery?

Not every patient with stomach cancer requires the same operation. The surgeon decides how much of the stomach needs to be removed after reviewing scans, biopsy findings and other investigations.

Partial Gastrectomy: In this procedure, only the affected portion of the stomach is removed. The remaining stomach is connected to the small intestine so food can continue moving through the digestive system.

Total Gastrectomy: Sometimes cancer affects a large portion of the stomach or is located in an area where preserving the remaining stomach is not suitable. In such situations, the entire stomach may need to be removed. The food pipe is then connected directly to the small intestine

Proximal or Distal Gastrectomy: Depending on the tumour's location, the upper or lower portion of the stomach may be removed while preserving the remaining healthy tissue.

An upper GI endoscopy is commonly performed to examine the stomach and collect a biopsy. The biopsy confirms the diagnosis and identifies the type of cancer.

A CT scan of the chest, abdomen and pelvis may help determine the extent of the disease. In selected patients, doctors may also recommend an endoscopic ultrasound or staging laparoscopy for more detailed assessment.

Blood tests, nutritional assessments and heart or lung fitness evaluations may also be required before surgery.

These investigations help the medical team decide whether surgery is appropriate and plan the safest treatment approach.

Is Chemotherapy Needed Before Stomach Cancer Surgery?

An important question patients often ask is whether chemotherapy is necessary before a gastrectomy.

The answer depends on the cancer stage and individual medical findings. Some patients with locally advanced stomach cancer may receive chemotherapy before surgery. This is known as neoadjuvant chemotherapy.

The purpose is to treat cancer cells before the operation and improve the overall treatment strategy. Some patients may also require chemotherapy after surgery to reduce the risk of cancer returning.

The medical oncologist reviews the biopsy, scans, tumour characteristics and the patient's overall health before recommending treatment.

Dr Priya Tiwari, a Medical Oncologist, can help patients understand the role of chemotherapy and systemic treatment as part of their stomach cancer care journey.

How Should Patients Prepare for Stomach Cancer Surgery?

Preparing for a gastrectomy is not limited to the day before surgery. A patient's nutritional health and physical condition can influence recovery.

Many people with stomach cancer experience reduced appetite, unexplained weight loss, nausea or difficulty eating. These problems can affect their nutritional status even before surgery.

Doctors may recommend a dietitian consultation to improve protein and calorie intake. Patients should also inform their medical team about existing health conditions, allergies and all medicines or supplements they take.

Smoking should be stopped before surgery, and patients should follow the anaesthesia team's instructions regarding fasting.

It is equally important to understand the planned procedure, possible complications and expected recovery period. Discussing these concerns beforehand can make the experience less stressful.

What Happens During Gastrectomy?

Gastrectomy is performed under general anaesthesia, meaning the patient remains asleep during the operation.

Depending on the cancer and the patient's condition, the surgeon may perform open surgery or minimally invasive surgery using laparoscopic or robotic-assisted techniques.

The affected portion or entire stomach is removed along with the required nearby lymph nodes. The remaining digestive organs are then connected to allow food to pass through the digestive system.

The removed tissue is sent for laboratory examination. The final pathology report helps doctors understand the cancer's extent, lymph node involvement and whether the surgical margins are free of cancer cells.

These findings are important when deciding whether additional treatment is required.

What Changes Can Patients Expect After Gastrectomy?

One of the biggest adjustments after stomach cancer surgery is learning to eat differently.

Since the stomach's capacity to store food is reduced or completely lost, patients may feel full after eating smaller portions. Eating large meals may cause discomfort, bloating or nausea.

Doctors and dietitians generally recommend eating smaller meals more frequently, chewing food properly and including adequate protein in the diet.

Some patients may also experience dumping syndrome, a condition in which food moves too quickly into the small intestine. It can cause sweating, dizziness, abdominal cramps, diarrhoea or weakness after eating.

Nutritional deficiencies are another concern. Patients who undergo total gastrectomy may need lifelong vitamin B12 replacement because the stomach produces a protein required for its absorption. Iron, calcium and vitamin D levels may also need monitoring.

The right dietary plan depends on the type of surgery and the patient's recovery.

How Long Does Recovery Take After Stomach Cancer Surgery?

Recovery varies from one patient to another. Hospitalisation may last several days or longer, depending on the procedure and whether complications occur.

During the initial recovery period, doctors monitor pain, bowel function, wound healing and the ability to tolerate food and fluids.

After returning home, patients should gradually increase their physical activity and avoid heavy lifting until their surgeon allows it.

Initial recovery may take around six to eight weeks, although adjusting to new eating habits and regaining strength can take several months.

Persistent vomiting, fever, severe abdominal pain, difficulty drinking fluids or unusual wound discharge should be reported to the medical team promptly.

Can Stomach Cancer Return After Surgery?

Although gastrectomy aims to remove the cancer, recurrence is still possible.

The risk depends on the original cancer stage, lymph node involvement, tumour characteristics and response to treatment.

This is why follow-up appointments are important even after successful surgery. Doctors may recommend clinical examinations, blood tests, imaging and other investigations depending on the patient's condition.

The final pathology report also helps the medical oncologist decide whether chemotherapy or additional treatment is necessary.

Undergoing a gastrectomy is a significant step in the treatment of stomach cancer, but understanding the process can help patients prepare both physically and emotionally.

From preoperative investigations and chemotherapy decisions to dietary adjustments and long-term nutritional care, every stage plays an important role in recovery.

Patients should remember that life after partial or total stomach removal is possible, although eating habits and nutritional needs may change.

For those exploring stomach cancer treatment in Delhi, understanding the available treatment options and discussing them with an experienced cancer care team can help make informed decisions. Dr Priya Tiwari, a Medical Oncologist, can guide patients through the medical oncology aspects of stomach cancer management, including chemotherapy planning and treatment after surgery.

The most important thing is to understand your diagnosis, ask questions and follow a treatment plan based on your individual medical needs.