Symptoms of stomach cancer often do not appear until the disease is advanced. Only about one in five stomach cancers in the United States are found at an early stage, before it has spread to other areas of the body. It is important to receive an early and accurate diagnosis to increase your chances of successful treatment.

Screening for Stomach Cancer

Cancer screening exams can help find stomach cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose stomach cancer early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

There is no definitive screening test known to detect stomach cancer. However, the best chance for treating the disease is to find it as early as possible.

Certain lifestyle choices may help prevent stomach cancer. These include maintaining a diet that includes healthy amounts of fruits and vegetables and that limits red meat or processed meats, as well as not using tobacco and limiting the intake of alcohol.

Stomach Cancer Risk Factors

A risk factor is anything that increases your chances of developing stomach cancer. Risk factors for stomach cancer include:

  • Having any of the following medical conditions:
    • Helicobacter pylori (H. pylori) infection of the stomach
    • Chronic gastritis (inflammation of the stomach)
    • Pernicious anemia
    • Intestinal metaplasia (a condition in which the normal stomach lining is replaced with the cells that line the intestines)
    • Familial adenomatous polyposis (FAP) or gastric polyps
  • Eating a diet high in salted, smoked foods and low in fruits and vegetables
  • Eating foods that have not been prepared or stored properly
  • Being older or male
  • Smoking cigarettes
  • Having a mother, father, sister or brother who has had stomach cancer

(Source: National Cancer Institute)

Not everyone with risk factors will get stomach cancer. But having certain factors appears to increase your risk of developing the disease. If you are at high risk for stomach cancer, talk to your doctor about tests to find out if you have early signs of the disease.

Diagnosing Stomach Cancer

If stomach cancer is suspected, your doctor may recommend the following tests:

Physical Exam & Medical History

Before any other testing, noninvasive tests such as an X-ray of the stomach area or an analysis of stool sample may be done. The doctor may also order a blood test to analyze your complete blood count to look for anemia, which could be caused by internal bleeding.

To confirm a diagnosis, the following tests may be done:

Upper Endoscopy

One of the main tests used to find stomach cancer is an upper endoscopy.

During an upper endoscopy, the doctor views the lining of your esophagus, stomach and the first part of the small intestine using a small camera attached to the end of a thin, flexible tube called an endoscope. If abnormal tissues are found, a biopsy (tissue sample) can be taken during the exam.

The tissue samples are sent to a lab, where they are looked at under a microscope to see if cancer is present.

Endoscopy can also be used as part of a special imaging test known as endoscopic ultrasound, which is described below:

Endoscopic Ultrasound

An endoscopic ultrasound helps the doctor find out if cancer has spread into the wall of the stomach, to nearby tissues or to lymph nodes.

Using an endoscope and sound waves, specialists create a detailed image of the layers of the stomach wall, nearby lymph nodes and other structures just outside the stomach.

Biopsy

A biopsy is the removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A biopsy of the stomach is usually done during the endoscopy.

Imaging Tests

Imaging tests produce pictures of the inside of the body. There are several imaging tests that might be done in people with stomach cancer. Imaging tests can help determine the extent, or stage, of the disease. Tests may include one of the following:

Computed Tomography Scan (CT Scan)

A type of X-ray test that produces detailed, cross-sectional images of your body.

Positron-Emission Tomography (PET) Scan

PET is useful if your doctor thinks the cancer may have spread to other parts of the body. This scan produces a detailed glucose map of the body. Cancer takes up sugar faster than normal cells. The doctor can tell which cells contain more sugar, or which ones are cancerous and which ones are normal.

Upper Gastrointestinal (GI) Series (Barium Swallow)

A barium swallow is an X-ray test that is less invasive than an endoscopy and examines the inner lining of the stomach, esophagus and part of the small intestine. Swallowing a chalky solution that contains barium helps doctors see any abnormalities in the lining of these organs.

Complete Blood Count and Blood Chemistry Studies

A blood sample is taken to measure the amounts of certain substances such as antibodies released into the blood. Doctors look for higher- or lower-than-normal amounts of certain chemicals or proteins, which can signal disease in the organ or tissue that produces it.

(Source: National Cancer Institute)

Staging Stomach Cancer

If you are diagnosed with stomach cancer, staging is a way of determining the amount and location of your cancer. This information helps the doctor plan the best treatment. Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.

Stomach cancer has four different stages:

Stage 0 (carcinoma in situ)

When abnormal cells are found in the inside lining of the mucosa (innermost layer) of the stomach wall. These abnormal cells may become cancer and spread into nearby normal tissue.

Stage I

Cancer has formed in the inside lining of the mucosa (innermost layer) of the stomach wall. Stage I is divided into stage IA and stage IB, depending on where the cancer has spread.

Stage IA

Cancer may have spread into the submucosa (layer of tissue next to the mucosa) of the stomach wall.

Stage IB

Cancer may have spread into the submucosa (layer of tissue next to the mucosa) of the stomach wall and is found in 1 or 2 lymph nodes near the tumor; or has spread to the muscle layer of the stomach wall.

Stage II

Stage II gastric cancer is divided into stage IIA and stage IIB, depending on where the cancer has spread.

Stage IIA

In this stage, cancer:

  • Has spread to the subserosa (layer of tissue next to the serosa) of the stomach wall; or
  • Has spread to the muscle layer of the stomach wall and is found in 1 or 2 lymph nodes near the tumor; or
  • May have spread to the submucosa (layer of tissue next to the mucosa) of the stomach wall and is found in 3 to 6 lymph nodes near the tumor

Stage IIB

In this stage, cancer:

  • Has spread to the serosa (outermost layer) of the stomach wall; or
  • Has spread to the subserosa (layer of tissue next to the serosa) of the stomach wall and is found in 1 or 2 lymph nodes near the tumor; or
  • Has spread to the muscle layer of the stomach wall and is found in 3 to 6 lymph nodes near the tumor; or
  • May have spread to the submucosa (layer of tissue next to the mucosa) of the stomach wall and is found in 7 or more lymph nodes near the tumor

Stage III

Stage III stomach cancer is divided into stage IIIA, stage IIIB and stage IIIC, depending on where the cancer has spread.

Stage IIIA

Cancer has spread to:

  • The serosa (outermost) layer of the stomach wall and is found in 1 or 2 lymph nodes near the tumor; or
  • The subserosa (layer of tissue next to the serosa) of the stomach wall and is found in 3 to 6 lymph nodes near the tumor; or
  • The muscle layer of the stomach wall and is found in 7 or more lymph nodes near the tumor

Stage IIIB

Cancer has spread to:

  • Nearby organs such as the spleen, transverse colon, liver, diaphragm, pancreas, kidney, adrenal gland or small intestine and may be found in 1 or 2 lymph nodes near the tumor; or
  • The serosa (outermost layer) of the stomach wall and is found in 3 to 6 lymph nodes near the tumor; or
  • The subserosa (layer of tissue next to the serosa) of the stomach wall and is found in 7 or more lymph nodes near the tumor

Stage IIIC

Cancer has spread to:

  • Nearby organs such as the spleen, transverse colon, liver, diaphragm, pancreas, kidney, adrenal gland or small intestine and may be found in 3 or more lymph nodes near the tumor; or
  • The serosa (outermost layer) of the stomach wall and is found in 7 or more lymph nodes near the tumor

Stage IV

In Stage IV, cancer has spread to distant parts of the body.

(Source: National Cancer Institute)


If you have received a stomach cancer diagnosis, or if you want a second opinion or just want to speak to a stomach cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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