How Is Stomach Cancer Diagnosed?

The first step in diagnosing stomach cancer is usually a thorough medical history and physical examination by the doctor.

If the history and/or examination indicate, the doctor will order laboratory blood tests and one or all of the following examinations:

• Fecal occult blood test - This laboratory test is used to determine the presence or absence of hidden (occult) blood in the stool. The occult blood test is performed because stomach cancer sometimes causes bleeding that can't be seen. The presence of blood in the stool by itself is not diagnostic of stomach cancer. Other conditions can cause occult blood, such as eating meat within a day or so of the test.

• Upper gastrointestinal (GI) series or barium swallow - The upper GI series involves taking x-rays of the esophagus and stomach (the upper GI tract) after drinking a harmless solution of barium, a dye that makes the stomach easier to see on x-rays. This test, also called the barium swallow, outlines the stomach, helping the doctor or radiologist to locate any abnormal areas. During the test, the doctor may pump air into the stomach to make suspicious areas easier to see.

• Endoscopy - An endoscope is a thin tube with a tiny camaralike end. During endoscopy (sometimes called gastroscopy), this tube is passed through the mouth and esophagus into the stomach for a direct visual examination. While not painful, the endoscope may cause some discomfort; a local anesthetic may be sprayed into the throat to reduce any discomfort. Sometimes medication is offered for relaxation.

When the endoscope is in place, the doctor can see directly into the stomach. If an abnormal area is seen, a sample of tissue can be removed from the suspicious area through the endoscope. This procedure is called a biopsy and is used to determine the presence or absence of cancer cells in the suspect tissue.