How does my doctor know I have Stomach Cancer?
Q: What do I do if I think I have stomach cancer?
A: If there is any reason to suspect stomach cancer, your doctor will ask you questions about risk factors and symptoms and do a complete physical exam. The doctor will feel your abdomen to see if there are any abnormal changes. You may need to have some tests done to find out what's going on.
Tests that may be done to find stomach cancer
- Upper endoscopy: In this test the patient is given drugs to make them sleepy and then a thin, flexible, lighted tube (called an endoscope) is placed down the patient's throat. Through the tube, the doctor can see the lining of the esophagus, stomach, and the first part of the small intestine. If anything does not look normal, tissue samples can be removed. These samples are looked at under a microscope to see if cancer is present and, if so, what type of cancer it is.
- Upper GI (gastrointestinal) series: People having this test drink liquid containing barium. The barium coats the lining of the esophagus, stomach, and first part of the small intestine. Then x-rays are taken. Sometimes after the barium is swallowed, a thin tube is passed into the stomach and air is pumped in. This makes the barium coating very thin so that even small areas of change will show up.
- Endoscopic ultrasound (EUS): In an ultrasound, sound waves are used to make pictures of internal organs. Most people know about ultrasound because it is used to get a picture of the baby during pregnancy. Ultrasound can also be done with a probe put down the throat into the stomach. It can help tell how far the cancer has spread within the stomach or into nearby tissues and lymph nodes.
- CT scan (computed tomography): This test uses a special x-ray machine that takes pictures from many angles. A computer then combines these pictures into images of slices of the part of your body being studied. The CT scan can help show where stomach cancer is and where it has spread. It can also be used to guide a biopsy needle into an area that might be cancer. The needle is used to take a small sample of tissue for testing in the lab.
- MRI scan (magnetic resonance imaging): Like CT scans, MRIs give doctors cross-section pictures of the body. But MRI uses powerful magnets instead of x-rays. MRI scans take longer than CT scans—often up to an hour. A contrast dye might be injected just as with CT scans, but is used less often. Most doctors prefer to use CT scans, but sometimes an MRI can give more information.
- PET scan (positron emission tomography): In this test, a special kind of radioactive sugar is injected into the patient's vein. The sugar collects in areas that have cancer and a scanner can spot these areas. This test is useful for finding cancer that has spread beyond the stomach.
- Chest x-rays: These can be used to tell whether the cancer has spread to the lungs. They may also be useful to find out if you have any serious lung or heart problems.
- Laparoscopy: This test may be done after cancer is found and more information is needed. A thin, flexible tube with a camera on the end is placed into the patient's side through a small cut (incision). It sends a picture of the inside of the abdomen to a video screen. The doctor can use this before surgery to see if all cancer can be removed and to spot spread of the cancer.
- Lab tests: These may include a blood test called a complete blood count (CBC) to look for anemia (a low red blood cell count that may be caused by bleeding), and a fecal occult blood test, which looks for small amounts of blood in the stool.
- If cancer is found, the doctor may want to do other tests, too, especially if you are going to have surgery. For instance, blood tests can be done to make sure your liver and kidneys are working the way they should. You may also have an electrocardiogram (EKG) to make sure your heart is working well.
Q: How is stomach cancer diagnosed?
A: Doctors often divide stomach cancers into 2 groups. Resectable cancers are those the doctor thinks can be completely removed during surgery. Unresectable cancers are those that can't be completely removed. This might be because the tumor has grown into nearby structures or lymph nodes. Or it may have grown too close to major blood vessels, or has spread to distant parts of the body.
Q: What is the staging of stomach cancer?
A: Staging is the process of finding out how far the cancer has spread. This is very important because the treatment and the outlook for your recovery depend on the stage of the cancer. After stage 0 (cancer that has not grown beyond the inner layer of cells that line the stomach), stages are labeled using Roman numerals I through IV (1-4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious cancer.
After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.
Q: What are the treatments for stomach cancer?
A: The main treatments for stomach cancer are surgery, chemotherapy (often called chemo), and radiation therapy. Often the best approach involves using 2 or more of these treatment methods. It is important that you understand the goal of your treatment. If a cure is not possible, treatment is aimed at relieving symptoms such as trouble eating, pain, or bleeding.
The 3 main types of surgery for stomach cancer:
- Endoscopic mucosal resection
- Subtotal (partial) gastrectomy
- Total gastrectomy
Chemotherapy most often called just "chemo." It is the use of drugs to kill cancer cells. Usually the drugs are given into a vein or by mouth as pills. Once the drugs enter the bloodstream, they spread throughout the body. Chemo is useful in treating cancer that has spread. Chemo may be used as the main treatment for stomach cancer that has spread to distant organs. It may help relieve symptoms for some patients, especially those with spread to other areas of the body
Last Medical Review: 12/05/2008
Last Revised: 12/05/2008
