Getting the diagnosis

To get to the bottom of your symptoms, there are a number of tests your doctor might do. These could include:

An upper endoscopy

An endoscopic ultrasound

A biopsy

Imaging tests like X-rays, CT or PET scans, and MRIs

If you are diagnosed with stomach cancer or GE junction cancer, it can be a shock. You might feel overwhelmed, scared, or even angry. Everyone reacts differently, but it’s important to take the time you need to absorb this information. Reach out to loved ones, family, friends, and even others with your condition for support throughout this time.

Remember, you are not alone


~95,764

people in the US were living with stomach cancer in 2014

28,000

new cases of stomach cancer were estimated in 2017

14,870

new cases of GE junction cancer were estimated in 2008

There are many ways for you to connect with other people going through this journey. Start connecting with Debbie’s Dream.

Understanding the diagnosis

Once you process the news, don’t hold back—ask your doctor any questions you may have. Your doctor may talk to you about whether the cancer is a "resectable cancer" or "unresectable cancer." This has to do with whether the tumor can be removed (resected) with surgery, and can help guide your treatment options.

What is staging?

Your doctor may also talk to you about the stage of your disease, using numbers that indicate the level of severity. For example, stage 0 is less severe, whereas stage 4 stomach cancer or GE junction cancer is more severe. Stomach cancer and GE junction cancer treatments may vary by stage, so this can help guide your doctor on the options that makes the most sense for you.

Very often, stomach cancer and GE junction cancer are diagnosed at a more advanced stage of the disease. This is not your fault. Because early-stage stomach cancer rarely causes symptoms, stomach cancer and GE junction cancer can be difficult to detect until a much later, or advanced stage.

What is advanced cancer?

When a cancer is referred to as “advanced cancer,” that means it has spread from the place where it started (your stomach or GE junction) to other parts of the body. If it has spread to tissue located near the original tumor, then the cancer is considered “locally advanced.” If it has spread to farther parts of the body (for example, from the stomach to the liver), then the cancer is considered to have “metastasized.”

Although advanced cancer is a more severe stage, there are treatments available to help—so that you can keep fighting for what matters most to you.

INDICATIONS and IMPORTANT SAFETY INFORMATION Warning: Severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing
Warning: Severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing
Indication
  • CYRAMZA is used alone or in combination with paclitaxel (a type of chemotherapy) to treat specific kinds of advanced cancer of the stomach or where the stomach and esophagus meet. CYRAMZA is for patients whose cancer has progressed on or after being treated with other initial types of chemotherapy. CYRAMZA is given through an intravenous infusion (IV).
What is the most important information I should know about CYRAMZA?

WARNING: SEVERE BLEEDING, TEARS IN THE STOMACH OR BOWEL WALL, AND DIFFICULTY IN WOUND HEALING

Severe bleeding, including bleeding in the stomach or bowel, has occurred with CYRAMZA. These events are sometimes fatal. Tell your doctor right away if you have bleeding or symptoms of bleeding, including lightheadedness. Your treatment will have to be permanently stopped if severe bleeding occurs.

Tears in the stomach or bowel wall may occur with CYRAMZA. These events are sometimes fatal. Tell your doctor if you have severe diarrhea, vomiting, or severe abdominal pain. Your treatment will have to be permanently stopped if this occurs.

Wounds may have difficulty healing with drugs like CYRAMZA. Tell your doctor if you have a wound that doesn’t heal properly. If you develop a wound that won’t heal during treatment, your doctor will stop CYRAMZA until the wound is fully healed. Also tell your doctor if you have planned surgery, as CYRAMZA treatment should be interrupted prior to surgery. Your doctor may restart CYRAMZA after your surgical wound has healed.

Possible Serious Side Effects
  • Strokes, mini-strokes, blood clots, and heart attacks have occurred in clinical trials with CYRAMZA. These events are sometimes fatal. Your treatment will have to be permanently stopped if these events occur.
  • Severe high blood pressure has occurred with CYRAMZA treatment. Your doctor will monitor your blood pressure every two weeks or more throughout treatment and may adjust, interrupt, or permanently stop treatment depending on the results. Tell your doctor if your blood pressure is high or if you have symptoms of high blood pressure, including severe headache or lightheadedness, or neurologic symptoms such as confusion, changes in your vision, or seizure.
  • Infusion reactions related to injecting CYRAMZA have occurred. Most of these reactions happened during or after the first or second CYRAMZA infusion. Signs and symptoms of infusion reactions include shaking or stiffness of the body, back pain or spasms, chest pain or tightness, chills, flushing, difficulty breathing, wheezing, becoming blue due to lack of oxygen, and tingling or numbness of the skin. In severe cases, rapid heartbeat, low blood pressure, and severe trouble breathing may occur. Your healthcare team will monitor you for these side effects. In the case of a severe infusion reaction, your CYRAMZA treatment will have to be immediately and permanently stopped.
  • CYRAMZA may worsen certain types of liver disease. Tell your doctor if you have or have had liver disease or other liver problems.
  • RPLS (reversible posterior leukoencephalopathy syndrome), a very rare but serious brain disorder, has been reported in clinical trials with CYRAMZA. Signs and symptoms of RPLS may include headache, seizures, visual changes, and changes in mental function. These symptoms usually stop or improve within days, but some patients can experience continuing changes in mental function or death.
  • Too much protein in the urine (proteinuria) has been reported in clinical trials with CYRAMZA. This may be a sign of kidney damage. Your doctor will monitor your urine protein levels during treatment. If you develop protein in your urine, your doctor may interrupt your treatment and decrease your dose of CYRAMZA. In severe cases your treatment will have to be permanently stopped.
  • Thyroid gland problems have been reported in clinical trials with CYRAMZA. Your doctor will do blood tests to monitor your thyroid gland function during treatment.
  • CYRAMZA can harm your unborn baby. You should avoid getting pregnant, and use adequate contraception while receiving CYRAMZA and for at least 3 months after stopping CYRAMZA.
What are the most common side effects of CYRAMZA?
  • The most common side effects reported in patients treated with CYRAMZA when given alone were high blood pressure, diarrhea, headache, and low sodium. The most common serious adverse events were anemia (a decrease in red blood cells) and blockage of the intestine. Red blood cell transfusions were given to 11% of CYRAMZA-treated patients and 8.7% of patients who received placebo.
  • The most common side effects reported in patients treated with CYRAMZA when given in combination with paclitaxel were tiredness; low white blood cell count; diarrhea; nosebleeds; high blood pressure; swelling in the arms, legs, hands, or feet; mouth sores; too much protein in the urine; low platelet count; low albumin (a protein in the blood); and bleeding in the gastrointestinal tract. The most common serious adverse events were low white blood cell count and low white blood cell count with fever; 19% of patients treated with CYRAMZA plus paclitaxel were given treatment to increase white blood cell count called granulocyte colony-stimulating factors.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/safety/medwatch or call 1-800-FDA-1088.

What should I tell my doctor before receiving treatment with CYRAMZA?

Before you receive CYRAMZA, tell your doctor if you:

  • Have had or are at high risk for strokes or heart attack.
  • Have high blood pressure or have blood pressure problems.
  • Are planning to have surgery of any kind.
  • Have or have had liver problems, including liver cirrhosis or other diseases of the liver.
  • Are pregnant or may be pregnant: CYRAMZA can harm your unborn baby. You should avoid getting pregnant, and use adequate contraception while receiving CYRAMZA and for at least 3 months after stopping CYRAMZA.
  • Are breastfeeding: your doctor will tell you to stop breastfeeding during treatment.

Tell your doctor about all the medications you are taking, including prescription and over-the-counter medications.

How is CYRAMZA given?
  • CYRAMZA is slowly infused (injected) into your vein. The infusion will last about 60 minutes. You will usually receive CYRAMZA once every 2 weeks.
  • Your doctor will also give additional medication(s) prior to your CYRAMZA infusion to address potential side effects.

CYRAMZA is available by prescription only.

Please see full Prescribing Information for additional information about CYRAMZA, including Boxed Warning for severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing. RB-G CON ISI 18DEC2017