Inoperable stomach cancer

I was diagnosed with advanced stomach cancer (T4N0M1) in August 2020. The cancer had spread to my peritoneum and as a result the doctors said it was inoperable. I am confused by the logic underlying this decision. They say that if I had a gastrectomy the cancer would likely pop-up again elsewhere, but it might not, so some hope. If I don't have the operation there is no hope. What would you choose? Would no doctor in the UK (NHS or private) be willing to operate on me under these circumstances?

  • Hello and thanks for your post,

     I am so sorry to hear about your situation.

    I can imagine that it must have been very disappointing to hear that your doctors were unable to offer you surgery.

     The idea of cutting things out sounds straightforward, but I think it is much more complex than it seems. I'm afraid I can't explain the rational in your case, but one of the main reasons to remove a primary cancer is to stop it from spreading, if this has already happened and the surgeons don't think they remove all of the cancer that has spread, then an operation won't succeed. Very small number of cancer cells can't easily be detected or seen, but are likely to be present once a cancer is known to have spread, so removing only what can be seen might not take all the cancer away. In time as small collections of cells grow, they would form a detectable secondary cancer (metastasis) from which cells may spread again. I don't think it is feasible to undertake multiple sequential operations to remove secondary cancers as they crop up because repeated surgery can take its toll. But do ask your specialist to explain in more detail what lies behind their thinking

    Your doctors have to weigh up the risks and the benefits from having the surgery which is a very big operation with what can be a long recovery time.   

    It will probably be the opinion of other doctors faced with a similar situation, but you could ask for a second surgical opinion. We have some information about how to go about getting one which you can see here

    We have some information on decisions about what treatment to offer when surgery may not be an option which you can see here

    I hope you manage to have further discussions with your oncology team about what your next steps are and if they are not able to offer you surgery what else they would suggest.

    I do hope that you are managing to get some support and help during this very difficult time.  

    You are more then welcome to give us a ring to talk any of this through with one of the nurses on the helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    All the Very Best,

    Catherine

  • Thanks Catherine, that's very helpful. B_B