Diagnosis
If your healthcare provider suspects you may have stomach cancer, they will order exams and tests. They will also do a physical exam and ask you questions about your health history, risk factors, symptoms and your family history. Diagnostic tests may include the following, though most patients will not need all tests:
- Blood tests: Your doctor may do blood tests, such as blood chemistry studies and a complete blood count (CBC), to look for signs of stomach cancer.
- Biopsy: During this procedure, a doctor removes a sample of stomach tissue with a needle. The tissue is sent to a lab to be examined under a microscope to look for cancer cells. A biopsy is the only way to confirm stomach cancer.
- Upper endoscopy (esophagogastroduodenoscopy or EGD): During this procedure, your physician uses an endoscope (a long, thin, flexible instrument) to examine and take pictures of the inside of your stomach.
- Computed tomography (CT or CAT) scan: This test allows doctors see images of your organs, bones and other soft tissues inside your body, using a combination of X-rays and software.
Learn more about diagnostic tests and our center’s overall diagnosis process.
Stages of Stomach Cancer
After being diagnosed with stomach cancer, our pathologists will determine the stage of your cancer. The stage of cancer describes the size of the tumor and how far it has spread in your body. Knowing the stage of your cancer is important when deciding how to best treat it, including whether your cancer can be removed (resected) with surgery. You may need additional tests to help our team assign a stage to your cancer.
To better understand the stages of stomach cancer, it’s helpful to understand the layers of the stomach lining. Stomach cancer starts in the inner lining of the stomach, called the mucosa. As the tumor gets larger, it can grow through the other layers of the stomach:
- Submucosa
- Muscularis propria (the muscle layer)
- Subserosa
- Serosa (the lining that covers the outside of the stomach)
As the cancer grows through the stomach layers, it can also spread to nearby lymph nodes. Once It has grown through all layers of the stomach, it can spread (metastasize) to other parts of the body.
The most common way to stage stomach cancer is by using the TNM system from the American Joint Committee on Cancer (AJCC). Staging is very complex, but generally the higher the number, such as stage IV, means a more advanced cancer.
These are the stage groupings of stomach cancer and what they mean:
- Stage 0: Also known as carcinoma in situ, this stage of cancer is only found in the inner lining, or mucosa, of the stomach.
- Stage I: The cancer is only in found in the stomach, but it has grown.
- Stage IA: The tumor has spread to the submucosa layer, but it is not in lymph nodes.
- Stage IB.The cancer has grown beyond the mucosa and to no more than one or two nearby lymph nodes.
- Stage II: The cancer has grown but has not spread beyond the stomach.
- Stage IIA: The cancer has spread through other layers of the stomach and to no more than three to six nearby lymph nodes.
- Stage IIB: The cancer has spread through several layers of the stomach and to no more than seven to 15 nearby lymph nodes.
- Stage III: The cancer has not spread to other organs but has grown.
- Stage IIIA:The cancer has grown through several layers of the stomach and has spread to nearby lymph nodes but not any other organs. Or the cancer has grown through the layers of the stomach and has spread into nearby organs or tissues, such as the intestines, liver, spleen or kidney, but has not spread to nearby lymph nodes.
- Stage IIIB: The cancer has grown through all the layers of the stomach and spread to as many as 15 lymph nodes. Or the cancer has grown through all the layers of the stomach, nearby organs or tissues and up to six nearby lymph nodes.
- Stage IIIC:The cancer has grown through all the layers of the stomach and has spread to 16 or more nearby lymph nodes, but not to any other organs or tissues. Or the cancer has grown through all the layers of the stomach and into nearby organs and has spread to seven or more nearby lymph nodes.
- Stage IV: Also known as metastatic cancer, in this stage the cancer has grown into any layers of the stomach and may have spread to lymph nodes. It has also spread to other parts of the body, such as the brain, lungs or liver.
Learn more about the stages of stomach cancer.
