Stomach Cancer Tests

At the end of the day, I really feel like I made a difference — I really made an impact in someone’s life.
JAMES LIN
M.D., GASTROENTEROLOGIST

Stomach cancer detection

Screening involves looking for cancer before you have symptoms and increases your chances of catching it at an early stage, when it is more likely to be treated and cured. In the United States, low rates of stomach cancer mean there is no practical reason for early screening but studies in other countries like Japan — where this type of cancer is more common — show that screening programs in high-risk groups successfully find disease when it is more treatable. Screening is most appropriate in groups of people known to have a high risk of stomach cancer.
 
City of Hope physicians are committed to finding and treating stomach cancer in its earliest stages. If you are concerned about persistent and troubling gastrointestinal symptoms — or you have a family history or genetic risk of stomach cancer — you may require a consultation.
 

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.

Although hereditary factors account for a small percentage of stomach cancers, your chances of having one of these conditions is higher if close family members, like siblings or parents, have been diagnosed.

City of Hope’s Division of Clinical Cancer Genomics offers genetic counseling and screening that can identify whether inherited conditions influence your risk — and guide you to the best treatments.

Diagnosing Stomach Cancer

Stomach cancer is a complex disease that is challenging to accurately diagnose and stage. City of Hope’s team of internationally trained gastric specialists use their clinical expertise and leading-edge technology to provide you with the most accurate diagnosis — and the most effective treatment.

Tests to diagnose stomach cancer

  • Upper endoscopy, the main test to diagnose stomach cancer, uses a thin tube with a camera at the end to visualize the esophagus, stomach and duodenum to check for abnormal areas. This procedure may be performed with an ultrasound to determine whether the disease has spread.
  • Endoscopic biopsy involves removing tissue or cells to be viewed later under a microscope by a pathologist, and usually is done during an endoscopy.                                                   
  • Blood chemistry studies may be ordered to check whether you are anemic. Anemia may be a result of bleeding, liver problems or poor nutrition related to cancer.

Staging stomach cancer

If cancer is suspected we may perform other tests to better visualize the cancer and determine if it has spread:

  • Endoscopic ultrasound is a small tube with a probe at the end that uses sound waves to construct a detailed image of the stomach and surrounding organs. EUS may be used to evaluate abnormal findings on previous tests.
  • A CT scan takes a series of pictures inside the body from different angles to determine if cancer has spread.

A PET/CT scan is a procedure in which a positron emission tomography scan and computed tomography scan are done at the same time. It involves injecting radioactive glucose and seeing where in the body it is used most, since malignant tumors need more glucose than normal cells.