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Diagnosis of stomach cancer involves taking a medical history and performing a physical examination and laboratory tests. A 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. A doctor will decide what tests are right for the individual. Fecal occult blood test: A fecal occult blood test is used to detect microscopic blood in the stool, which may indicate stomach or other gastrointestinal (GI) cancers, such as colorectal cancer. Complete blood count: A complete blood count (CBC) is a simple blood test used to measure the concentration of white blood cells, red blood cells, and platelets. Upper GI series: In an upper GI series, or barium swallow, the individual drinks a thick, chalky liquid (barium) that coats the esophagus and stomach and makes it easier to detect abnormal areas on X-rays. 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. After the test, the individual can eat normally and resume usual activities, although extra water consumption will be necessary to help flush the barium from the system. The most common complication of the procedure is temporary constipation. Upper endoscopy: In an upper endoscopy, the doctor 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 doctor 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. Upper endoscopy takes about 20-30 minutes, although individuals are not sent home until the medication wears off, which is usually one to two hours later. Complications of the procedure rarely occur and include bleeding and perforation of the stomach lining. The most common complication is a slight sore throat from swallowing the endoscope. Imaging tests: Imaging tests such as computerized tomography (CT scan), ultrasound, magnetic resonance imaging (MRI), 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. Staging: Staging is a method of judging the progress of the cancer in an individual. Once doctors know how severe the progression of the cancer is, the best course of treatment can be followed. The staging process involves a doctor examining the tumor and the extent to which it has spread to other parts of the body. There are a number of levels of severity in staging stomach cancer. These range from 0 to 4, with 4 being the most severe stage. Stage 0: In stage 0, the cancer has just begun to affect the inner lining of the stomach. The survival rate for those with stage 0 stomach cancer is greater than 90%. Stage 1: In stage 1, the cancer has begun to penetrate toward the outer layer of stomach. Nearby lymph nodes may be involved. There is a 50-80% survival rate with those diagnosed with stage 1 stomach cancer. Stage 2: In stage 2, the cancer has progressed further through tissue layers of stomach and more distant lymph nodes may be involved. There is a 30-40% survival rate with those diagnosed with stage 2 stomach cancer. Stage 3: Stage 3 cancer has penetrated all tissue layers of stomach and distant lymph nodes may be involved. There is a 10-20% survival rate with those diagnosed with stage 3 stomach cancer. Stage 4: Stage 4 cancer has affected nearby organs and tissues. Cancer may even have been carried through the lymph system to distant parts of the body. This is known as metastasis. There is less than a 5% survival rate with those diagnosed with stage 4 stomach cancer.
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