Diagnosis and Prognosis of Stomach Cancer
by Rosalyn Carson-DeWitt, MD
The doctor will ask about your symptoms, and medical and family history. The abdominal area will be carefully examined. Your doctor may look for other possible causes of your symptoms. Your doctor may recommend different tests in order to identify if cancer or other gastrointestinal conditions are suspected.
Suspicion of Stomach Cancer
If you are having gastrointestinal symptoms, your doctor may conduct certain tests to identify abnormalities. These may include:
Diagnosis of Stomach Cancer
Diagnosis of stomach cancer is confirmed with a biopsy. A biopsy is a collection of tissue samples that are removed from the stomach lining. Tissue samples can also be taken from the esophagus and first part of the small intestine. After removal, the samples are examined under a microscope. This is the only way to confirm a diagnosis.
Staging of Stomach Cancer
If stomach cancer is confirmed, results from completed tests and new tests will help determine the stage of cancer. Staging is used to determine characteristics of the tumor that will help develop the prognosis and treatment plan. Factors that play a role in staging include where the tumor is found, how far the original tumor has spread, whether lymph nodes are involved, if cancer has spread to other tissue, and microscopic cellular details.
Surgical staging is done with an exploratory laparotomy or endoscopy. During exploratory laparotomy, an incision is made in the abdominal wall to gain access to the abdominal and pelvic cavities. The areas can be examined for the presence of tumors. If cancer has not visibly spread, a peritoneal wash may be done. Saline solution is used to wash the abdominal cavity. Samples are taken to look for the presence of cancer cells in the wash. Their presence indicates that cancer has spread beyond the stomach, even if tumors are not visible.
Tests that may help determine stomach cancer stage:
Stages of Stomach Cancer
The stomach is made of a number of tissue layers.
The location and depth of tumor is important in staging. Stomach cancer is staged from 0-IV.
For planning treatment, sometimes another staging method is used. In this method, staging is based on whether or not the tumor can be surgically removed. These stages include
Prognosis is a forecast of the probable course and/or outcome of a disease or condition. Prognosis is most often expressed as the percentage of patients who are expected to survive over 5 or 10 years. Cancer prognosis is an inexact science. This is because the predictions are based on the experience of large groups of patients with cancer in various stages. Using this information to predict the future of an individual patient is always imperfect and often flawed, but it is the only method available.
Stomach cancer is usually found in later stages. As a result, the number of patients who survive for 5 years or more after diagnosis is fairly low, about 29%.
Individual rates depend on the stage of the cancer at the time of diagnosis. Survival rates decrease as cancer stages increase.
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How is stomach cancer staged? American Cancer Society website. Available at: https://www.cancer.org/cancer/stomach-cancer/detection-diagnosis-staging/staging.html. Updated February 10, 2016. Accessed September 1, 2017.
Stages of gastric cancer. National Cancer Institute website. Available at https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq#section/_26. Updated April 27, 2017. Accessed September 1, 2017.
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Updated January 2017. Accessed September 1, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/1/2017
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