How Is Gastric Cancer Diagnosed?
Gastric cancer is hard to detect in early stages because symptoms are uncommon and nonspecific. When symptoms do occur, they can easily be mistaken for more common ailments such as a stomach virus. Gastric cancer symptoms may include a loss of appetite, indigestion, nausea, stomach discomfort, heartburn, black stool, vomiting, unintentional weight loss, feeling full earlier than normal, and pain after eating.
The gold standard for diagnosing gastric cancer is an upper endoscopy or esophagogastroduodenoscopy (EGD). A gastroenterologist will guide a small camera and light into the stomach to visually inspect the stomach. If the doctor sees anything abnormal, the doctor will take a sample (a biopsy) of it and send it to a pathologist for evaluation. The pathologist will evaluate the sampled tissue under a microscope to look for abnormalities including cancer cells, H. pylori infection, and inflammatory or precancerous changes. If gastric cancer is confirmed, additional diagnostic procedures such as an endoscopic ultrasound (EUS) may be requested. During an EUS, a special endoscopic equipment using sound waves will be employed to determine the depth of tumor invasion and identify lymph nodes around the stomach, which may harbor cancer cells.
Further work-up of gastric cancer includes CT of the abdomen and pelvis, CXR, and at times, PET scan. These non-invasive imaging tests will provide additional necessary information about the extent of tumor, whether or not it has spread to the lymph nodes or distant organs such as liver or peritoneum. A multidisciplinary team led by one of the physicians will then review all of the information and recommend the best treatment for each individual patient.