Gastric Cancer

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Diagnosis

Diagnosis of stomach cancer involves taking a medical history and performing a physical examination and laboratory tests. A palpable (i.e., able to be felt with the fingers) tumor or mass may indicate advanced disease. Tests may include fecal occult blood test, complete blood count (CBC), upper GI series (also called barium swallow), gastroscopy, and imaging tests.

Fecal occult blood test is used to detect microscopic blood in the stool, which may indicate stomach or other gastrointestinal (GI) cancers (e.g., colorectal cancer).

Complete blood count (CBC) is a simple blood test used to measure the concentration of white blood cells, red blood cells, and platelets.

In an upper GI series, or barium swallow, the patient drinks a thick, chalky liquid (barium) that coats the esophagus and stomach and makes it easier to detect abnormal areas on x-ray. In double-contrast barium swallow, air is blown into the esophagus and stomach to help the liquid coat the wall of the organs more thoroughly.

In gastroscopy, the physician inserts a thin tube that contains a light and camera (called a gastroscope) through the mouth and esophagus and into the stomach. The gastroscope allows the physician to see the inside of the stomach. Small instruments can be passed through the gastroscope and used to remove a sample of tissue for examination (biopsy) in a laboratory. A local anesthetic is used to reduce sensation in the esophagus during this procedure.

Imaging tests such as computerized tomography (CT scan), ultrasound, and positron emission tomography (PET) scan may be used to detect metastatic stomach cancer. Once a diagnosis of stomach cancer is made, the disease is staged.

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