Stomach Cancer

Diagnosing Stomach Cancer

There are several tests that may be conducted if Stomach Cancer is suspected. Usually when people are worried, they speak to their GP, who may organise blood tests (to check how well the liver and kidneys are working) and conduct a physical examination to feel for any swollen or painful areas.

Sometimes GPs do not suspect cancer, but a patient feels strongly they would like further investigations. Dr Andy Gaya recommends two approaches:

• Bupa and other companies offer excellent generalised health screening Private cancer screening tests | Bupa UK
• Trucheck is an advanced Multi Cancer Early Detection Blood test which can detect a variety of cancers at an early stage from a blood test Trucheck™ cancer test from blood in healthy people | Trucheck™

It is important to note that there is no 100% accurate screening test, and whilst negative screening tests are reassuring there can sometimes be “false negatives” which is why screening tests are repeated every few years.

Once a patient has been referred to hospital specialists (for Stomach Cancer this is usually a Gastroenterologist) they will want to take a good look at the stomach with a Gastroscopy procedure. This is when a long, thin, flexible tube (with a camera on the end) is passed down the throat and food pipe into the stomach to check for any abnormalities and take sample of tissue (called a biopsy).

If Stomach Cancer is confirmed from a biopsy, then a patient might have a CT Scan or a PET-CT Scan at the hospital. These big scanning machines can look at where cancer is located in the body to help inform the patient’s treatment. 

If surgery is planned then doctors need to have a closer look at the Stomach Cancer and see if it has spread; this is part of a Stomach Cancer diagnosis and allows doctors to ‘grade’ the cancer. This is usually done with either Endoscopic Ultrasound (a camera and endoscope through the mouth) or Laparoscopy where a small incision is made in the abdomen to allow a small camera and specialist surgical instruments to be inserted.

The most common type of Stomach Cancer begins in the glandular cells (which produce mucus and digestive juices) in the inner lining of the stomach. This Stomach Cancer is called Adenocarcinoma.

There are other less common types of Stomach Cancer:

• Squamous cell cancer develops in the squamous cells covering the lining of the stomach and are quite rare.
• Gastrointestinal stromal tumour (GIST) – a rare type of ‘sarcoma’ found in the digestive system, usually in the wall of the stomach. Sarcomas can show up almost anywhere in the body and grow uncontrollably into a mass or lump.
• Neuroendocrine tumours (NETs) start in the neuroendocrine (hormone producing) cells of the stomach and develop into a hard mass called a tumour, and are quite rare.
• Lymphoma, when cancer begins in the lymphatic drainage system of the stomach, is also rare 

Doctors also stage or grade cancer to guide the best treatment plan for a patient. Most cases of stomach cancer are graded using the TNM system. TNM stands for tumour, nodes, and metastases:

• T describes how far the tumour has grown into the stomach wall
• N describes whether the cancer has spread to the lymph nodes
• M describes whether the cancer has spread (metastasised) to other parts of the body

Tumours and nodes will be assigned a number from 0 up to 3 or 4. Lower numbers indicate that the cancer has not spread as far and a patient is considered to have a ‘lower grade’ cancer. Metastases are only assigned a 0, meaning the cancer has not spread to another part of the body, or a 1, meaning it has spread to another part of the body.