Stomach Cancer Awareness Month: 5 Key Tests How Stomach Cancer is Detected, As Per Oncologist

Stomach cancer is a serious health condition that requires prompt diagnosis for effective treatment. In honour of Stomach Cancer Awareness Month, Dr Pankaj Kumar Pande, Director of Surgical Oncology at Max Super Speciality Hospital, Shalimar Bagh, explains the key tests and methods used to detect stomach cancer. Early diagnosis through these methods can significantly improve the chances of successful treatment.

Key Tests How Stomach Cancer is Detected

Endoscopy (Gastroscopy): The First Step in Diagnosing Stomach Cancer

When stomach cancer is suspected, an upper gastrointestinal (GI) endoscopy is typically the first test conducted. Dr Pankaj Kumar Pande states, “Endoscopy allows doctors to directly visualise the stomach lining and identify any abnormal growths, ulcers, or tumours." This procedure involves inserting a flexible tube with a camera (endoscope) through the mouth into the stomach. If any suspicious areas are detected, a biopsy is often performed during the procedure to gather tissue for further analysis.

Biopsy: Confirming the Diagnosis of Stomach Cancer

A biopsy is essential for confirming stomach cancer. Dr. Pande highlights, "During an endoscopy, if abnormal tissue is seen, a biopsy is performed to confirm the presence of cancer cells." The tissue sample is examined by a pathologist to determine whether the tumor is malignant, and the biopsy results help doctors identify the cancer type. A biopsy is one of the most definitive ways to diagnose stomach cancer.

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Imaging Studies: Assessing Tumor Size and Spread

Several imaging tests are used to assess the size, location, and spread (staging) of the tumour. Dr Pande explains the importance of imaging in determining cancer’s extent. The following imaging tests are commonly employed:

X-rays

In this test, patients swallow a barium solution that coats the stomach, allowing abnormal areas to be visible on an X-ray. Although less commonly used today, this method can still help detect larger tumours or structural changes in the stomach.

• CT Scan (Computed Tomography): A CT scan provides detailed cross-sectional images of the abdomen and pelvis, helping doctors assess the tumour's size, location, and whether it has spread to nearby lymph nodes or organs. It is often used to stage the cancer and check for metastasis (spread to distant organs).
• Endoscopic Ultrasound (EUS): Combining endoscopy and ultrasound, EUS provides detailed images of the stomach and surrounding structures. This method is particularly helpful for assessing the depth of tumour invasion and lymph node involvement.
• PET Scan (Positron Emission Tomography): A PET scan helps detect cancer spread by using a small amount of radioactive glucose. Cancer cells absorb more glucose, making them appear brighter on the scan, which is helpful in identifying metastasis.

Blood Tests: Supporting the Diagnosis

While blood tests are not used to diagnose stomach cancer directly, they can provide additional information. Tumour markers like carcinoembryonic antigen (CEA) and CA 19-9 may be elevated in some stomach cancer patients. Dr Pande notes, "Blood tests can support the diagnosis but are not definitive on their own."

Laparoscopy: Inspecting for Metastasis

If there is concern that cancer has spread beyond the stomach, a laparoscopy may be performed. This minimally invasive procedure involves inserting a small camera through an incision in the abdomen to visually inspect the stomach and surrounding organs for metastasis, especially in the peritoneal cavity. Dr Pande explains, "Laparoscopy is helpful when staging cancer and planning treatment, particularly in advanced cases."

Diagnosing stomach cancer involves multiple steps, including endoscopy, biopsy, imaging studies, blood tests, and in some cases, laparoscopy. Each of these methods plays a crucial role in confirming the presence of cancer, determining its stage, and planning an effective treatment strategy. Dr Pankaj Kumar Pande emphasises, "A combination of these tests is necessary to get a complete picture of the cancer's extent and develop the best treatment plan for the patient."

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