Diagnosis and Prognosis of Stomach Cancer
- Medical history (concentrating on various medical conditions or previous surgeries that may increase your risk of developing stomach cancer)
- History of tobacco and alcohol use
- Dietary intake
- The presence of stomach cancer or other associated conditions in your family
- Any occupational exposures you may have had
- Tenderness or discomfort during the exam
- Free fluid within the abdomen
- Masses that can be felt
- An enlarged or abnormally hard liver
- How deeply the cancer cells have penetrated the layers of the stomach
- If cancer is present in the lymph nodes surrounding the stomach
- If there are cancer cells in neighboring organs and tissue
- If cancer has invaded distant organs or tissues within the body
- Blood tests —Blood tests can reveal symptoms of cancer or its spread, such as a nemia or problems with liver function.
- Chest x-ray —A chest x-ray is a series of standard x-ray images of your chest. It is important to examine the lungs for metastatic cancer.
Abdominal computed tomography (CT) scan
—An abdominal CT scan can reveal the following:
- Presence of a tumor
- Lymph node enlargement, which may be a sign of cancer spread
- Abnormalities in other organs or tissues throughout the abdomen that might indicate metastases
Pelvic computed tomography (CT) scan
—A pelvic CT can demonstrate metastatic spread of stomach cancer by identifying any of the following:
- Enlarged lymph nodes
- Presence of tumors in the ovaries or other organs
- Other tissue abnormalities
- Endoscopic ultrasonography —An endoscope (thin, flexible, lighted scope) is passed through the mouth, down the esophagus, and into the stomach and intestine. A tiny ultrasound unit at the tip of the endoscope bounces sound waves off of the adjacent organs to generate ultrasound images of the intestinal tract and surrounding tissues.
- Laparoscopy —Tiny incisions are made in the abdomen, allowing a scope to be passed into the abdomen. Your doctor can use this scope to examine the lining of your abdomen (peritoneum) and your liver, as well as other abdominal organs and tissue. Tiny tools can be passed through the laparoscope to take biopsy samples; the tissue samples will be checked for cancer cells.
- Peritoneal lavage —Saline solution (salt water) is washed through your abdomen and then suctioned out. The saline is then examined under a microscope for the presence of cancer cells.
- TX: Tumor cannot be evaluated.
- T0: There is no evidence of tumor.
- Tis: Cancer cells are present only in the mucosa.
- T1: Cancer cells are present in the submucosa.
- T2a: Cancer cells are present in the muscularis propria.
- T2b: Cancer cells are present in the subserosa.
- T3: Cancer cells are present all the way through to the serosa, but not in any adjacent tissues or organs.
- T4: Cancer cells have invaded neighboring tissues or organs.
- NX: Nodes cannot be evaluated.
- N0: There are no cancer cells in the lymph nodes surrounding the stomach.
- N1: There are cancer cells in 1-6 of the lymph nodes surrounding the stomach.
- N2: There are cancer cells in 7-15 of the lymph nodes surrounding the stomach.
- N3: There are cancer cells in more than 15 of the lymph nodes surrounding the stomach.
- MX: Presence of metastasis cannot be evaluated.
- M0: There is no distant metastasis.
- M1: There is distant metastasis, such as to distant lymph nodes, or the liver, lungs, brain, and/or bone.
|Stage||T, N, and M categories|
|STAGE 0||Tis , NO, MO|
|STAGE IA||T1, N0, M0|
|STAGE IB||T1, N1, M0|
|T2a or T2b, N0, M0|
|Stage II||T1, N2, M0|
|T2a or T2b, N1, M0|
|T3, N0, M0|
|Stage IIIA||T2a or T2b, N2, MO|
|T3, N1, M0|
|T4, N0, M0|
|Stage IIIB||T3, N2, M0|
|Stage IV||T1-3, N3, M0|
|T4, N1-3, M0|
|Any T, Any N, M1|
Cecil Textbook of Medicine. Philadelphia, PA: WB Saunders Company; 2002: 738-741.
Conn’s Current Therapy 2002. Philadelphia, PA: WB Saunders Company; 2002: 527-529.
Greene FL, ed. AJCC Staging Handbook. 6th ed. New York: Springer; 2002: 111-118.
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. Philadelphia, PA: WB Saunders Company; 1998: 733-749.
What is stomach cancer? American Cancer Society website.Available at: http://www.cancer.org/ . Accessed December 2002.
What you need to know about stomach cancer. National Cancer Institute website. Available at http://www.cancer.gov/cancerinfo/wyntk/stomach . Accessed December 2002.
- Reviewer: Igor Puzanov, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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