Skip to main contentLast updated: 24-Oct-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Stomach Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ Google: 4.89 from 216 reviews (Gota clinic) · 4.94 from 18 reviews (Apollo, Bhat)
In short
The biggest change is that every stomach cancer is now tested for a set of markers. These tests decide which medicine is added to chemotherapy.
Immunotherapy and targeted drugs have moved into first-line treatment. Operations are also becoming gentler, with more of the stomach kept when it is safe.
Some ideas, such as blood tests for hidden cancer, are still research. A new result does not change your plan until your own team has weighed it.
How stomach cancer is first tested, staged and treated is set out on the stomach cancer treatment in Ahmedabad page. This post is a plain summary of recent changes.
A biopsy now answers more than “is it cancer”. The tumour is also tested for markers that decide which medicine is likely to help.
| Marker | What it shows | What it can change |
|---|---|---|
| HER2 | A growth signal on the tumour cell | A drug aimed at HER2 is added to chemotherapy |
| MSI or mismatch repair | Whether the tumour cannot repair its own DNA | Immunotherapy tends to work well, and may be used before surgery in selected people |
| PD-L1 | How much the tumour hides from the immune system | Immunotherapy is added to chemotherapy, with more benefit at higher scores |
| Claudin 18.2 | A protein on the tumour surface | A drug aimed at it can be added to chemotherapy |
| FGFR2b | Another surface marker, found on a wider gene panel | A drug is being studied; it is not yet routine |
These tests are done on the biopsy or on the removed tumour. They are ordered together, so the sample is not used up. If a report does not list them, ask whether they were done. The molecular side is set out on the post about pathology and tumour markers in stomach cancer.
When cancer can be removed but has grown deep or reached glands, chemotherapy before and after surgery is now standard. Immunotherapy is being added to it.
Not every trial agrees, so immunotherapy around surgery is chosen tumour by tumour. Approval and availability also differ by drug and country.
The usual plan for cancer confined to the stomach wall and glands is covered on the post about treatment of locally advanced stomach cancer.
For cancer that has spread, first-line treatment now means chemotherapy plus a drug chosen by the tumour markers. Longer follow-up has held these gains.
For cancer on the lining of the belly, a trial from China gave chemotherapy straight into the abdomen. It was added to standard medicine. People lived longer. This is promising but needs confirming elsewhere. Treatment of spread cancer is on the post about treatment of stomach cancer that has spread.
For some early cancers in the upper stomach, removing only the top part gives similar survival. Life after surgery is also better.
Choosing a smaller operation depends on the position, depth and type of the tumour. It also depends on careful staging before surgery.
Large studies now show that keyhole surgery gives the same long-term survival as open surgery in experienced hands.
| Question | What was found |
|---|---|
| Keyhole or open | Pooled trials show the same five-year survival and the same time to cancer return |
| Robotic or keyhole, lower part of stomach | A large Japanese registry found fewer complications and less blood loss with robotic |
| Robotic or keyhole, whole stomach | No clear fall in complications |
| Cancer outcomes with robotic | Return-free survival was similar to keyhole |
| Hospital experience | Fewer deaths after gastrectomy at centres that do many each year |
These are comparisons of large groups, not promises for one person. The skill of the team and the safety of the join matter more than the instrument.
Testing for the H. pylori germ and treating it is still the main way to lower the chance of stomach cancer where the germ is common.
Who should be tested is covered on the post about risk factors for stomach cancer.
Several ideas are still in the research stage. They may help in the future, but they are not yet a reason to change a plan.
New does not always mean better for you. The right treatment comes from your tumour tests, your scans and your health, not from a headline.
HER2, MSI or mismatch repair, PD-L1 and Claudin 18.2 are now asked for. They decide whether a targeted drug or immunotherapy is added to chemotherapy.
Yes, for many people with spread cancer, mainly those whose tumours test positive for PD-L1, HER2 or MSI-high. Around surgery it is chosen tumour by tumour.
Part of it can, for early cancers in the upper stomach that are small and well placed. Larger or deeper cancers still need the whole stomach removed.
For the lower stomach it may cause fewer complications in large studies. For removal of the whole stomach no clear gain is seen. Cancer results look similar.
People with long-standing acidity, ulcers or a family history of stomach cancer should ask. A simple stool or breath test finds it, and a short course of medicines treats it.
Tests for tumour DNA in the blood are still research. They are not yet used to decide treatment.
The full range of stomach cancer care is on the stomach cancer treatment page. For questions before you travel, call +91-63555-64601.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of endoscopy, biopsy and scan reports, second opinions and follow-up.
Apollo Hospital, Bhat, Gandhinagar
Apollo Hospital International Limited, GIDC Bhat Industrial Estate, Bhat, Gandhinagar. Endoscopy and biopsy, CT scans, surgery for stomach cancer, and inpatient care.
Read about a new drug or a new trial and wondering if it applies to you? Whether a new option fits depends on your tumour tests, the stage and your general health. Reports and scans can be sent ahead on WhatsApp, so the discussion starts with them already read. The plan is decided at the consultation, after examination. Call +91-63555-64601 Send your reports before the visit
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