Stomach Cancer

Diagnosis

Some of the methods for diagnosis of stomach cancer are:

• Medical history and physical examination:
The cancer specialist will discuss the symptoms experienced by the patients, such as eating difficulty or heartburn. He/she may also obtain a comprehensive medical history and family history of the patient to determine the level of risk for stomach cancer.
• Blood tests: Although blood tests are not diagnostic tests for stomach cancer, they provide vital information about the overall health status of the patient. The test may provide the number of red blood cells that may be low due to bleeding. In addition, liver function tests provide information about the potential spread of cancer to the liver. In some cases, the blood is examined to detect the cancer cells in the blood. The test is usually done in patients in whom a biopsy is not viable.
• Upper endoscopy: Upper endoscopy, also known as esophagogastroduodenoscopy, is performed when it is suspected that the patient might have stomach cancer. It is done with an endoscope, a thin, long tube with a camera fitted at the end. The endoscopic specialist guides the endoscope into the stomach through the mouth, and the images of the stomach tissues are transmitted on the monitor. It allows the visualization of the inner lining of the stomach, esophagus, and upper part of the small intestine. If any abnormal tissue is located, a sample of it can be obtained for further examination.
• Upper gastrointestinal series: It is less commonly used than the upper endoscopy for two reasons. First, there may be a risk of missing the abnormal tissues, and second, it does not allow the endoscopic specialist to take samples of abnormal tissues. However, it is relatively less invasive than upper endoscopy and can provide vital information in some cases. The patient is advised to drink a sufficient amount of barium that lines the inner surface of gastrointestinal organs. The X-ray may also be used to detect any abnormality.
• PET scan: Positron Emission Tomography scan detect cells with high active cellular metabolism, such as cancer cells. In this procedure, a radioactive form of sugar is injected into the patient and is taken up by the cells with high cellular activity. This activity is detected with a special camera. PET scan also determines the extent of cancer spread.
• Magnetic resonance imaging: MRI uses powerful magnetic and radio waves to detect abnormal tissues. Although this test is not often used compared to a CT scan for detecting stomach cancer, it provides crucial information about the spread of cancer to the liver.
• CT scan: Computed tomography provides detailed images of the stomach. The radiologist also obtains images from another body part through CT to determine if cancer has spread to other organs, including nearby lymph nodes and the liver. CT is also used to guide during the biopsy, a procedure known as CT-guided biopsy.
• Chest X-ray: If the patient is diagnosed with stomach cancer and is suspected that cancer may have spread to the lungs (due to the presence of pulmonary symptoms), he may advise the patient to undergo a chest X-ray. However, if the patient has already undergone a chest CT scan, he does not require a chest X-ray.
• Biopsy: Biopsy is the process of obtaining a sample of abnormal tissue for evaluating it under a microscope. The pathologists look for abnormal or cancerous cells in the sample.
• Laparoscopic surgery: If the imaging techniques do not provide conclusive evidence about the spread of cancer to nearby organs, the oncologist may advise the patient to undergo laparoscopic surgery. It is a minimally invasive procedure involving the insertion of a laparoscope to view the internal organs to detect the presence of cancer. The laparoscopic surgeon may also obtain the tissue samples for further analysis if required.