Stomach Cancer: Tests After Diagnosis
What tests might I have after being diagnosed?
After a diagnosis of stomach cancer, you will likely need more tests. These help your
healthcare providers learn more about the cancer. They can help show if it has grown
into nearby areas (invade) or spread to other parts of your body (metastasis). The
test results help your healthcare providers decide the best way to treat the cancer.
If you have any questions about these or other tests, talk with your healthcare team.
The tests you may have include:
Imaging tests
CT scan
A CT scan is a series of X-rays that a computer combines to make a detailed 3-D picture
of your body. You may have a CT scan of your chest and belly (abdomen). They're used
to check for signs of cancer in other organs, such as your liver or lungs. The scans
show nearby lymph nodes, too. Cancer often first spreads to lymph nodes.
You may be asked to drink a special dye called contrast before the scan. During the
CT scan you may be given more contrast through an IV (intravenous) line in a vein
in your hand or arm. The contrast dye helps to clearly show tissues and organs on
the images. The dye may cause a warm flush feeling from head to toe. Tell your healthcare
provider if you’re allergic to contrast dye or if you have had a reaction to it in
the past.
A CT scan doesn't hurt. During the test, you’ll lie still on an exam table. The table
slides through the center of the ring-shaped CT scanner. The scanner doesn't touch
you. It directs X-ray beams at your body. You may be asked to hold your breath a few
times during the scan.
Endoscopic ultrasound (EUS)
An ultrasound uses sound waves and a computer to make images of the inside of your
body. An EUS is done from inside your stomach using a tool called an endoscope. This
test can show how far cancer has spread into your stomach wall and nearby tissues
and lymph nodes. It gives very specific information about the stage of your stomach
cancer. This information helps your healthcare providers plan your treatment.
An endoscope is a long, thin, flexible tube with a light and a tiny camera. It also
has a special ultrasound tool at the tip. Before the test, you'll be given medicine
to make you sleepy. A numbing medicine will be sprayed into your throat to help prevent
gagging. Then the endoscope is put into your mouth or nose. It’s gently guided down
into your throat, through your esophagus, and into your stomach. The ultrasound tip
sends images to a computer.
An EUS can show how far the tumor has grown in or through your stomach wall. It can
also be used to look at lymph nodes around your stomach. This is to see if cancer
cells might have spread to them. Your healthcare provider may pass a thin needle through
the endoscope, through your stomach wall, and into nearby lymph nodes. Then the needle
can be used to take tiny pieces of tissue (called samples) from the lymph nodes. This
is called a biopsy. The tissue samples are sent to a lab. A specialist (pathologist)
checks them for cancer.
MRI
An MRI scanner uses large magnets and radio waves to make images of your body without
the use of X-rays. MRI is not used as often as CT scans to look for the spread of
stomach cancer. But MRI does a better job than a CT scan at showing any cancer that
has spread to your brain and spinal cord.
You may be given a special contrast dye in a vein in your hand or arm before the MRI.
It helps make the picture clearer. For this test, you’ll lie still on a table as it
slides into a long, narrow, tube-like scanner. The scanner sends radio waves at the
part of your body to be scanned. A computer puts together the data to make a 3-D image
of the inside of your body.
The scanner is very loud. And it takes longer than a CT scan. You may be given earplugs
or headphones to wear. If you’re uncomfortable in small spaces, you may need a sedative
before this test. A two-way intercom will let you talk to and hear the technician
during the test.
PET scan
This test also helps show if cancer has spread beyond the stomach. A small amount
of mildly radioactive sugar (glucose) solution is put into your blood through a vein
in your hand or arm. Cancer cells use the glucose faster than normal cells do. After
about an hour, a scan is done to make images that show where the glucose has collected.
These areas may be cancer, but they may be other things too. The scan looks at your
whole body. So this test can help find stomach cancer that has spread.
For this test, you’ll lie still on a table that’s pushed into the PET scanner. It
will rotate around you and take pictures. Other than the injection, a PET scan is
painless. Some people are sensitive to the glucose. This may cause nausea, a headache,
or vomiting. Some machines can do PET and CT scans at the same time (PET-CT scan).
This way, areas that show up on the PET scan can be compared with the more detailed
images of the CT scan.
Laparoscopy
This surgical procedure is used to see if the cancer has spread to other organs and
tissue, such as the liver and lymph nodes. It can find tiny growths that are not easily
seen on CT or PET scans.
This procedure is done in an operating room. First, you’ll be given medicine that
puts you into a deep sleep. Then your healthcare provider makes a small cut in the
skin over your belly. A long, thin, flexible tube with a camera on the end is put
into your belly through the cut. The camera is moved around inside your belly to get
close-up images of the organs and lymph nodes near your stomach.
If suspicious areas are seen, your healthcare provider can remove tissue samples for
testing. This is called a laparoscopic biopsy.
Working with your healthcare provider
Your healthcare provider will talk with you about which tests you’ll have. Get ready
for the tests as instructed. Ask questions and talk about any concerns you have.