Making the Diagnosis
If a doctor suspects stomach cancer, a thorough patient history will first be done. This includes asking about your lifestyle, such as tobacco or alcohol use and whether you have a family history of stomach cancer. A physical exam may follow, along with some of the following tests:
- blood tests
- stool tests called fecal occult blood test - to find blood in the stool that might not be visible to the naked eye
- barium swallow or upper gastrointestinal (GI) series - the patient swallows a barium solution and the doctor uses an X-ray to track the barium's progress as it passes through the esophagus and stomach
- endoscopy - a small tube with a light on one end is slid down the throat and into the stomach so the doctor can look directly at the stomach lining
- biopsy - using a gastroscopy instrument that's fitted with a special cutter, a small piece of tissue can be taken and examined under a microscope
If cancer is diagnosed, the doctor needs to determine the stage the cancer has reached. This may involve more tests, such as:
- chest X-ray
- ultrasounds
- computed tomography (CT) scans
- magnetic resonance imaging (MRI) scans
- PET scan
- diagnostic laparoscopy
- blood tests
In its early stages, stomach cancer is very treatable. Unfortunately, early stomach cancer causes few symptoms. Usually, a diagnosis is made when the cancer is more advanced. Because it can take some time to identify stomach cancer, only about 10% of people are diagnosed while it's still in the early stages.
The stages are defined as:
- stage 0: the cancer has not spread beyond the surface layer of stomach tissue
- stage 1: the cancer has spread just underneath the first layer of stomach tissue but hasn't yet invaded the muscles
- stage 2: the cancer has spread to the lymph nodes near the stomach or the main muscle layer
- stage 3: the cancer has spread through the muscle and to the lymph nodes but not to any organs, or it may be in nearby tissue but not in any lymph nodes
- stage 4: the cancer has spread completely through the stomach wall, lymph nodes, and organs
- recurrent: cancer has returned after treatment
Other staging systems may be used. Ask your doctor about the stage of your cancer and what it means to you.