Introduction
The Stomach
Understanding Cancer
Risk Factors
Symptoms
Diagnosis
Staging
Treatment
Nutrition
Follow-up Care
Complementary and Alternative Medicine
Sources of Support
The Promise of Cancer Research
National Cancer Institute Information Resources
National Cancer Institute Publications
Introduction
This National Cancer Institute (NCI) booklet
(NIH Publication No. 05-1554)
has important information about
cancer* of the stomach. Stomach cancer is also called gastric cancer.
You will read about possible causes, symptoms, diagnosis, and treatment. You will also find ideas about how to cope with the disease.
Scientists are studying stomach cancer to find out more about its causes. And they are looking for better ways to treat it.
NCI provides free information about cancer, including the publications mentioned in this booklet. You can order these materials by telephone or on the Internet. You can also read them on the Internet and print your own copy.
*Words that may be new to readers appear in italics. The "Dictionary" section explains these terms. Some words in the "Dictionary" have a "sounds-like" spelling to show how to pronounce them.
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The Stomach
The
stomach
is part of the
digestive system.
It is a hollow
organ
in the upper
abdomen,
under the ribs.
The wall of the stomach has five layers:
-
Inner layer or lining
(mucosa):
Juices made by
glands
in the inner layer help
digest food. Most stomach cancers begin in this layer.
-
Submucosa: This is the support tissue for the inner layer.
-
Muscle layer: Muscles in this layer create a rippling motion that mixes and
mashes food.
-
Subserosa: This is the support tissue for the outer layer.
-
Outer layer (serosa): The outer layer covers the stomach. It holds the stomach
in place.
Food moves from the mouth through the
esophagus
to reach the stomach. In the
stomach, the food becomes liquid. The liquid then moves into the
small intestine, where it is digested even more.
This picture shows the stomach and nearby organs.
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Understanding Cancer
Cancer begins in
cells,
the building blocks that make up
tissues.
Tissues make
up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When
cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can
form a mass of tissue called a growth or
tumor.
Tumors can be
benign
or
malignant:
-
Benign tumors are not cancer:
-
Benign tumors are rarely life-threatening.
-
Most benign tumors can be removed. They usually do not grow back.
-
Cells from benign tumors do not invade the tissues around them.
-
Cells from benign tumors do not spread to other parts of the body.
-
Malignant tumors are cancer:
-
Malignant tumors are generally more serious than benign tumors. They may be
life- threatening.
-
Malignant tumors often can be removed. But sometimes they grow back.
-
Cells from malignant tumors can invade and damage nearby tissues and organs.
-
Cells from malignant tumors can spread
(metastasize) to other parts of the
body. Cancer cells spread by breaking away from the original tumor and entering
the bloodstream or the
lymphatic system.
The cells invade other organs and form
new tumors that damage these organs. The spread of cancer is called
metastasis.
Stomach cancer can affect nearby organs and
lymph nodes:
-
A stomach tumor can grow through the stomach's outer layer into nearby organs,
such as the
pancreas,
esophagus, or intestine.
-
Stomach cancer cells can spread through the blood to the
liver,
lungs,
and
other organs.
-
Cancer cells also can spread through the lymphatic system to lymph nodes all
over the body.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the original
tumor. For example, if stomach cancer spreads to the liver, the cancer cells in
the liver are actually stomach cancer cells. The disease is metastatic stomach
cancer, not liver cancer. For that reason, it is treated as stomach cancer, not
liver cancer. Doctors call the new tumor "distant" or metastatic disease.
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Risk Factors
No one knows the exact causes of stomach cancer. Doctors often cannot explain
why one person develops this disease and another does not.
Research has shown that people with certain
risk factors
are more likely than
others to develop stomach cancer. A risk factor is something that may increase
the chance of developing a disease.
Studies have found the following risk factors for stomach cancer:
Most people who have known risk factors do not develop stomach cancer. For
example, many people have
H. pylori
in their stomach but never develop cancer.
On the other hand, people who do develop the disease sometimes have no known
risk factors.
If you think you may be at risk, you should talk with your doctor. Your doctor
may be able to suggest ways to reduce your risk and can plan a schedule for
checkups.
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Symptoms
Early stomach cancer often does not cause clear symptoms. As the cancer grows, the most common symptoms are:
- Discomfort in the stomach area
- Feeling full or bloated after a small meal
- Nausea and vomiting
- Weight loss
Most often, these symptoms are not due to cancer. Other health problems, such as an ulcer or infection, can cause the same symptoms. Anyone with these symptoms should tell the doctor so that problems can be found and treated as early as possible.
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Diagnosis
If you have a symptom that suggests stomach cancer, your doctor must find out
whether it is really due to cancer or to some other cause. Your doctor may
refer you to a
gastroenterologist,
a doctor whose specialty is diagnosing and
treating digestive problems.
The doctor asks about your personal and family health history. You may have
blood or other lab tests. You also may have:
-
Physical exam: The doctor checks your abdomen for fluid, swelling, or other
changes. The doctor also feels for swollen lymph nodes. Your skin and eyes are
checked to see if they seem yellow.
-
Upper GI series:
The doctor orders
x-rays
of your esophagus and stomach. The
x-rays are taken after you drink a
barium solution. The solution makes your
stomach show up more clearly on the x-rays.
-
Endoscopy:
The doctor uses a thin, lighted tube
(endoscope)
to look into your
stomach. The doctor first numbs your throat with an
anesthetic
spray. You also
may receive medicine to help you relax. The tube is passed through your mouth
and esophagus to the stomach.
-
Biopsy:
The doctor uses an endoscope to remove tissue from the stomach. A
pathologist
checks the tissue under a microscope for cancer cells. A biopsy is
the only sure way to know if cancer cells are present.
You may want to ask your doctor these questions about having a biopsy:
- How will the biopsy be done?
- Will I have to go to the hospital?
- Will I have to do anything to prepare for it?
- How long will it take? Will I be awake? Will it hurt?
- Are there any risks? What are the chances of infection or bleeding after the procedure?
- How long will it take me to recover? When can I resume my normal diet?
- How soon will I know the results? Who will explain them to me?
- If I do have cancer, who will talk to me about next steps? When?
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Staging
To plan the best treatment, your doctor needs to know the extent
(stage) of the
disease. The stage is based on whether the tumor has invaded nearby tissues,
whether the cancer has spread, and if so, to what parts of the body. Stomach
cancer can spread to the lymph nodes, liver, pancreas, and other organs. The
doctor may order tests to check these areas:
-
Blood tests: The lab does a
complete blood count
to check for
anemia.
Blood tests also show how well your liver is working.
-
Chest x-ray:
An x-ray machine takes pictures of your lungs.
The doctor can then study these pictures on film. Tumors in your lungs can show
up on the x-ray.
-
CT scan:
An x-ray machine linked to a computer takes a series of
detailed pictures of your organs. You may receive an
injection
of dye. The dye
makes abnormal areas easier to see. Tumors in your liver, pancreas, or
elsewhere in the body can show up on a CT scan.
-
Endoscopic ultrasound:
The doctor passes a thin, lighted tube
(endoscope) down your throat. A probe at the end of the tube sends out sound
waves that you cannot hear. The waves bounce off tissues in your stomach and
other organs.
-
Laparoscopy:
A
surgeon
makes small
incisions
(cuts) in your abdomen. The
surgeon inserts a thin, lighted tube
(laparoscope) into the abdomen. The
surgeon may remove lymph nodes or take tissue samples for biopsy.
Sometimes staging is not complete until after surgery to remove the tumor and
nearby lymph nodes.
These are the stages of stomach cancer:
-
Stage 0: The cancer is found only in the inner layer of the stomach. It is
carcinoma in situ.
-
Stage I is one of the following:
-
The tumor has invaded only the submucosa. (The picture in section 2
shows the layers of the stomach.) Cancer cells may be found in up to 6 lymph nodes.
-
Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have not
spread to lymph nodes or other organs.
-
Stage II is one of the following:
-
The tumor has invaded only the submucosa. Cancer cells have spread to 7 to 15
lymph nodes.
-
Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have
spread to 1 to 6 lymph nodes.
-
Or, the tumor has penetrated the outer layer of the stomach. Cancer cells have
not spread to lymph nodes or other organs.
-
Stage III is one of the following:
-
The tumor has invaded the muscle layer or subserosa. Cancer cells have spread
to 7 to 15 lymph nodes.
-
Or, the tumor has penetrated the outer layer. Cancer cells have spread to 1 to
15 lymph nodes.
-
Or, the tumor has invaded nearby organs, such as the liver or
spleen.
Cancer
cells have not spread to lymph nodes or to distant organs.
-
Stage IV is one of the following:
-
Cancer cells have spread to more than 15 lymph nodes.
-
Or, the tumor has invaded nearby organs and at least 1 lymph node.
-
Or, cancer cells have spread to distant organs.
-
Recurrent cancer:
The cancer has come back (recurred) after a period of time
when it could not be detected. It may recur in the stomach or in another part
of the body.
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Treatment
Many people with stomach cancer want to take an active part in making decisions
about their medical care. It is natural to want to learn all you can about the
disease and your treatment choices. However, shock and stress after the
diagnosis can make it hard to think of everything you want to ask your doctor.
It often helps to make a list of questions before an appointment.
To help remember what the doctor says, you may take notes or ask whether you
may use a tape recorder. You may also want to have a family member or friend
with you when you talk to the doctor - to take part in the discussion, to take
notes, or just to listen.
You do not need to ask all your questions at once. You will have other chances
to ask your doctor or nurse to explain things that are not clear and to ask for
more details.
Your doctor may refer you to a specialist who has experience treating stomach
cancer, or you may ask for a referral. Specialists who treat stomach cancer
include
gastroenterologists,
surgeons,
medical oncologists,
and
radiation oncologists.
Before starting treatment, you might want a second opinion about your diagnosis
and treatment plan. Many insurance companies cover a second opinion if you or
your doctor requests it. It may take some time and effort to gather medical
records and arrange to see another doctor. Usually it is not a problem to take
several weeks to get a second opinion. In most cases, the delay in starting
treatment will not make treatment less effective. To make sure, you should
discuss this delay with your doctor. Sometimes people with stomach cancer need
treatment right away.
There are a number of ways to find a doctor for a second opinion:
-
Your doctor may refer you to one or more specialists. At cancer centers,
several specialists often work together as a team.
-
NCI's Cancer Information Service, at 1-800-4-CANCER, can tell you about nearby
treatment centers. Information Specialists also can assist you online through
LiveHelp at http://www.cancer.gov/cis.
-
A local or state medical society, a nearby hospital, or a medical school can
usually provide the names of specialists.
-
The American Board of Medical Specialties (ABMS) has a list of doctors who have
had training and passed exams in their specialty. You can find this list in the
Official ABMS Directory of Board Certified Medical Specialists. The Directory
is in most public libraries. Also, ABMS offers this information at
http://www.abms.org. (Click on "Who's Certified.")
-
NCI provides a helpful fact sheet called "How To Find a Doctor or Treatment
Facility If You Have Cancer."
The choice of treatment depends mainly on the size and place of the tumor, the
stage of disease, and your general health. Treatment for stomach cancer may
involve
surgery,
chemotherapy,
or
radiation therapy.
Many people have more than
one type of treatment.
Your doctor can describe your treatment choices and the expected results. You
and your doctor can work together to develop a treatment plan that meets your
needs.
Cancer treatment is either
local therapy
or
systemic therapy:
-
Local therapy: Surgery and radiation therapy are local therapies. They remove
or destroy cancer in or near the stomach. When stomach cancer has spread to
other parts of the body, local therapy may be used to control the disease in
those specific areas.
-
Systemic therapy: Chemotherapy is systemic therapy. The drug enters the
bloodstream and destroys or controls cancer throughout the body.
Because cancer treatments often damage healthy cells and tissues,
side effects
are common. Side effects depend mainly on the type and extent of the treatment.
Side effects may not be the same for each person, and they may change from one
treatment session to the next.
Before treatment starts, your health care team will explain possible side
effects and suggest ways to help you manage them. NCI provides helpful booklets
about cancer treatments and coping with side effects. These include
Chemotherapy and You, Radiation Therapy and You, and Eating Hints for Cancer
Patients.
At any stage of disease, supportive care is available to relieve the side
effects of treatment, to control pain and other symptoms, and to ease emotional
concerns. Information about such care is available on NCI's Web site at
http://www.cancer.gov/cancertopics/coping, and from Information
Specialists at 1-800-4-CANCER or
LiveHelp (http://www.cancer.gov/cis).
You may want to talk to your doctor about taking part in a
clinical trial,
a
research study of new treatment methods. The section on "The Promise of Cancer
Research" has more information about clinical trials.
You may want to ask your doctor these questions about treatment:
- What is the stage of the disease?
- What are my treatment choices? Which do you suggest for me? Why?
- Would a clinical trial (research study) be a good choice for me?
- Will I have more than one kind of treatment?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment? What can we do to control my side effects? How else can I take care of myself during treatment?
- How will treatment affect my normal activities? Am I likely to have eating or other problems?
- Whom should I call if I have problems during treatment?
- What is the treatment likely to cost? Does my insurance cover this treatment?
- How often should I have checkups?
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Surgery is the most common treatment for stomach cancer. The type of surgery
depends on the extent of the cancer. There are two main types of stomach cancer
surgery:
-
Partial (subtotal)
gastrectomy: The surgeon removes the part of the stomach
with cancer. The surgeon also may remove part of the esophagus or part of the
small intestine. Nearby lymph nodes and other tissues may be removed.
-
Total gastrectomy: The doctor removes the entire stomach, nearby lymph nodes,
parts of the esophagus and small intestine, and other tissues near the tumor.
The spleen also may be removed. The surgeon then connects the esophagus
directly to the small intestine. The surgeon makes a new "stomach" out of
tissue from the intestine.
It is natural to be concerned about eating after surgery for stomach cancer.
During surgery, the surgeon may place a feeding tube into your small intestine.
This tube helps you get enough nutrition while you heal. Information about
eating after surgery is in the "Nutrition" section.
The time it takes to heal after surgery is different for each person. You may
be uncomfortable for the first few days. Medicine can help control your pain.
Before surgery, you should discuss the plan for pain relief with your doctor or
nurse. After surgery, your doctor can adjust the plan if you need more pain
relief.
Many people who have stomach surgery feel tired or weak for a while. The
surgery also can cause
constipation
or
diarrhea.
These symptoms usually can be
controlled with diet changes and medicine. Your health care team will watch for
signs of bleeding, infection, or other problems that may require treatment.
You may want to ask your doctor these questions about surgery:
- What kind of surgery do you recommend for me?
- Will you remove lymph nodes? Will you remove other tissue? Why?
- How will I feel after surgery?
- Will I need a special diet?
- If I have pain, how will you control it?
- How long will I be in the hospital?
- Am I likely to have eating problems? Will I need a feeding tube? If so, for how long? How do I take care of it? Who can help me if I have a problem?
- Will I have any lasting side effects?
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Chemotherapy uses anticancer drugs to kill cancer cells. The drugs enter the
bloodstream and can affect cancer cells all over the body.
Most people who receive chemotherapy have it after surgery. Radiation therapy
may be given along with chemotherapy.
Anticancer drugs for stomach cancer are usually injected into a blood vessel.
But some drugs may be given by mouth. You may have your treatment in a clinic
at the hospital, at the doctor's office, or at home. Some people may need to
stay in the hospital during treatment.
The side effects of chemotherapy depend mainly on the specific drugs and the
dose. The drugs affect cancer cells and other cells that divide rapidly:
-
Blood cells: These cells fight infection, help blood to clot, and carry oxygen
to all parts of your body. When drugs affect your blood cells, you are more
likely to get infections, bruise or bleed easily, and feel very weak and tired.
-
Cells in hair roots: Chemotherapy drugs can cause hair loss. Your hair will
grow back, but it may be somewhat different in color and texture.
-
Cells that line the digestive tract: Chemotherapy can cause poor appetite,
nausea and vomiting, diarrhea, or mouth and lip sores.
The drugs used for stomach cancer also may cause a skin rash or itching. Your
health care team can suggest ways to control many of these side effects.
You may want to ask your doctor these questions about chemotherapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the drugs work?
- When will treatment start? When will it end?
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Radiation therapy (also called radiotherapy) uses high-energy rays to kill
cancer cells. It affects cells only in the treated area.
The radiation comes from a large machine outside the body. Most people go to a
hospital or clinic for treatment. Treatments are usually 5 days a week for
several weeks.
Side effects depend mainly on the dose of radiation and the part of your body
that is treated. Radiation therapy to the abdomen may cause pain in the stomach
or the intestine. You may have nausea and diarrhea. Also, your skin in the
treated area may become red, dry, and tender.
You are likely to become very tired during radiation therapy, especially in the
later weeks of treatment. Resting is important, but doctors usually advise
patients to try to stay as active as they can.
Although the side effects of radiation therapy can be distressing, your doctor
can usually treat or control them. Also, side effects usually go away after
treatment ends.
You may want to ask your doctor these questions about radiation therapy:
- Why do I need this treatment?
- When will the treatments begin? When will they end?
- How will I feel during treatment?
- How will we know if the radiation treatment is working?
- Are there any lasting effects?
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Nutrition
It is important to eat well during and after cancer treatment. You need the
right amount of calories, protein, vitamins, and minerals. Eating well may help
you feel better and have more energy.
Eating well can be hard. Sometimes, especially during or soon after treatment,
you may not feel like eating. You may be uncomfortable or tired. You may find
that foods do not taste as good as they used to. You also may have side effects
of treatment such as poor appetite, nausea, vomiting, or diarrhea.
A
registered dietitian can suggest ways to
deal with these problems. Some people with stomach cancer are helped by
receiving nutrition by a feeding tube or by injection into a blood vessel. Some
are helped by nutritional beverage products.
You may want to read the NCI booklet Eating
Hints for Cancer Patients. It contains many useful ideas and
recipes.
Nutrition After Stomach Surgery
Weight loss after surgery for stomach cancer is common. You may need to change
the types of food you eat. A registered dietitian can help you plan a diet that
will give you the nutrition you need.
Another common problem after stomach surgery is
dumping syndrome. This problem occurs when
food or liquid enters the small intestine too fast. It can cause cramps,
nausea, bloating, diarrhea, and dizziness. Eating smaller meals can help
prevent dumping syndrome. Also, you may wish to cut down on very sweet foods
and drinks, such as cookies, candy, soda, and juices. A registered dietitian
can suggest foods to try. Also, your health care team may suggest medicine to
control the symptoms.
You may need to take daily supplements of vitamins and minerals, such as
calcium. You also may need injections of
vitamin B12.
You may want to ask a registered dietitian these questions about nutrition:
-
What foods are best soon after surgery?
-
How can I avoid dumping syndrome?
-
Are there foods or drinks I should avoid?
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Follow-up Care
Follow-up care after treatment for stomach cancer is important. Even when there
are no longer any signs of cancer, the disease sometimes returns because
undetected cancer cells remained somewhere in the body after treatment. Your
doctor will monitor your recovery and check for
recurrence
of the cancer.
Checkups help ensure that any changes in your health are noted and treated if
needed. Checkups may include a physical exam, lab tests, x-rays, CT scans,
endoscopy, or other tests. Between scheduled visits, you should contact the
doctor if you have any health problems.
Facing Forward Series: Life After Cancer Treatment is an NCI booklet for people
who have finished their treatment. It answers questions about follow-up care
and other concerns. It has tips for making the best use of medical visits. It
also suggests ways to talk with the doctor about making a plan of action for
recovery and future health.
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Complementary and Alternative Medicine
Some people with cancer use
complementary and alternative medicine (CAM):
- An approach is generally called complementary medicine when it is used along with standard treatment.
- An approach is called alternative medicine when it is used instead of standard treatment.
Acupuncture,
massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing are types of CAM.
Many people say that CAM helps them feel better. However, some types of CAM may change the way standard treatment works. These changes could be harmful. And some types of CAM could be harmful even if used alone. Before trying any type of CAM, you should discuss its possible benefits and risks with your doctor.
Some types of CAM are expensive. Health insurance may not cover the cost.
NCI offers a booklet called
Thinking About Complementary and Alternative Medicine.
You also may request materials from the Federal Government's National Center for Complementary and Alternative Medicine. You can reach their clearinghouse toll-free at
1-888-644-6226 (voice) and 1-866-464-3615 (TTY). In addition, you can visit the Center's Web site at
http://www.nccam.nih.gov, or send an e-mail to
info@nccam.nih.gov.
You may want to ask your doctor these questions about CAM:
- What benefits can I expect from this approach?
- What are its risks?
- Do the expected benefits outweigh the risks?
- What side effects should I watch for?
- Will CAM change the way my cancer treatment works? Could this be harmful?
- Is this approach under study in a clinical trial? If so, who sponsors the trial?
- Will my health insurance pay for this approach?
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Sources of Support
Living with a serious disease such as stomach cancer is not easy. You may worry
about caring for your family, keeping your job, or continuing daily activities.
Concerns about treatments and managing side effects, hospital stays, and
medical bills are also common. Doctors, nurses, and other members of your
health care team can answer questions about treatment, working, or other
activities. Meeting with a social worker, counselor, or member of the clergy
also can be helpful if you want to talk about your feelings or concerns. Often,
a social worker can suggest resources for financial aid, transportation, home
care, or emotional support.
Support groups also can help. In these groups, patients or their family members
meet with other patients or their families to share what they have learned
about coping with the disease and the effects of treatment. Groups may offer
support in person, over the telephone, or on the Internet. You may want to talk
with a member of your health care team about finding a support group.
Information Specialists at 1-800-4-CANCER and at
LiveHelp (http://www.cancer.gov/cis)
can help you locate programs, services, and publications. For a list of
organizations offering support, you may want to get the NCI fact sheet
"National Organizations That Offer Services to People With Cancer and Their
Families." For tips on coping, you may want to read the NCI booklet
Taking Time: Support for People With Cancer and the People Who Care About Them.
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The Promise of Cancer Research
Doctors all over the country are conducting many types of clinical trials
(research studies in which people volunteer to take part). For stomach cancer,
they are studying surgery, chemotherapy, radiation therapy, and combinations of
these types of treatment.
Clinical trials are designed to answer important questions and to find out
whether new approaches are safe and effective. Research already has led to
advances, and researchers continue to search for more effective methods for
dealing with stomach cancer.
People who join clinical trials may be among the first to benefit if a new
approach is effective. And even if people in a trial do not benefit directly,
they still make an important contribution by helping doctors learn more about
stomach cancer and how to control it in other patients. Although clinical
trials may have some risks, doctors do all they can to protect their patients.
If you are interested in being part of a clinical trial, talk with your doctor.
You may want to read the NCI booklet Taking Part in Cancer Treatment Research Studies. It explains how clinical trials are carried out and explains their possible benefits and risks.
NCI's Web site includes a section on clinical trials at http://www.cancer.gov/clinicaltrials.
It has general information about clinical trials as well as a search form to
help you find studies of stomach cancer in progress. Information Specialists at
1-800-4-CANCER or at
LiveHelp at http://www.cancer.gov/cis
can answer questions and provide information about clinical trials.
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National Cancer Institute Information Resources
You may want more information for yourself, your family, and your doctor. The
following National Cancer Institute (NCI) services are available to help you.
Telephone
The NCI's Cancer Information Service (CIS) provides accurate, up-to-date
information on cancer to patients and their families, health professionals, and
the general public. Information Specialists explain the latest scientific
information in plain language and respond in English, Spanish, or on TTY
equipment. Calls to the CIS are free.
Telephone: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615
Internet
The NCI's Web site (http://www.cancer.gov) provides information
from many NCI sources. It offers current information on cancer prevention,
screening, diagnosis, treatment, genetics, supportive care, and ongoing
clinical trials. It has information about NCI's research programs and funding
opportunities, cancer statistics, and the Institute itself. Information
Specialists provide live, online assistance through
LiveHelp at http://www.cancer.gov/cis.
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National Cancer Institute Publications
National Cancer Institute (NCI) publications can be ordered by writing to the
address below:
Publications Ordering Service
National Cancer Institute
Suite 3035A
6116 Executive Boulevard, MSC 8322
Bethesda, MD 20892-8322
Many NCI publications can be viewed, downloaded, and ordered from
http://www.cancer.gov/publications
on the Internet. In addition, people in the United States and its territories
may order these and other NCI publications by calling the NCI's Cancer
Information Service at 1-800-4-CANCER.
Cancer Treatment and Support
Chemotherapy
and You: A Guide to Self-Help During Cancer Treatment (also
available in Spanish: La quimioterapia y usted: una guía de autoayuda durante
el tratamiento del cáncer)
Helping Yourself During Chemotherapy: 4 Steps for Patients
Radiation Therapy and You: A Guide to Self-Help During Cancer Treatment (also
available in Spanish: La radioterapia y usted: una guía de autoayuda durante el
tratamiento del cáncer)
Eating Hints for Cancer Patients: Before, During & After Treatment (also
available in Spanish: Consejos de alimentación para pacientes con cáncer:
antes, durante y después del tratamiento)
Understanding Cancer Pain (also available in Spanish:
El dolor relacionado con
el cáncer)
Pain Control: A Guide for People with Cancer and Their Families (also
available
in Spanish: Control del dolor: guía para las personas con cáncer y sus
familias)
Get Relief from Cancer Pain
Thinking About Complementary and Alternative Medicine: A Guide for People with
Cancer
"La medicina complementaria y alternativa en el tratamiento del cáncer:
preguntas y respuestas"
"How To Find a Doctor or Treatment Facility If You Have Cancer" (also available
in Spanish: "Cómo encontrar a un doctor o un establecimiento de tratamiento si
usted tiene cáncer")
"National Organizations That Offer Services to People With Cancer and Their
Families" (also available in Spanish: "Organizaciones nacionales que brindan
servicios a las personas con cáncer y a sus familias")
Living With Cancer
Advanced Cancer: Living Each Day
Facing Forward Series: Life After
Cancer Treatment (also available in Spanish:
Siga adelante: la vida después del tratamiento del cáncer)
Facing Forward Series: Ways You Can Make a
Difference in Cancer
Taking Time: Support for People with Cancer and
the People Who Care About Them
When Cancer Recurs: Meeting the Challenge
Clinical Trials
Taking Part in Cancer Treatment Research Studies
Taking Part in
Clinical Trials: Cancer Prevention Studies: What Participants Need To Know
(also available in Spanish: La participación en los estudios
clínicos: estudios para la prevención del cáncer)
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