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Diagnosing Stomach Cancer

Initial Examination

If you're having symptoms that are like those of stomach cancer, your doctor will want to know why. Your doctor is likely to ask you questions about these things.

In addition to asking you these questions, the doctor will also do a physical exam, blood tests, and one or more of the following tests:

Testing for Stomach Cancer

The results of these tests may be enough to rule out cancer. You may need more tests to confirm a diagnosis, though.

Fecal Occult Blood Test (FOBT)

A fecal occult blood test (FOBT) checks for hidden blood in your stool. The doctor may place a small amount of your stool on a plastic slide or a special type of paper, or you may do this test at home. Stomach cancer can sometimes cause small amounts of bleeding that is hard to see. But so can certain noncancerous conditions. Even if the test shows blood in your stool, you may need other tests to confirm whether or not it is due to cancer.

Drawing of an upper endoscopy
An upper endoscopy to check for
stomach cancer. (Click to enlarge)

Upper Endoscopy

An upper endoscopy—called endoscopic gastroduodenoscopy (EGD)—is a procedure that helps find most stomach cancers. During this test, a doctor looks inside your stomach with a thin, lighted tube called an endoscope. The doctor guides it through your throat and down into your stomach. You are sedated during this test. An upper endoscopy also checks your esophagus and part of your duodenum, which is the first section of your small intestine. If the doctor sees tissue that is abnormal, he or she takes a small sample to be checked for cancer cells. This sample is called a biopsy. A pathologist looks at the sample under a microscope.

In addition to checking for stomach cancer, this biopsy can also tell whether H. pylori bacteria infection—a noncancerous disease—or another type of cancer called a lymphoma is present. Your doctor may do upper endoscopy along with an endoscopic ultrasound (EUS) exam. The EUS uses sound waves to make a better picture of your stomach, nearby tissues, and lymph nodes.

Upper GI Series

An upper GI series—also called a barium swallow—is a series of X-rays taken to examine small abnormalities in the stomach. This test is less common than it once was. For this exam, you drink a thick, chalky fluid with barium in it. This fluid lines the stomach, making it easier to see on an X-ray. To see very early cancers, the doctor may use a "double contrast" technique. For this, a small tube is placed in the stomach after drinking the barium. Air is then pumped into your stomach to make the barium coating thinner.

Helicobacter pylori (H. pylori) Test

H. pylori is the strain of bacteria that may cause stomach ulcers and perhaps even stomach cancer. To find out if you have these bacteria in your stomach, you may undergo a breath test or a biopsy.

Laparoscopic Surgery

During laparoscopic surgery, the surgeon makes a small incision in the skin and inserts an instrument to examine the inside of the abdomen. If any suspicious lesion is found, it can be removed and looked at under the microscope (called a laparoscopic biopsy).

To confirm a diagnosis, your doctor will need to remove tissue from your stomach and have it examined under a microscope. This is called a biopsy.

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