For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best. For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.
This section describes options for diagnosing stomach cancer. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:. In addition to a physical examination, the following tests may be used to diagnose stomach cancer:. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis.
A pathologist then analyzes the sample s. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Molecular testing of the tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. Results of these tests can help determine your treatment options.
For stomach cancer, testing may be done for PD-L1 and high microsatellite instability MSI-H , which may also be called a mismatch repair deficiency. Testing can also be done to determine if the tumor is making too much of a protein called human epidermal growth factor receptor 2 HER2 , particularly if the cancer is more advanced. The results of these tests help doctors find out if immunotherapy is a treatment option see Types of Treatment. An endoscopy allows the doctor to see the inside of the body with a thin, lighted, flexible tube called a gastroscope or endoscope.
The person may be sedated as the tube is inserted through the mouth, down the esophagus, and into the stomach and small bowel. Sedation is giving medication to become more relaxed, calm, or sleepy. The doctor can remove a sample of tissue as a biopsy during an endoscopy and check it for signs of cancer. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die.
For stomach cancer, targeted drugs are usually combined with chemotherapy for advanced cancers or cancer that comes back after treatment. Your doctor may test your cancer cells to see which targeted drugs are most likely to work for you. Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make it hard for the immune system cells to recognize the cancer cells as dangerous.
Immunotherapy works by interfering with that process. For stomach cancer, immunotherapy might be used when the cancer is advanced, if it comes back or if it spreads to other parts of the body.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
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A cancer diagnosis can be overwhelming and frightening. Once you start to adjust after the initial shock of your diagnosis, you may find that it helps to stay focused on tasks that help you cope. For example, try to:. Start by seeing your family doctor if you have signs or symptoms that worry you. If your doctor suspects that you may have a stomach problem, you may be referred to a doctor who specializes in conditions that affect the digestive system gastroenterologist. Once stomach cancer is diagnosed, you may be referred to a cancer specialist oncologist or a surgeon who specializes in operating on the digestive tract.
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be prepared.
It can also be used to help prevent or relieve symptoms or other complications from stomach cancer, without the need for more extensive surgery. See Surgery for Stomach Cancer. Your doctor may suspect cancer if an abnormal-looking area is seen on endoscopy or an imaging test, but the only way to tell for sure if it's cancer is by doing a biopsy. During a biopsy, the doctor removes small pieces samples of the abnormal area. Biopsies to check for stomach cancer are most often done during an upper endoscopy.
If the doctor sees any abnormal areas in the stomach lining during the endoscopy, instruments can be passed down the endoscope to biopsy them.
Some stomach cancers can start deep within the stomach wall, which can make them hard to biopsy with standard endoscopy. If the doctor suspects cancer might be deeper in the stomach wall, endoscopic ultrasound described below can be used to guide a thin, hollow needle into the wall of the stomach to get a biopsy sample. Biopsies may also be taken from areas of possible cancer spread, such as nearby lymph nodes or suspicious areas in other parts of the body.
Biopsy samples are sent to a lab to be looked at under a microscope. The samples are checked to see if they contain cancer, and if they do, what kind it is for example, intestinal or diffuse adenocarcinoma, carcinoid tumor, gastrointestinal stromal tumor [GIST], or lymphoma. If stomach cancer is found, more lab tests may be done on the biopsy samples to learn more about the cancer cells.
This might affect how the cancer is treated. These cancers can be treated with drugs that target the HER2 protein. Testing for other gene or protein changes: The cancer cells may also be tested for other gene or protein changes that might affect treatment. For example:. See Testing Biopsy and Cytology Specimens for Cancer to learn more about different types of biopsies and tests, how they are used to diagnose cancer, and what the results can tell you.
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests may be done for a number of reasons, including:. This is an x-ray test to look at the inner lining of the esophagus, stomach, and first part of the small intestine. This test is used less often than upper endoscopy to look for stomach cancer or other stomach problems, as it can miss some abnormal areas, and it doesn't allow the doctor to take biopsy samples.
But it is less invasive than endoscopy, and it might be useful in some situations. For this test, you drink a white chalky solution containing a substance called barium.
The barium coats the inner lining of the esophagus, stomach, and small intestine.
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