Stomach Cancer Treatment in India
Get Stomach Cancer Treatment at internationally accredited (JCI/NABH) Indian hospitals at a fraction of Western costs, with end-to-end international patient support — visa, travel, stay, and follow-up care.
Stomach Cancer Treatment in UAE
Stomach Cancer Treatment at leading UAE hospitals in Dubai and Abu Dhabi — world-class care closer to home, visa-free entry for many nationalities, international specialists, and modern facilities.
Overview
Stomach cancer (gastric adenocarcinoma) is treated through a multidisciplinary protocol combining surgery, perioperative chemotherapy, targeted therapy, and—where indicated—immunotherapy; experienced oncology centers in India and the UAE achieve 5-year overall survival rates of 30–60% depending on stage at diagnosis. International patients choose GAF Healthcare to access high-volume gastric oncology units staffed by surgeons trained at leading Western and Asian cancer institutes, at a fraction of the cost they would pay at home. GAF Healthcare coordinates every clinical and logistical detail—from staging workup through post-operative surveillance—across its partner network of NABH- and JCI-accredited hospitals in India and JCI- and DHA-licensed centers in Dubai and Abu Dhabi.
Hospital Stay: 10–21 days (varies by extent of resection: distal gastrectomy vs. total gastrectomy, open vs. robotic) • Total Stay in Country (Fit-to-Fly): 4–8 weeks (intercontinental flight is generally permitted once the surgical wound is fully closed, nutritional intake is adequate via oral or enteral route, and the treating surgeon issues medical clearance) • Success Rate: Stage I: 70–90% 5-year survival; Stage II: 45–65%; Stage III: 20–40%; Stage IV (palliative intent): median survival 12–18 months with modern systemic therapy
What Is It?
Gastric cancer arises predominantly from the glandular epithelium of the stomach lining (adenocarcinoma in ~95% of cases) and is further classified by anatomic location (cardia/gastro-esophageal junction vs. body vs. antrum/pylorus), Lauren histological subtype (intestinal, diffuse, or mixed), and molecular subtype per The Cancer Genome Atlas (TCGA) classification—Epstein-Barr virus-positive, microsatellite instable (MSI-H), chromosomally instable (CIN), and genomically stable (GS). Helicobacter pylori infection, atrophic gastritis, intestinal metaplasia, smoking, high-salt diets, and hereditary diffuse gastric cancer (CDH1 germline mutations) are the principal etiological drivers. Physiologically, tumor growth disrupts gastric acid secretion, impairs digestion, and commonly causes protein-calorie malnutrition; advanced disease may obstruct the gastric outlet or invade adjacent structures (pancreas, transverse colon, liver), producing ascites, peritoneal carcinomatosis, or hepatic metastases.
Accurate staging is the cornerstone of treatment planning and is performed using a combination of upper GI endoscopy with biopsy, endoscopic ultrasound (EUS) for T- and N-staging, contrast-enhanced CT of the chest, abdomen, and pelvis, and PET-CT to detect occult distant metastases. Diagnostic laparoscopy with peritoneal cytology is recommended for all patients with cT3–T4 or node-positive disease before committing to curative resection, as up to 20–30% harbor peritoneal disease not visible on cross-sectional imaging. Molecular profiling—including HER2 amplification by IHC/FISH, microsatellite instability (MSI/MMR) testing, PD-L1 combined positive score (CPS), VEGFR-2 expression, and FGFR2b amplification—is mandatory to guide first-line systemic therapy selection.
The current international standard of care for resectable gastric cancer is perioperative chemotherapy (FLOT regimen: docetaxel, oxaliplatin, leucovorin, 5-fluorouracil) combined with D2 lymphadenectomy gastrectomy, consistent with the FLOT4-AIO trial data demonstrating superiority over ECF/ECX. For HER2-positive metastatic disease, trastuzumab combined with platinum-fluoropyrimidine doublet chemotherapy remains first-line per the ToGA trial, with trastuzumab deruxtecan (T-DXd) approved in the second-line setting. MSI-H tumors derive exceptional benefit from immune checkpoint inhibitors (nivolumab, pembrolizumab), and the KEYNOTE-811 and CheckMate 649 trials have established immunotherapy combinations as standard first-line options for advanced disease. Multidisciplinary tumor board review—comprising gastric surgeons, medical oncologists, radiation oncologists, radiologists, pathologists, nutritionists, and palliative care specialists—is conducted at all GAF Healthcare partner centers before initiating treatment.
Candidates
• ELIGIBLE FOR CURATIVE SURGICAL RESECTION:
• Clinical stage IA–IIIC (cT1–T4a, N0–N3, M0) confirmed by EUS, CT, PET-CT, and diagnostic laparoscopy
• Adequate cardiopulmonary reserve: ECOG performance status 0–2; left ventricular ejection fraction ≥50% (required before anthracycline-based chemotherapy); FEV1 ≥1.0 L for total gastrectomy candidates
• Nutritional optimization achievable: albumin >3.0 g/dL or correctable with pre-operative enteral nutrition; BMI considerations reviewed by bariatric-oncology team
• Absence of peritoneal carcinomatosis on diagnostic laparoscopy with negative peritoneal cytology
• No unresectable liver metastases (isolated resectable hepatic metastases may be considered within a clinical trial or multidisciplinary consensus)
• ELIGIBLE FOR PALLIATIVE / SYSTEMIC THERAPY:
• Stage IV disease (distant metastases, positive peritoneal cytology, unresectable T4b tumors)
• Molecular profiling completed: HER2 IHC/FISH, MSI/MMR, PD-L1 CPS, FGFR2b
• ECOG performance status 0–2 for doublet/triplet chemotherapy; PS 3 for best supportive care
• REQUIRED PRE-TREATMENT DIAGNOSTICS:
• Upper GI endoscopy with multiple biopsies (minimum 6–8 biopsies per ESMO guideline)
• Endoscopic ultrasound (EUS) for T and N staging
• Contrast-enhanced CT chest/abdomen/pelvis
• PET-CT (18F-FDG) to exclude occult distant metastases
• Diagnostic laparoscopy + peritoneal lavage cytology (cT3+ or node-positive)
• Complete molecular panel: HER2, MSI-PCR or IHC (MLH1/MSH2/MSH6/PMS2), PD-L1 CPS by 22C3 assay, FGFR2b IHC/NGS
• Comprehensive metabolic panel, CBC, LFTs, renal function, CEA, CA 19-9, CA 72-4
• Echocardiography if anthracycline use planned; pulmonary function tests if total gastrectomy anticipated
• Nutritional assessment: albumin, prealbumin, transferrin; dietitian evaluation
• RELATIVE CONTRAINDICATIONS / HIGH-RISK CONSIDERATIONS:
• Diffuse peritoneal carcinomatosis (curative resection not indicated; hyperthermic intraperitoneal chemotherapy/HIPEC only within select trial protocols)
• Severe cardiac comorbidity (NYHA Class III–IV heart failure, unstable angina, recent MI within 6 months)
• Uncontrolled coagulopathy or active hemorrhagic diathesis
• CDH1 germline mutation carriers with hereditary diffuse gastric cancer (HDGC) require prophylactic total gastrectomy discussion, which is a separate clinical pathway
• Prior extensive upper abdominal surgery (relative; requires individualized surgical planning)
Procedure
SURGICAL APPROACHES:
1. Distal (Subtotal) Gastrectomy with D2 Lymphadenectomy:
Indicated for tumors of the antrum and pylorus (lower two-thirds of the stomach). At least 4–5 cm proximal margin from the tumor is required. Reconstruction is performed via Billroth II (gastrojejunostomy) or Roux-en-Y configuration to prevent bile reflux. D2 dissection removes lymph node stations 1–12 as defined by the Japanese Gastric Cancer Association (JGCA), and retrieval of a minimum of 16 lymph nodes is required for accurate N-staging. D2 lymphadenectomy is the global standard and is associated with superior disease-specific survival compared to D1 in high-volume centers.
2. Total Gastrectomy with D2 Lymphadenectomy:
Required for proximal tumors (cardia, fundus, body), Siewert Type II–III gastroesophageal junction (GEJ) tumors, and cases where negative proximal margins cannot be achieved with subtotal resection. Esophagojejunostomy reconstruction (Roux-en-Y) restores GI continuity. A jejunal pouch (Hunt-Lawrence pouch) may be fashioned to improve post-gastrectomy nutritional outcomes. A feeding jejunostomy is routinely placed intraoperatively to support enteral nutrition during the perioperative period.
3. Minimally Invasive Gastrectomy (Laparoscopic and Robotic-Assisted):
Laparoscopic distal gastrectomy for early gastric cancer (EGC, cT1–T2) is a well-validated approach with level I evidence (KLASS-01, JLSSG0901 trials), offering equivalent oncologic outcomes to open surgery with reduced blood loss, shorter hospital stay (6–9 days vs. 10–14 days), lower wound complication rates, and faster return to adjuvant chemotherapy. Robotic-assisted gastrectomy (da Vinci Xi system) offers enhanced 3D visualization, articulated wristed instruments enabling precise intracorporeal anastomosis, and a stable operating platform particularly advantageous for D2 dissection around the splenic hilum and hepatoduodenal ligament. GAF Healthcare partner centers in India (Mumbai, Chennai, Hyderabad) and the UAE (Dubai, Abu Dhabi) operate FDA-approved da Vinci robotic platforms. Robotic total gastrectomy for proximal and locally advanced tumors is increasingly performed at high-volume centers with outcomes equivalent to open surgery.
4. Endoscopic Resection (Endoscopic Submucosal Dissection / ESD):
Reserved for early gastric cancer meeting expanded Gotoda criteria: differentiated histology, intramucosa (T1a), no ulceration, ≤2 cm; or differentiated T1a ≤3 cm with ulceration; or differentiated T1b sm1 ≤3 cm. ESD achieves en-bloc curative resection in expert hands without the morbidity of surgical resection. Performed under endoscopic guidance using electrosurgical knives (IT knife-2, Flush knife BT). Available at select partner centers in India and the UAE.
SYSTEMIC THERAPY PROTOCOLS:
5. Perioperative Chemotherapy (FLOT Regimen — Standard of Care for Resectable Disease):
Fluorouracil 2600 mg/m² continuous infusion 24h + leucovorin 200 mg/m² + oxaliplatin 85 mg/m² + docetaxel 50 mg/m², administered every 2 weeks. Four cycles pre-operatively and four cycles post-operatively (FLOT4-AIO: median OS 50 months vs. 35 months for ECF/ECX; pCR rate 16%). Granulocyte colony-stimulating factor (G-CSF) prophylaxis and antiemetic protocol (5-HT3 antagonist + dexamethasone + NK1 antagonist) are mandatory.
6. Adjuvant Therapy (Post-surgical, Asia-Pacific context):
Capecitabine + Oxaliplatin (CAPOX) for 8 cycles post-D2 gastrectomy (CLASSIC trial: 3-year DFS 74% vs. 59%; HRR 0.56). S-1 monotherapy (tegafur/gimeracil/oteracil) is an alternative adjuvant option widely used in East/Southeast Asian patients per ACTS-GC data.
7. First-Line Metastatic Therapy:
• HER2-positive (IHC 3+ or IHC 2+/FISH amplified): Trastuzumab + CAPOX or mFOLFOX6 (ToGA trial: median OS 13.8 months). Trastuzumab deruxtecan (T-DXd, DESTINY-Gastric01/02) achieves 40–42% ORR and 12–17 months OS in HER2+ second-line.
• MSI-H/dMMR tumors: Pembrolizumab + chemotherapy (KEYNOTE-590/811) or Nivolumab + chemotherapy (CheckMate 649: mOS 14.4 months); pembrolizumab monotherapy approved for MSI-H solid tumors regardless of site.
• HER2-negative, PD-L1 CPS ≥5: Nivolumab + FOLFOX or CAPOX (CheckMate 649).
• FGFR2b-positive (IHC ≥2+ in ≥10% cells or FGFR2 amplification): Bemarituzumab + mFOLFOX6 (FIGHT trial) — available in clinical trial settings at partner centers.
• Standard chemotherapy backbone: mFOLFOX6, CAPOX, FOLFIRI ± ramucirumab (VEGFR-2 inhibitor, second-line, RAINBOW trial: mOS 9.6 months).
8. Radiation Therapy:
Chemoradiation (45 Gy in 25 fractions with concurrent 5-FU/leucovorin or capecitabine) is used in the adjuvant setting for R1 resection (positive margins) or when D2 lymphadenectomy was not performed (INT-0116 protocol). Intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) minimize dose to kidneys, spinal cord, and liver at partner centers equipped with Elekta Versa HD or Varian TrueBeam linear accelerators.
9. Hyperthermic Intraperitoneal Chemotherapy (HIPEC):
For selected patients with limited peritoneal carcinomatosis (Peritoneal Cancer Index ≤6), cytoreductive surgery (CRS) + HIPEC (cisplatin 75 mg/m² + mitomycin-C 15 mg/m² at 41–42°C for 60–90 minutes) offers potential for long-term disease control at highly specialized centers. This approach remains investigational for gastric cancer and is offered only within multidisciplinary consensus at select partner institutions.
Cost of Stomach Cancer Treatment: India vs. UAE
The cost of stomach cancer treatment varies significantly depending on the surgical approach (endoscopic vs. laparoscopic vs. robotic vs. open multi-visceral), the number of chemotherapy cycles administered, the use of targeted biological agents (trastuzumab, ramucirumab) or immune checkpoint inhibitors, and the duration of hospitalization. India offers world-class oncologic outcomes at 45–60% lower total cost than comparable programs in the UAE, owing to lower operative facility fees, nursing costs, and medication pricing. Both destinations offer internationally accredited cancer centers with experienced multidisciplinary teams; the UAE (Dubai/Abu Dhabi) additionally offers proximity for Middle Eastern and African patients, Arabic-language services, and premium hospitality-grade facilities. All cost estimates below represent total package costs (surgery + hospital stay + standard perioperative medications + nursing care + standard pre-operative workup) and exclude the cost of biological agents (trastuzumab, nivolumab, pembrolizumab) and multi-cycle chemotherapy, which are quoted separately based on the individualized protocol.
| Destination | Estimated Cost (USD) | Key Advantage |
|---|---|---|
| India | $5,000 – $18,000 | ~56% less than the UAE |
| UAE (Dubai/Abu Dhabi) | $12,000 – $40,000 | Premium care, JCI/DHA accredited |
Estimates typically include surgery, hospital stay, and standard medications. Contact us for a personalised quote.
Recovery & Aftercare
PHASE 1 — PRE-ARRIVAL PREPARATION (Weeks 1–3 before travel):
• GAF Healthcare coordinator collects existing pathology reports, imaging (CT/PET-CT DICOM files), endoscopy reports, and blood work and submits to the designated oncology team for remote multidisciplinary tumor board review.
• A written second-opinion report and individualized treatment plan (surgical vs. chemotherapy-first vs. palliative) is issued within 5–7 business days.
• Visa assistance initiated: e-Medical visa (India) processed in 3–5 business days; UAE entry visa or visa-on-arrival arranged as applicable.
• Nutritional prehabilitation initiated: patients with albumin <3.0 g/dL begin enteral or high-protein oral supplementation; smoking cessation mandatory.
• FLOT pre-operative chemotherapy (if applicable) may begin at the patient's home country after protocol review, or at the partner center after arrival.
PHASE 2 — ARRIVAL & STAGING CONFIRMATION (Days 1–4 in country):
• Airport pickup by GAF Healthcare-assigned driver; direct transfer to hospital or partner accommodation.
• Day 1–2: Repeat or confirmatory staging workup: upper GI endoscopy, EUS, CT, PET-CT (if not recently performed or if >8 weeks old).
• Day 2–3: Diagnostic laparoscopy under general anesthesia (1-day procedure) to confirm absence of peritoneal disease if indicated; peritoneal wash cytology sent.
• Day 3–4: Multidisciplinary tumor board meeting at the treating center; final treatment plan confirmed. Anesthesia pre-assessment, cardiology clearance, nutritional assessment completed. Jejunostomy feeding tube placement discussed.
• Patient and family meet the primary surgeon, medical oncologist, and oncology nurse navigator.
PHASE 3 — PRE-OPERATIVE CHEMOTHERAPY (If FLOT perioperative protocol, Weeks 1–8 pre-surgery):
• 4 cycles of FLOT administered at the partner center's oncology day unit over 8 weeks (each cycle q2w).
• Imaging restaging (CT/PET-CT) after Cycle 4 to assess response.
• Nutritional support, anti-emetic management, and G-CSF administration supervised throughout.
• Patients may return home between chemotherapy cycles if the treating team approves; re-admission 1 week before surgery.
PHASE 4 — SURGERY (Day of operation + Hospital Days 1–14):
• Surgical technique selected based on tumor location and stage: robotic-assisted or laparoscopic distal/total gastrectomy with D2 lymphadenectomy, or open gastrectomy for locally advanced tumors requiring multi-visceral resection.
• Operative duration: 3–6 hours (robotic/laparoscopic); 4–7 hours (open multi-visceral).
• Intraoperative frozen section of proximal and distal margins confirmed.
• Feeding jejunostomy placed; nasogastric tube inserted.
• ICU observation: 24–48 hours post-operatively for monitoring of anastomotic integrity, hemodynamics, and respiratory function.
• Hospital Day 2–4: Early mobilization with physiotherapist; jejunostomy feeds commenced at 20 mL/hour and titrated.
• Hospital Day 4–5: Water swallow test / contrast swallow study to confirm anastomotic integrity before initiating oral fluids.
• Hospital Day 5–7: Oral intake progressed from clear liquids → soft puree diet; drain outputs assessed.
• Hospital Day 7–10: Surgical drains removed if amylase-poor and serous; discharge criteria assessed (tolerating soft diet, afebrile, mobile).
• Minimally invasive cases: discharge typically Day 7–9. Open multi-visceral resection: discharge Day 10–14.
• Final histopathology and lymph node count reviewed; pTNM staging confirmed; R0/R1 status documented.
PHASE 5 — POST-OPERATIVE RECOVERY & ADJUVANT THERAPY (Weeks 2–8 in country):
• Week 2–3: Weekly outpatient follow-up with surgeon and oncology dietitian. Jejunostomy feeds weaned as oral caloric targets met (>60% of requirements orally). Wound check, staple/suture removal.
• Week 3–4: Oncology review; initiation of adjuvant FLOT (cycles 5–8) or CAPOX if perioperative protocol used, approximately 4–6 weeks post-surgery.
• Vitamin B12, iron, calcium, vitamin D supplementation initiated (mandatory for all gastrectomy patients to prevent post-gastrectomy metabolic complications).
• Dumping syndrome education; dietary modification counseling by specialized oncology dietitian.
• Week 4–8: Completion of initial adjuvant chemotherapy cycles if remaining treatment is conducted at the partner center. Patients who wish to continue adjuvant chemotherapy at home receive a detailed written protocol and coordination letters.
• FIT-TO-FLY MILESTONE: International flight permitted when (a) surgical wound fully healed with no active drainage, (b) tolerating ≥1000 kcal/day orally or via jejunostomy, (c) no anastomotic leak or intra-abdominal collection on imaging, (d) DVT prophylaxis plan in place for flight (low-molecular-weight heparin), and (e) written surgical clearance issued. This typically occurs 4–6 weeks post-surgery for minimally invasive cases and 6–8 weeks for complex open resections.
PHASE 6 — LONG-TERM SURVEILLANCE (Home country, with GAF telemedicine support):
• CT chest/abdomen/pelvis every 6 months for 3 years, then annually.
• Upper GI endoscopy at 1 year post-surgery for partial gastrectomy patients.
• CEA, CA 19-9 monitoring every 3–6 months.
• Annual vitamin B12, iron studies, bone density scan (DEXA) after total gastrectomy.
• GAF Healthcare telemedicine follow-up connects the patient's home oncologist with the treating center.
Risks & Considerations
Stomach cancer surgery and multimodal treatment carry significant risks that patients must discuss in detail with their multidisciplinary team before proceeding. Surgical risks include anastomotic leak (incidence 2–8% after total gastrectomy; managed with radiologically guided drainage or reoperation), duodenal stump blow-out (rare, ~1–2%, life-threatening), intra-abdominal abscess, delayed gastric emptying, and bile reflux gastritis. The Clavien-Dindo classification is used at all GAF partner centers to grade and benchmark post-operative complications; 30-day mortality at high-volume JCI-accredited centers is <2% for elective gastrectomy. Dumping syndrome (early and late) affects 10–20% of patients and requires strict dietary management. Nutritional deficiencies—particularly vitamin B12, iron, calcium, and fat-soluble vitamins—are universal after total gastrectomy and require lifelong supplementation. Chemotherapy-specific risks include peripheral neuropathy (oxaliplatin, cumulative and dose-dependent), febrile neutropenia (FLOT: ~25% incidence; managed with G-CSF), hand-foot syndrome (capecitabine), and cardiotoxicity (anthracyclines used in ECX/ECF regimens, less common with FLOT). Trastuzumab carries a 4–8% risk of asymptomatic left ventricular dysfunction and requires ECHO monitoring every 3 cycles. Immune checkpoint inhibitors (nivolumab, pembrolizumab) may cause immune-related adverse events (irAEs) including immune-mediated pneumonitis, colitis, hepatitis, endocrinopathies, and severe skin reactions (grade 3–4 irAE incidence ~14%); high-dose corticosteroid management protocols are in place at all partner centers. For international patients specifically, the risks of long-haul air travel following major abdominal surgery include deep vein thrombosis (DVT) and pulmonary embolism; all patients traveling internationally post-gastrectomy receive individualized DVT prophylaxis plans including low-molecular-weight heparin, compression stockings, and in-flight mobility guidance. GAF Healthcare's clinical coordinators monitor all patients until fit-to-fly criteria are met and coordinate emergency medical support in the rare event of post-discharge complications.
Top Hospitals for Stomach Cancer Treatment
The following JCI and NABH-accredited hospitals are among the most experienced in specialist care, with dedicated teams and high-volume programmes.
Apollo Hospitals
New Delhi, India
Medanta - The Medicity
Gurgaon, India
Kokilaben Dhirubhai Ambani Hospital
Mumbai, India
Tata Memorial Hospital
Mumbai, India
Top Doctors for Stomach Cancer Treatment
Internationally trained specialists in Cancer Care. Review their profiles, compare experience, and connect directly through GAF Healthcare.
Dr. Gopi Srikanth
MBBS, MD Internal Medicine, DM Gastroenterology and Hepatology, Fellowship in Pancreatology, Fellowship in Endoscopic Ultrasound
Gastroenterologist
Yashoda Hospitals, Hyderabad, India
10+ Yearsof experience
Dr. Gopi Srikanth is a Consultant Gastroenterologist and Hepatobiliary specialist at Yashoda Hospitals in Hyderabad, bringing over 10 years of clinical expertise in digestive and liver disease management. He holds a DM in Gastroenterology and Hepatology from AIIMS New Delhi and completed advanced fellowships in Pancreatology and Endoscopic Ultrasound from prestigious institutions including the World Endoscopy Organisation, which distinguish him as a… Read more
Dr. Guruprasad Shetty
MBBS, MS (General Surgery), DNB (General Surgery), FMAS, FIAGES, Fellowship in Surgical Gastroenterology and Minimally Invasive Surgery
Surgical Gastroenterologist & Hepatobiliary Surgeon
Apollo Hospitals, Mumbai, India
15+ Yearsof experience
Dr. Guruprasad Shetty is a Senior Consultant in Surgical Gastroenterology, Hepatopancreaticobiliary, and Transplant Surgery at Apollo Hospitals in Mumbai, bringing over 15 years of specialized surgical expertise. He holds exceptional credentials including MBBS, MS in General Surgery, DNB, FMAS (Fellowship in Minimal Access Surgery), and FIAGES, alongside a specialized fellowship in Surgical Gastroenterology and Minimally Invasive Surgery. His… Read more
Dr. Hitesh Panchal
MBBS, MD in Internal Medicine, DrNB in Gastroenterology
Gastroenterologist
Medanta - The Medicity, Gurgaon, India
9+ Yearsof experience
Dr. Hitesh Panchal is an Associate Consultant in Gastroenterology & Hepatobiliary Medicine at Medanta – The Medicity in Gurgaon, bringing 9+ years of clinical experience to the care of complex digestive and liver disorders. He completed his medical training at the esteemed B.J. Medical College, Ahmedabad, earning his MBBS in 2017 and MD in Internal Medicine in 2020, before pursuing his DrNB in Gastroenterology at Medanta, one of India's leading… Read more
Dr. Jatin Yegurla
MBBS, MD, DM
Gastroenterologist and Hepatologist
Apollo Hospital, Jubilee Hills, Hyderabad, India
10+ Yearsof experience
Dr. Jatin Yegurla is a Consultant Gastroenterologist and Hepatologist based at Apollo Hospital, Jubilee Hills in Hyderabad, with over 10 years of clinical expertise. He holds an MBBS degree, MD in Internal Medicine from PGIMER Chandigarh, and a DM in Gastroenterology, establishing a strong academic foundation in digestive health and hepatology. His comprehensive qualifications and sustained commitment to the specialty reflect his dedication to… Read more
Dr. Karunesh Kumar
MBBS, MD (Pediatrics), FNB (PGHN), RCPCH Fellowship
Pediatric Gastroenterologist
Indraprastha Apollo Hospital, New Delhi, India
14+ Yearsof experience
Dr. Karunesh Kumar is a Consultant Gastroenterologist and Hepatobiliary specialist at Indraprastha Apollo Hospital in New Delhi, with over 14 years of clinical experience in pediatric gastroenterology and hepatology. He holds prestigious qualifications including MBBS, MD in Pediatrics, FNB in Pediatric Gastroenterology, Hepatology and Nutrition (PGHN), and an RCPCH Fellowship from King's College, London, reflecting his commitment to world-leading training… Read more
Frequently Asked Questions — Stomach Cancer Treatment
The total cost of stomach cancer treatment depends heavily on the stage of disease, the surgical approach chosen, and the number of systemic therapy cycles required. For surgical treatment (gastrectomy with D2 lymphadenectomy, hospital stay, standard perioperative medications, and routine pre-operative workup), costs in India at JCI- and NABH-accredited centers range from approximately USD 5,000 to USD 18,000. This range covers minimally invasive distal gastrectomy on the lower end and complex open total gastrectomy or multi-visceral resection with robotic assistance on the upper end. In the UAE at JCI- and DHA-licensed hospitals in Dubai and Abu Dhabi, equivalent surgical packages range from USD 12,000 to USD 40,000. India is typically 45–60% more affordable for the same surgical quality and accreditation standards. Importantly, the cost of biological agents and immune checkpoint inhibitors—trastuzumab, trastuzumab deruxtecan, nivolumab, pembrolizumab, or ramucirumab—is quoted separately as it varies significantly based on HER2/MSI/PD-L1 status, weight-based dosing, and number of cycles. A personalized cost estimate for your specific treatment protocol is prepared by GAF Healthcare's clinical team after review of your staging reports and molecular profile.
The minimum recommended in-country stay before international air travel following gastric cancer surgery is 4–6 weeks for patients who undergo minimally invasive (laparoscopic or robotic) gastrectomy without complications, and 6–8 weeks for patients who undergo open multi-visceral resection or experience post-operative complications such as anastomotic leak or delayed gastric emptying. Your treating surgical oncologist will issue written fit-to-fly clearance only when all of the following criteria are confirmed: (1) the surgical wound is fully healed with no active drainage or infection; (2) you are tolerating a minimum of 1,000 kcal per day via oral intake or jejunostomy feeding; (3) no anastomotic leak, intra-abdominal abscess, or fluid collection is present on post-operative imaging; (4) your hemoglobin and nutritional parameters are stable; and (5) a DVT prophylaxis plan (low-molecular-weight heparin injection, compression stockings) is in place for the flight. Patients who are also undergoing the first cycles of adjuvant chemotherapy (FLOT cycles 5–8 or CAPOX) at the partner center before returning home may need to extend their stay to 8–12 weeks to complete the initial adjuvant phase. GAF Healthcare's coordinators track all fit-to-fly milestones and assist with airline medical clearance documentation.
Success rates for stomach cancer treatment are highly stage-dependent and are best expressed as 5-year overall survival (OS) rates. At GAF Healthcare's partner centers in India and the UAE—which are high-volume gastric oncology units performing D2 lymphadenectomy as standard—5-year survival rates align with international benchmarks: Stage IA: 85–92%; Stage IB: 70–80%; Stage IIA: 58–68%; Stage IIB: 46–55%; Stage IIIA: 36–45%; Stage IIIB: 22–33%; Stage IIIC: 12–20%; Stage IV (metastatic, systemic therapy intent): median overall survival of 12–18 months with modern combination regimens. For HER2-positive metastatic disease treated with trastuzumab-based therapy, median OS is approximately 14–16 months; for MSI-H/dMMR tumors treated with immune checkpoint inhibitors, a subset of patients (15–25%) achieve durable long-term responses exceeding 3 years. The probability of achieving an R0 (microscopically margin-free) resection—the single most important prognostic surgical factor—exceeds 85% at high-volume centers following adequate pre-operative staging and perioperative FLOT chemotherapy. Pathological complete response (pCR) to neoadjuvant FLOT chemotherapy, achieved in approximately 15–17% of patients, is associated with markedly improved long-term survival. All survival data discussed with patients at GAF partner centers is individualized based on tumor histology, molecular subtype, pTNM stage, and response to initial therapy.
Why Plan Your Treatment Through Gaf Healthcare?
GAF Healthcare provides a dedicated end-to-end non-medical support infrastructure designed specifically for international oncology patients.
VISA & ENTRY ASSISTANCE: For India: GAF Healthcare facilitates the e-Medical Visa application through the Indian government's e-Visa portal. The e-Medical Visa allows a stay of up to 60 days (triple-entry), is typically approved within 3–5 business days, and also covers one accompanying attendant (e-Medical Attendant Visa). Required documents include a letter from the treating Indian hospital (provided by GAF), passport copy, and recent photographs. For the UAE (Dubai and Abu Dhabi): Citizens of over 100 countries receive a free-of-charge visa on arrival for 30–90 days. GCC nationals, EU/UK/US/Canadian passport holders, and many Asian nationals do not require pre-arranged visas. For nationalities requiring advance visas, GAF Healthcare's UAE coordination team facilitates Medical Entry Permits through the DHA (Dubai Health Authority) or DOH (Abu Dhabi Department of Health), typically approved within 5–7 business days.
AIRPORT TRANSFERS & GROUND LOGISTICS: A GAF Healthcare-assigned vehicle with a trained medical escort (for patients requiring oxygen or IV medication during transit) meets every patient at the arrival terminal. Wheelchair assistance is pre-arranged for patients with reduced mobility. All transfers between airport, hospital, and accommodation are managed by the GAF ground team.
MEDICAL TRANSLATION & LANGUAGE SUPPORT: Dedicated medical interpreters are available in Arabic, Russian, Kazakh, Uzbek, Swahili, Amharic, and French at partner centers in both India and the UAE. Clinical documents, consent forms, discharge summaries, and chemotherapy protocols are translated into the patient's preferred language. A bilingual GAF patient coordinator is assigned as a single point of contact throughout the treatment journey and is reachable 24/7.
ACCOMMODATION FOR PATIENTS & ATTENDANTS: GAF Healthcare partners with service apartments and hotels adjacent to all partner hospitals at pre-negotiated rates ranging from USD 30–80/night (India) and USD 80–200/night (UAE). Accommodations are equipped with kitchenettes (essential for post-gastrectomy dietary management), wheelchair accessibility, and proximity to hospital outpatient facilities for daily chemotherapy or wound review visits. Long-stay discounts of 15–25% are available for gastrectomy patients who require 4–8 weeks in-country. Meals compliant with the oncology dietitian's post-gastrectomy prescription (small, frequent, low-sugar, low-fat, soft-texture diet) are arrangeable through hospital dietary services or partner catering providers.
TELEMEDICINE & POST-DISCHARGE COORDINATION: Upon returning home, each patient receives a detailed discharge summary in English (and translated into their language), a surveillance schedule, and a GAF telemedicine link enabling video consultations with the treating surgical oncologist and medical oncologist at regular intervals. GAF coordinates sharing of follow-up imaging and blood results between the home oncologist and the treating center to ensure continuity of care.
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