Testing For Other Conditions And Cancers
Individuals who have hereditary diffuse gastric cancer syndrome and Lynch syndrome have a drastically increased risk of stomach cancer. Recognizing these and taking precautions after receiving a doctors advice can reduce the risk.
People with close family members who have had stomach cancer and those who had invasive lobular breast cancer before the age of 50 years might benefit from genetic testing.
If a test shows changes in the CDH1 gene, a doctor may recommend removing the stomach before cancer develops.
Current research is looking into the possible cancer links of chronic Helicobacter pylori infection in the stomach lining.
Early studies suggest that treating H. pylori infection with antibiotics can reduce the risk of stomach cancer, although further research is necessary.
How Does My Doctor Know I Have Stomach Cancer
Q: What do I do if I think I have stomach cancer?A: If there is any reason to suspect stomach cancer, your doctor will ask you questions about risk factors and symptoms and do a complete physical exam. The doctor will feel your abdomen to see if there are any abnormal changes. You may need to have some tests done to find out whats going on.
Tests that may be done to find stomach cancer
Q: How is stomach cancer diagnosed?A: Doctors often divide stomach cancers into 2 groups. Resectable cancers are those the doctor thinks can be completely removed during surgery. Unresectable cancers are those that cant be completely removed. This might be because the tumor has grown into nearby structures or lymph nodes. Or it may have grown too close to major blood vessels, or has spread to distant parts of the body.
Q: What is the staging of stomach cancer?A: Staging is the process of finding out how far the cancer has spread. This is very important because the treatment and the outlook for your recovery depend on the stage of the cancer. After stage 0 , stages are labeled using Roman numerals I through IV . As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV , means a more serious cancer.
After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.
- Endoscopic mucosal resection
Hereditary Causes Of Stomach Cancer
Inheriting certain genetic diseases puts you at risk of getting stomach cancer and being diagnosed earlier in life. Inherited conditions that influence your risk include:
- Hereditary diffuse gastric cancer is rare, but when it is found the risk of developing stomach cancer is between 70 and 80 percent. A problem with a gene called CDH1 causes this type of stomach cancer, and in women it is associated with a higher risk of breast cancer.
- Lynch syndrome, also called hereditary nonpolyposis colorectal cancer, is a condition that also increases the risk of stomach cancer. Problems with genes called MLH1 or MSH2 and several others lead to Lynch syndrome.
- Familial adenomatous polyposis involves developing multiple noncancerous polyps in the colon, stomach and intestines that may later progress to cancer. This condition, caused by a defect in the APC gene, most often leads to colorectal cancer but in some cases it increases risk for stomach cancer.
- BRCA1 and BRCA2 genes are more commonly associated with breast cancer, but may also increase the risk of stomach cancer.
- Li-Fraumeni syndrome increases the risk of developing stomach cancer at a young age.
- Peutz-Jeghers syndrome leads to polyps in several passages in the body, including the nose, lungs, bladder, stomach and intestines, and is associated with an increased risk of stomach cancer.
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If You’re Told You Have Stomach Cancer
Being told you have stomach cancer can feel overwhelming. You may be feeling anxious about what will happen next.
It can help to bring someone with you to any appointments you have.
A group of specialists will look after you throughout your diagnosis, treatment and recovery.
Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.
You can ask them any questions you have.
Can You Treat Stomach Cancer By Changing Your Diet
Using a healthy diet to treat stomach cancer is not enough to cure cancer, but you can talk to your doctor about using it as part of a medical plan to improve your overall health. Those who eat a diet rich in produce like fresh fruits and vegetables and whole grains may decrease their risk for stomach cancer. However, some studies show that increasing plant-based foods reduces the risk of fatal stomach cancer in men, but not women. Talk with your healthcare provider about your dietary options.
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The Power Of A Dogs Nose
Dogs love to use their nose to smell food, people, animals and even wounds and cuts. Has your dog ever smelled a cut on you? Maybe youve personally experienced it. If you have a cut on your arm, your dog is able to smell it, even through your sleeve. They can smell the change and they will point it out to you.
A dogs nose is already well-known to be an expert at smelling things. This is because they can smell in parts per trillion. This means less than a drop of blood in 20 gigantic sized swimming pools. That is 50,000 times more than a human. Isnt that amazing?
Us humans love to use our eyes and were pretty good at it. When we enter a room, first thing we do is walk in and see the room. For dogs, they walk in a room and smell it. When you see a cat, they smell a cat when you see a cut, they smell a cut. That is why dogs are so good at detecting drugs, explosives and missing people. Fortunately, now researchers, many other people and pet owners know they can detect cancer. Dogs are so good at it that they can detect it at a very early stage. Even at stage zero. Cancer has a smell. Even oncologists say that cancer has a smell that can be scented around stage 3 or 4 through a patients breath. If a human can smell it, it makes a lot of sense that a dog can do too, but at a much earlier stage.
Positron Emission Tomography Scan
A PET scan can be useful to help determine the extent of the cancer in the body. For this test, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells. A special camera is then used to create a picture of areas of radioactivity in the body. The picture is not detailed like a CT or MRI scan, but a PET scan can look for possible areas of cancer spread in all areas of the body at once.
Many newer machines can do both a PET and CT scan at the same time . This lets the doctor see areas that âlight upâ on the PET scan in more detail.
Although PET scans can be useful for finding areas of cancer spread, they arenât always helpful in certain kinds of stomach cancer because some types donât take up much of the radioactive sugar.
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How Stomach Cancer Is Diagnosed
There are many tests used for diagnosing stomach cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
The type of cancer suspected
Your signs and symptoms
Your age and general health
The results of earlier medical tests
In addition to a physical examination, the following tests may be used to diagnose stomach cancer:
After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.
The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.
How Does Cancer Blood Testing Work
The proliferation of cancer cells is brought about by mutated DNA. Fragments of the erroneous DNA and certain proteins get released into the bloodstream as the tumors start to grow. Some of these proteins include antigens released by the tumor. A total of 16 gene mutations and a number of proteins related to cancer can be identified from the blood. Each of these proteins corresponds to a different type of cancer, making it possible to identify all eight types of cancer using just one blood sample.
Cancer blood tests can also be performed to detect circulating tumor cells , which are another indicator of malignant cells in the body. The cells that are identified in the blood can be used to trace back to where they originated from and find the part of the body where the tumor might be.
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What Is The Galleri Test
The Galleri test was recently designed as an innovative method of detecting cancer. Instead of individually screening for different forms of cancer it is considered an all-encompassing screening process that can detect multiple forms of cancer concurrently.
Using a single blood test the Galleri test is able to detect when cancers shed DNA into the bloodstream. Utilizing a technology known as Next-Generation DNA Sequencing and machine learning doctors can search for patterns in DNA code and determine if cancer is present along with the origination location in the body.
Healthy blood cells typically have a certain configuration pattern whereas cancerous cells exhibit an entirely different form. The results of the Galleri test will display one of two different end results including:
- No cancer DNA which means no cancer is detected in the bloodstream
- A cancer signal means a person may potentially have cancer
A positive cancer signal on the Galleri test can help medical professionals identify which organ in the body cancer is originating from with approximately a 90% accuracy rate. If detected, a secondary test form can help to verify the presence of the disease in the body. What separates the Galleri test from others is that it can help detect cancer much earlier prior to the onset of physical symptoms.
High Grade Gastric Epithelial Dysplasia
Most patients who develop high-grade gastric epithelial dysplasia are at high risk for developing invasive gastric carcinoma. According to the MAPS guidelines, histological diagnosis of high-grade dysplasia in the absence of endoscopic data indicates an immediate need for endoscopic re-examination with wide biopsy sampling and subsequent surveillance at six-month to one-year intervals.
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What Are The Different Stages Of Stomach Cancer
Stomach cancer is staged based on the severity of cancerous cell growth and spread. Adenocarcinoma is initially evaluated by the tumor, node metastasis system.
- T: How deeply has the tumor spread into the stomach wall?
- N: Has the stomach cancer spread to the lymph nodes?
- M: Has the stomach cancer spread to other parts of the body?
After the TNM staging information has been taken into account, the cancer is staged at 0 or 1 to 4. Tumor classifications for staging are as follows:
- Stage 0 is early cancer on the surface of the stomach lining.
- Stage 2A or 2B, commonly with deeper stomach wall involved
- Stage 3A or 3B or 3C, commonly with lymph node involvement
- Stage 4 means cancer has metastasized elsewhere in the body outside of the stomach.
Stomach Cancer Is On The Decline
The really good news is that this type of cancer is very rare in the United States, and its actually decreasing in incidence, says Dr. El-Hayek. Less than 2 percent of all new cancer diagnoses are from stomach cancer.
The main reason for the decrease in cases is probably that infections from Helicobacter pylori, a type of bacteria known more commonly as H. pylori, are being diagnosed earlier than they used to be, Dr. El-Hayek notes. H. pylori is believed to be one of the major causes of stomach cancer because it can cause chronic inflammation in your stomach lining, as well as ulcers.
Now that were making the diagnosis of H. pylori earlier when patients get symptoms, theyre treated with antibiotics, the infection is eradicated and the overall risk of stomach cancer is presumably decreased, Dr. El-Hayek says.
Although H. pylori infections are extremely common, many people dont ever have any symptoms. For those who do get symptoms, its normally this dull, achy pain after eating, says Dr. El-Hayek. You might also notice nausea, bloating, burping, weight loss and lack of appetite. If you experience any of these, Dr. El-Hayek recommends that you see your doctor for testing.
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Early Warning Signs Of Stomach Cancer
Early signs of stomach cancer may include:
- Feeling full: Many stomach cancer patients experience a sense of fullness in the upper abdomen after eating small meals.
- Heartburn: Indigestion, heartburn or symptoms similar to an ulcer may be signs of a stomach tumor.
- Nausea and vomiting: Some stomach cancer patients have symptoms that include nausea and vomiting. Sometimes, the vomit contains blood.
Other common symptoms of cancers that develop in the stomach may include:
- Unexplained weight loss: Lack of appetite or unexplained weight loss is a common sign of cancer.
- Stomach pain: Abdominal discomfort or pain in the abdomen above the navel may be a symptom of a stomach tumor. Also, swelling or fluid build-up in the abdomen may also be caused by stomach cancer.
Most of the time, stomach cancer isnt the reason for these symptomsthese are common discomforts that may be triggered by conditions such as an ulcer or a stomach virus, or even a heavy meal. Since many early-stage symptoms may easily be ignored or attributed to a more common cause, catching stomach cancer before it advances may be challenging.
Anyone experiencing early-stage stomach cancer symptoms that lack a known cause, or that seem to be worsening is urged to make a doctors appointment. Whether the symptoms are due to stomach cancer or something else, doctors may help identify the problem and treat it properly.
Stomach Cancer: Advanced Diagnosis Options
In addition to taking a full family history and a physical examination, there are several advanced diagnosis methods we may use to help identify the presence of stomach cancer. This may include:
- Fecal occult blood test to check for hidden blood in feces. Learn more about fecal occult blood test.
- Upper endoscopy to check for presence of abnormal cells. Learn more about upper endoscopy.
- Upper GI series, a diagnostic test and X-ray series of the digestive system. Learn more about upper GI series.
- Helicobacter pylori test: H. pylori is a bacteria that can cause stomach ulcers and stomach cancer. We identify it through breath test or biopsy.
- Laparoscopic surgery, a minimally invasive surgery to explore the inside of the abdomen. Learn more about laparoscopic surgery.
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How Stomach Cancer Spreads
There are 3 ways stomach cancer can spread:
- directly the cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum
- through the lymphatic system the lymphatic system is a series of glands located throughout your body, similar to the blood circulatory system the glands produce specialised cells needed by your immune system to fight infection
- through the blood which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver
Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer.
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Tumour Markers Blood Test
As well as blood tests to check your general health, your doctor may test for cancer markers. Markers are chemical substances that can show up in the bloodstream in some types of cancer.
For example, the markers CEA and CA 19-9 are sometimes raised in stomach cancer, as well as other cancers. But some people with stomach cancer do not have raised levels in their blood and they can be raised in non cancerous conditions.
If your tumour markers are raised at diagnosis, your doctor might check the levels again after treatment and as part of your follow up.
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What Is The Prognosis For People Who Have Stomach Cancer
The outlook for stomach cancer depends on the stage of cancer. People in the early stages of stomach cancer have a much better prognosis than those at a later stage. The 5-year survival rate for stomach cancer may be as high as 70% or as low as 6% .
Speak with your provider for a more accurate assessment of your prognosis. The type of cancer you have, its spread, your health and how your cancer responds to treatment all shape your prognosis.
The Ajcc Tnm Staging System
The staging system most often used for stomach cancer is the American Joint Committee on Cancer TNM system, which was last updated in 2018.
This system is used to stage all stomach cancers except those starting in the gastroesophageal junction or those that start in the cardia and are growing into the gastroesophageal junction. Those cancers are staged like cancers of the esophagus. Other types of cancer that can start in the stomach, such as gastrointestinal stromal tumors and lymphomas, are staged differently as well.
The TNM system for stomach cancer is based on 3 key pieces of information:
The T category describes the extent of the main tumor, including how far it has grown into the layers of the stomach wall and if it has reached nearby structures or organs.
The 5 layers of the stomach wall include:
- Mucosa: the innermost layer, where nearly all stomach cancers start. The mucosa has 3 parts: epithelial cells, a layer of connective tissue , and a thin layer of muscle .
- Submucosa: a supporting layer under the mucosa
- Muscularis propria: a thick layer of muscle that moves and mixes the stomach contents
- Serosa: the outer, wrapping layer of the stomach
The N category describes any cancer spread to nearby lymph nodes.
The M category describes any spread to distant parts of the body, such as the liver or lungs.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced.