Stomach Cancer
Make an AppointmentHow is Stomach Cancer Diagnosed?
Diagnosing stomach cancer, also known as gastric cancer, involves a combination of clinical assessment, specialist procedures, and advanced imaging. Early and accurate diagnosis is crucial for effective management and improved outcomes.
At Subang Jaya Medical Centre (SJMC), our multidisciplinary team uses the latest diagnostic tools to ensure precise evaluation.
Endoscopy and Biopsy
The primary method for detecting stomach cancer is an upper endoscopy. During this procedure, a thin, flexible tube with a camera (endoscope) is gently passed down the throat into the stomach. This allows doctors to visually inspect the stomach lining for suspicious growths or lesions.
If abnormal areas are found, a biopsy is performed by taking small tissue samples through the endoscope. These samples are then analysed in a laboratory to confirm the presence of cancer cells
Imaging and Staging Tests
Once stomach cancer is confirmed, further tests help determine the stage, or how far the cancer has spread. Staging is essential for planning the most suitable treatment approach.
- Blood tests:While not used to diagnose cancer directly, blood tests can assess overall health and detect possible spread to organs such as the liver.
- CT (Computed Tomography) and PET (Positron Emission Tomography) scans: These imaging tests provide detailed pictures of the stomach and surrounding organs, helping to identify metastasis (spread) to lymph nodes, liver, or other tissues.
- Endoscopic ultrasound: This test uses sound waves to create images of the stomach wall and nearby lymph nodes. It helps determine the depth of tumour invasion and guides biopsies of suspicious lymph nodes.
- Staging laparoscopy: In some cases, a minimally invasive surgical procedure is performed to look for cancer spread within the abdomen, especially when imaging results are unclear.
Specialised and Emerging Tests
- Circulating tumour DNA (ctDNA) testing: In selected cases, especially when a biopsy is not possible, a blood test may be used to detect fragments of tumour DNA. This can provide additional information for advanced cancers.
- Stomach cancer screening: Screening is generally reserved for individuals at high risk, such as those with a strong family history or certain genetic syndromes. Upper endoscopy is the most common screening tool in high-risk populations
Understanding Stomach Cancer Staging
Staging describes how far the cancer has grown and spread. The stages range from 0 (very early, confined to the inner lining) to stage 4 (cancer has spread to distant organs).
Staging helps guide treatment decisions and provides important information about prognosis.
- Stage 0: Cancer is limited to the innermost layer of the stomach.
- Stage 1: Tumour has grown into deeper layers but remains localised.
- Stage 2 & 3: Cancer has invaded further into the stomach wall and may involve nearby lymph nodes.
- Stage 4: Cancer has spread (metastasised) to distant organs such as the liver, peritoneum, or distant lymph nodes.
Your healthcare team may restage the cancer after initial treatment, especially if surgery or chemotherapy is performed first.
Treatment Options for Stomach (Gastric) Cancer
Treatment for stomach cancer is individualised based on the cancer’s stage, location, type, and the patient’s overall health. At SJMC, our specialists work closely with patients to develop a comprehensive care plan.
Surgery
Surgery is often the main treatment for early-stage gastric cancer. Procedures include:
- Endoscopic mucosal resection: Removal of small, early-stage tumours from the stomach lining using a tube passed through the throat.
- Subtotal gastrectomy: Removal of part of the stomach and surrounding tissue, typically for cancers near the lower stomach.
- Total gastrectomy: Removal of the entire stomach, with the oesophagus connected directly to the small intestine, usually for cancers near the upper stomach.
- Lymph node removal: Nearby lymph nodes are often removed and tested for cancer spread.
- Palliative surgery: For advanced cases, surgery may relieve symptoms such as obstruction or bleeding
Chemotherapy
Chemotherapy uses medicines to destroy cancer cells. It can be given:
- Before surgery (neoadjuvant): To shrink tumours and make them easier to remove.
- After surgery (adjuvant): To kill any remaining cancer cells and reduce the risk of recurrence.
- Systemically: Through the bloodstream, reaching cancer cells throughout the body.
- HIPEC (Hyperthermic Intraperitoneal Chemotherapy): Heated chemotherapy delivered directly into the abdomen during surgery, mainly for advanced cases.
Radiation Therapy
Radiation uses high-energy beams to target and kill cancer cells. It may be used:
- Before surgery to shrink tumours.
- In combination with chemotherapy (chemoradiation)
- Before surgery to shrink tumours
- After surgery, if cancer cells remain
- To relieve symptoms in advanced or inoperable cases
Targeted Therapy and Immunotherapy
- Targeted therapy: These medicines block specific molecules that help cancer cells grow. They are often used for advanced or recurrent gastric cancer, usually in combination with chemotherapy.
- Immunotherapy: This approach stimulates the body’s immune system to attack cancer cells. It may be considered for advanced or treatment-resistant cases.
Palliative Care
Palliative care focuses on improving quality of life by managing symptoms such as pain, nausea, or difficulty eating. It is provided alongside other treatments and involves a team of doctors, nurses, and support staff.
Preparing for Your Appointment
If you are referred for stomach cancer assessment or treatment, preparation can help you get the most from your visit:
- List any symptoms, even those that seem unrelated
- Bring a record of medications, supplements, and allergies
- Note any family history of cancer or genetic conditions
- Prepare questions about diagnosis, treatment options, side effects, and prognosis
- Consider bringing a friend or family member for support
SJMC’s team includes gastroenterologists, oncologists, surgeons, and palliative care specialists to guide you through every step of your care journey.
Coping and Support
A stomach cancer diagnosis can be overwhelming. Support is available through counselling, patient support groups, and survivorship programmes. Staying informed, maintaining activity as tolerated, and connecting with others can help you cope during and after treatment.