How is stomach cancer diagnosed?
Stomach cancer can be hard to find early. Often there are no symptoms in the early stages and, in many cases, the cancer has spread before it is found. When symptoms do occur, they are often so vague that the person ignores them. Stomach cancer can cause:
Indigestion or a burning sensation (heartburn);
Discomfort or pain in the abdomen;
Nausea and vomiting;
Diarrhea or constipation;
Bloating of the stomach after meals;
Loss of appetite;
Weakness and fatigue; and
Bleeding (vomiting blood or having blood in the stool).
Any of these symptoms can be caused by cancer or by other, less serious health problems, such as a stomach virus or an ulcer. People who have any of these symptoms should see their doctor. They may be referred to a gastroenterologist (GI), a doctor who specializes in diagnosing and treating digestive problems.
How is stomach cancer diagnosed?
To find the cause of symptoms, the doctor asks about the patient's medical history, does a physical exam, and may order laboratory studies. The patient may also have one or all of the following exams:
Fecal occult blood test - a check for hidden (occult) blood in the stool. This test is done by placing a small amount of stool on a plastic slide or on special paper. It may be tested in the doctor's office or sent to a laboratory. This test is done because stomach cancer sometimes causes bleeding that cannot be seen. However, noncancerous conditions can also cause bleeding, so having blood in the stool does not necessarily mean that a person has cancer.
Upper GI series - x-rays of the esophagus and stomach (the upper gastrointestinal, or GI, tract). The x-rays are taken after the patient drinks a barium solution, a thick chalky liquid. (This test is sometimes called a barium swallow.) The barium outlines the stomach on the x-rays, helping the doctor find tumors or other abnormal areas. During the test, the doctor may pump air into the stomach to make small tumors easier to see. For further information, please visit the Upper GI Series article.
Endoscopy - an exam of the esophagus and stomach using a thin, lighted tube called a gastroscope, which is passed through the mouth and esophagus to the stomach. The patient's throat is sprayed with a local anesthetic to reduce discomfort and gagging. Patients also may receive medicine to relax them. Through the gastroscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor can remove some tissue through the gastroscope. Another doctor, a pathologist, examines the tissue under a microscope to check for cancer cells. This procedure, removing tissue and examining it under a microscope, is called a biopsy. A biopsy is the only sure way to know whether cancer cells are present.
Staging
If the pathologist finds cancer cells in the tissue sample, the patient's doctor needs to know the stage, or extent, of the disease. Staging exams and tests help the doctor find out whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT (or CAT) scan, an ultrasound exam, or other tests to check these areas.
Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and may take samples of tissue from other areas in the abdomen. All of these samples are examined by a pathologist to check for cancer cells. Decisions about treatment after surgery depend on these findings.
How is stomach cancer diagnosed?
