Stomach (Gastric) Cancer Diagnosis & Screening

Stomach (Gastric) Cancer Diagnosis & Screening


How do doctors know if you have stomach cancer?

MSK diagnoses cancer using many new technologies that we developed or improved. We’re always researching ways to diagnose cancer with greater accuracy, which lets us improve treatment results.

Learn more about how we diagnose cancer.

Before you start stomach cancer treatment, your doctor first will get a clear understanding of the cause of your symptoms.

There are many kinds of stomach cancers. An accurate diagnosis gives us important information about the kind you have. We can choose treatments that work best on that type of stomach cancer.

To make their diagnosis, MSK experts learn about your medical history and overall health. They will give you a thorough exam and diagnostic tests.

They also will describe the stage of the stomach cancer. Staging is part of the diagnosis process. It tells us how advanced a cancer is. It describes the tumor’s size, location, and how far it has spread. Staging helps your care team choose the best treatment and follow-up care for you.

Pathologists are doctors who use a microscope to make a diagnosis. Your pathologist will examine tissue samples to find the cancer’s stage.  Learn more about the role of pathology in diagnosing cancer.

The latest genetic tests to diagnose gastric cancer

MSK offers 2 next-generation DNA sequencing tests.

  • MSK-IMPACT® looks for gene changes (mutations or variants) in tumor cells that are linked to cancer. MSK uses this genomic profiling for gastric cancer.
  • MSK-ACCESS® can find tumor mutations in blood. It also helps doctors tell how well the cancer is responding to treatment.

We also offer circulating tumor DNA (ctDNA) testing for people who may have early-stage cancer. People who still have ctDNA in their body after they had surgery do not have the best treatment results.

We’re using MSK-ACCESS to test people with gastric cancer. We’re also working on a test that’s like MSK-ACCESS, but even more sensitive.

Learn about tumor genetic testing at MSK. 

How do we screen for stomach cancer?

Cancer screening is checking for cancer in people who do not have symptoms. Screenings can help find cancer early, when it’s easier to treat. Treating cancer early often means there’s a better chance of curing it.

There are no recommended screening tests for stomach cancer for people who are not at risk for getting the disease. If you’re at higher risk for gastric cancer, there are the tests that can find stomach cancer earlier. 


How does an upper endoscopy find stomach cancer?  

An upper endoscopy is a test that lets your doctor see the inside of your stomach on a video screen.

The endoscope lets your doctor look at the inner lining of the stomach wall. It can also be used to take tissue samples, a procedure called a biopsy. A pathologist will examine the samples.

MSK’s stomach cancer experts will look for early signs of stomach cancer. Imaging technology can spot very small lesions that could be cancer.

You will be sedated or have anesthesia (medicine to make you sleep). Your doctor will use a thin, flexible tube called an endoscope. It has a light and small camera. They will put the tube into your mouth, down your esophagus (food pipe) and into your stomach. 

How does a barium X-ray find stomach cancer? 

This test lets your radiologist take X-ray images to look at your stomach. A radiologist is a doctor with special training in image-guided procedures.

You will get contrast dye during your procedure. Contrast is a special dye used to make it easier for your radiologist to see differences in the organs in your body. The contrast used for this test is barium, a white, chalk-like liquid metal. Barium shows up on the X-ray and helps your doctors see clear images of your stomach. 

How does a computed tomography (CT) scan find stomach cancer?

CT scan makes 3D images of your stomach. The images show bone, organs, muscles, tumors, and other soft tissue. CT scans are sometimes called CAT scans. This test can show the location and size of a tumor.

During a CT scan, a machine uses radiation to take detailed pictures of your stomach. It takes a series of pictures from different angles. A computer linked to the machine puts the pictures together to make a 3D image.

Some CT scans use a special material called contrast dye. The contrast dye makes differences inside your body easier to see. 

How does a positron emission tomography (PET) scan find stomach cancer?

PET scans are a type of nuclear medicine scan. They show how much glucose (sugar) is used in your stomach. Cells use glucose for energy. Cancer cells often use more glucose than healthy cells. A PET scan can help us find cancer cells by showing areas that are using more glucose than normal.

During a PET scan, a small amount of radioactive glucose is injected (put) into your vein. A machine then takes detailed, computerized pictures of where the glucose is being used.

How does an endoscopic ultrasound (EUS) find stomach cancer? 

An EUS is a procedure that uses sound waves to show images of your stomach. It gives us information about:

  • How deep a tumor grows into your tissue.
  • If your lymph nodes are enlarged.
  • If there’s a tumor in nearby tissues.
  • How a tumor has responded to cancer treatment.

Your doctor will use a flexible tube called an endoscope to see the inside your stomach on a video screen. They will put the thin, lighted tube into your mouth and down into your stomach.

An ultrasound probe at the tip of the endoscope uses high-frequency sound waves to make still or moving pictures. The probe gives off sound waves that bounce off tissues or organs and make echo patterns.

These patterns are shown as images, called sonograms, on the ultrasound machine’s screen. The sound waves bounce off your stomach’s walls. They make pictures of your abdominal (stomach) area, including nearby lymph nodes and organs. 

How does a laparoscopy find stomach cancer? 

Diagnostic laparoscopy is a minimally invasive procedure that lets your doctor see your stomach. Minimally invasive means the procedure is done with 2 or 3 small incisions (cuts), which does less harm to your body.

A laparoscope is a long, thin surgical tool with a video camera on the end of it. During a laparoscopy, your surgeon puts the laparoscope into your abdomen (belly) through a small cut in your skin. This tool lets them see inside your stomach. They can inspect the outside wall of the stomach, lymph nodes, and nearby organs. They can check if cancer has spread to those areas.

Your surgeon may also do a biopsy during the laparoscopy. This procedure removes tissue samples that will be examined for cancer cells. 

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