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□■Diagnosis

If you ever suffer severe pain in the stomach, you should make an appointment to be examined by  a doctor to see whether they are due to cancer or some other causes. Your doctor may suggest you to see a gastroenterologist who is specialized in diagnosing and treating digestive problems. Personal and family history will be asked by your doctor . You will have to undergone a few tests too. The tests may be used areas following:


   A thorough physical exam
A thorough body check-up to examined the general signs of health including checking for presence of signs or symptoms  such as lumps or anything else that seems unusual. The doctor also will check for swollen lymph nodes. Patient’s health habits and past illness and treatments will also be taken notice by doctor.



 ●  Blood test
Blood sample will be taken to measure the amount of certain substances which are released into the body by organs. Unusual amount of a substances can also be a sign of disease in organ or tissue that produces it. A complete blood count (CBC) which is a procedure in which sample of blood is checked for the number of red blood cells and platelets. The amount of hemoglobin (the protein which carries oxygen)in the red blood cells are checked too.



    Upper endoscopy
It is a procedure to examined the inside of esophagus, stomach and duodenum (first part of small intestine) for any abnormal areas. An endoscope , a thin lighted tube is passed through the mouth and down the throat into esophagus. It is to look for any abnormal areas in the esophagus, stomach and duodenum. The doctor will first numb your throat with anesthetic spray before starting procedure. You may receive other medication to help you to relax. During this procedure, doctor normally will do biopsy. It is the removal of cells or tissues to be view under microscope. It is to check for any sign of cancer.
                                   
                   ★( Adapted from http://www.theendocenter.net/our-services.htm)


  CT Scan
Doctor will do this procedure to makes a series of detailed pictures of areas in body. A dye may be injected to vein or swallowed to help organs to be view more clearly . The pictures are made by computer linked to an x-ray machine.
                               

Staging
If you were diagnosed with stomach cancer, the gastroenterologist needs to examine the stage of your disease in order to help you to choose the best treatment. Staging is the attempt to find out on,
-          How big and deeply the tumor invades the wall of the stomach?
-          Has the tumor invaded other tissues ?
-          Has the cancer spread and affected which parts of body?
When stomach cancer has spread to other parts, cancer cell can be found at nearby lymph nodes, liver, pancreas or other organs. Your doctor may check you with these few tests:

a.   CT Scan
Organs and detailed pictures of organs can be seen at an x-ray machine linked to a computer after dye is injected into your body.

b.  Endoscopic ultrasound
A probe at the end of endoscope will send out sound waves that human cannot hear. A picture will be created by computer with the waves bounces off tissue in your stomach and other organs. This can show how depth has the cancer invaded your stomach wall. Tissue sample of lymph nodes can be taken too.

c.   Laparoscopy
Small incisions or cuts is made at your abdomen. Then ,a thin lighted tube is inserted into the abdomen a few tissue and lymph nodes sample is taken for biopsy.




These are the stages of stomach cancer:

 Stage 0 :
In this stage, the tumor is found only in the inner layer of the stomach. It is known as carcinoma or situ. Gastrectomy or lymph nodes dissection treatment will be suggested by doctor for patient at this stage.

 Stage 1:
In this stage, the cancer tumor has invaded only the submucosca , the layer with blood vessels and nerves. The cancer cell may be found at maximum of 6 lymph nodes. The cancer tumor can also has invaded the muscle layer .  However, the cancer cell have not spread to other organs or more lymph nodes. A total or partial gastrectomy is the treatment for patients at this stage.

 Stage 2 :
In this stage, the stomach tumor has invaded the submucosca  layer. The cancer cell may have spread to 7 to 15 lymph nodes. The tumor may also invaded the muscle layer but not the other organs. Doctor may suggests patient to undergo gastrectomy ,  chemotheraphy and radiation theraphy or lymph nodes dissection.

 Stage 3 :
In this stage, the tumor has penetrated the outer layer. The cancer cell have spread 1 to 15 lymph nodes.  Total gastrectomy, chemotheraphy and radiation theraphy treatment will be given to patient who suffer from stomach cancer at this stage.

 Stage 4 :
In this stage , the cancer cell has spread to more than 15 lymph nodes. The tumor may have invaded to another nearby organ .  For patients at this stage, they are usually treated with surgery to relieve symptoms, reduce bleeding or removing the blocking tumor. They have to undergone chemotheraphy  to relieve symptoms too.


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