How Does My Doctor Know I Have Stomach Cancer?

If you have an upper GI series or a barium swallow, your doctor will use X-rays to look at your stomach.

• Medical history

• Family history of cancer

• Lifestyle habits, such as what you eat and whether or not you smoke

• Any previous stomach surgeries or stomach ulcers

• Any symptoms or discomfort

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. The results of these tests may be enough to rule out cancer. Or you may need more tests to confirm a diagnosis.

Fecal Occult Blood Test (FOBT)

This test 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.

Upper Endoscopy

This test is also called endoscopic gastroduodenoscopy (EGD). This procedure 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, 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

This is also called a barium swallow. During it, even small abnormalities in the stomach can be seen. This test is less common than it once was. For this exam, you’ll 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, you swallow a small tube after drinking the barium. Air is then pumped into your stomach to make the barium coating thinner.

Helicobacter pylori (H. pylori) Test

H. pylori are the bacteria that may cause stomach ulcers and perhaps even stomach cancer. To find out if you have these bacteria in your stomach, you may have a breath test. Or your doctor may check for the bacteria during a biopsy.

Laparoscopic Surgery

During this procedure, the surgeon makes a small incision in the skin and inserts an instrument to examine the abdomen. If any suspicious lesion is found, it can be removed and looked at under the microscope. This is 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.