Diagnosing Stomach Cancer

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Diagnosing stomach cancer promptly is crucial as it enables early intervention and treatment. Early detection increases the likelihood of successful treatment outcomes and improves the chances of cure. Timely diagnosis allows healthcare providers to implement appropriate treatment strategies, potentially enhancing the patient’s quality of life and prolonging survival. Additionally, early diagnosis may offer patients more treatment options, including less invasive procedures and a better chance of avoiding complications associated with advanced-stage cancer. Therefore, timely diagnosis plays a vital role in optimizing patient care and overall prognosis for individuals with stomach cancer.

Tests and procedures in diagnosing stomach cancer include:

  • Upper endoscopy: This procedure involves inserting a thin tube with a tiny camera at its end down the throat and into the stomach to visually inspect for signs of cancer.

  • Biopsy: If suspicious areas indicative of cancer are identified during upper endoscopy, a biopsy may be performed to obtain a tissue sample. Specialized tools are used to extract the sample, which is then sent to a laboratory for analysis.

Determining the stage of stomach cancer

Once you’re found to have stomach cancer, you might have other tests to see if the cancer has spread. This information is used to give the cancer a stage. The stage tells your provider how advanced your cancer is and about your prognosis. Tests and procedures used to find the stage of stomach cancer include:

  • Blood tests. A blood test can’t diagnose stomach cancer. Blood tests can give your provider clues about your health. For example, tests to measure your liver health might show problems caused by stomach cancer that spreads to the liver.

    Another type of blood test looks for pieces of cancer cells in the blood. This is called a circulating tumor DNA test. It’s only used in certain situations for people with stomach cancer. For example, this test might be used if you have advanced cancer and can’t have a biopsy. Collecting pieces of cells from the blood can give your health care team information to help plan your treatment.

  • Stomach ultrasound. Ultrasound is an imaging test that uses sound waves to make pictures. For stomach cancer, the pictures can show how far the cancer has grown into the stomach wall. To get the pictures, a thin tube with a camera on the tip goes down the throat and into the stomach. A special ultrasound tool is used to make pictures of the stomach.

    Ultrasound might be used to look at lymph nodes near the stomach. The images can help guide a needle to collect tissue from the lymph nodes. The tissue is tested in a lab to look for cancer cells.

  • Imaging tests. Imaging tests make pictures to help your care team look for signs that stomach cancer has spread. The pictures could show cancer cells in nearby lymph nodes or other parts of the body. Tests may include CT and positron emission tomography (PET).
  • Surgery. Sometimes imaging tests don’t give a clear picture of your cancer, so surgery is needed to see inside the body. Surgery can look for cancer that has spread, which is also called metastasized cancer. Surgery might help your health care team make sure there are no small bits of cancer on the liver or in the belly.

Additional tests may be used in specific situations to provide comprehensive information for staging stomach cancer. Staging assigns a numerical value from 0 to 4, indicating the extent and severity of the cancer.

  • Stage 0: Cancer is confined to the inner surface of the stomach, characterized by small size.
  • Stage 1: Cancer has penetrated the inner layers of the stomach.
  • Stage 2 and Stage 3: Cancer progresses deeper into the stomach wall, possibly spreading to nearby lymph nodes.
  • Stage 4: Cancer has extended beyond the stomach, potentially invading nearby organs. Stage 4 encompasses metastatic cancer, where cancer cells have spread to distant parts of the body. Stomach cancer often metastasizes to lymph nodes, the liver, and the peritoneum (lining around abdominal organs).

Following initial treatment, your healthcare team may assign a new stage to the cancer. Different staging systems for stomach cancer exist, which may be utilized post-surgery or post-chemotherapy. These stages provide critical information guiding further treatment decisions and prognosis assessment.

Understanding your prognosis

Your healthcare team utilizes the stage of your stomach cancer to assess your prognosis, which indicates the likelihood of a cure. Generally, early-stage stomach cancer has a favorable prognosis, whereas higher stages correspond to lower chances of a cure. However, even when a cure is not achievable, treatments can effectively manage the cancer, prolonging life and improving comfort.

Factors influencing the prognosis of stomach cancer include:

  1. The specific type of cancer.
  2. The stage of the cancer.
  3. The tumor’s location within the stomach.
  4. Your overall health condition.
  5. The completeness of cancer removal through surgery.
  6. The response of the cancer to treatments such as chemotherapy or radiation therapy.

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