🔟 Diagnostic Process — Stomach (Gastric) Cancer
Diagnosing stomach cancer requires a combination of clinical evaluation, imaging, endoscopy, biopsy, and molecular testing. Because early symptoms are vague, diagnosis often occurs only after persistent digestive issues or alarming signs prompt further investigation. This section follows your CancerLoop.com template and includes authoritative embedded links.
patient presents with symptoms such as persistent indigestion, unexplained weight loss, anemia, or difficulty swallowing. Clinicians then proceed through a structured evaluation:
- Clinical assessment
- Laboratory tests
- Imaging studies
- Upper endoscopy (EGD)
- Biopsy and histopathology
- Staging tests
- Molecular and genetic testing
Authoritative reference: NCI – Diagnosis & Staging https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis (cancer.gov in Bing)
⭐ Clinical Evaluation
Medical History
Clinicians assess:
- Duration and nature of symptoms
- Risk factors (H. pylori, smoking, diet, family history)
- Weight changes
- Gastrointestinal bleeding
- History of gastritis or ulcers
Physical Examination
May reveal:
- Abdominal tenderness
- Palpable mass (rare)
- Signs of anemia
- Enlarged lymph nodes (Virchow’s node)
⭐ Laboratory Tests
Complete Blood Count (CBC)
Detects anemia caused by chronic bleeding.
Iron Studies
Low iron levels may indicate occult gastrointestinal bleeding.
Liver Function Tests
Abnormal results may suggest liver metastasis.
Tumor Markers
Not diagnostic but sometimes elevated:
- CEA
- CA 19‑9
- CA 72‑4
Reference: MedlinePlus – Stomach Disorders https://medlineplus.gov/stomachdisorders.html
⭐ Imaging Studies
CT Scan (Chest, Abdomen, Pelvis)
Primary imaging tool for staging. Detects:
- Tumor size
- Lymph node involvement
- Liver or lung metastasis
- Peritoneal spread
MRI
Useful for evaluating liver lesions or complex anatomy.
PET Scan
Detects metabolically active cancer cells. Helpful for identifying distant metastasis.
Reference: NCI – Imaging Tests https://www.cancer.gov/about-cancer/diagnosis-staging/imaging-tests
⭐ Upper Endoscopy (EGD) — The Gold Standard
Endoscopy
Endoscopy is the most important diagnostic tool for stomach cancer. It allows direct visualization of:
- Ulcers
- Masses
- Thickened mucosa
- Abnormal vascular patterns
- Precancerous lesions
Endoscopy also enables biopsy, which is essential for diagnosis.
Reference: CDC – Screening Tests https://www.cdc.gov/cancer/dcpc/prevention/screening.htm
⭐ Biopsy & Histopathology
Biopsy
Multiple tissue samples are taken during endoscopy. Biopsy confirms:
- Presence of cancer
- Type (adenocarcinoma, GIST, lymphoma, neuroendocrine tumor)
- Grade
- Molecular markers
Histopathology
Pathologists examine tissue under a microscope to determine:
- Intestinal vs diffuse type
- Signet ring cell features
- Depth of invasion
- Lymphovascular involvement
Reference: NCI – Pathology Reports https://www.cancer.gov/about-cancer/diagnosis-staging/pathology-reports
⭐ Staging Tests
Endoscopic Ultrasound (EUS)
Determines:
- Depth of tumor invasion
- Local lymph node involvement
- Whether surgery is feasible
Diagnostic Laparoscopy
Used to detect:
- Peritoneal metastasis
- Small lesions not visible on imaging
- Ascites
- Liver surface metastasis
Often performed before surgery to avoid unnecessary operations.