Staging and Detection Tests
Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:
- Different types of scans
- Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)
Scans and other tests may also be used:
- In a “surveillance program” looking for any signs of relapse after treatment
- In a “screening program” to detect cancer early in individuals at high-risk
- To monitor responses to treatment
Tests that may be used include:
Blood, urine and stool samples – The doctor may take these tests to check for bilirubin and other substances. Bilirubin is a substance that passes from the liver to the gallbladder to the intestine. Tumor blockage may cause the level of bilirubin in the blood, stool or urine to become very high.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.
Types of scans and procedures include:
Barium swallow – You swallow barium liquid, and it flows through the esophagus and into the stomach. X-rays are taken to look for abnormal areas.
Upper endoscopy – A thin, lighted tube, called an endoscope, is used to look inside the first part of the stomach to check for abnormal areas and could possibly biopsy these areas.
Ultrasound – High-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.
PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”
Treatment and Therapies
The following treatments may be used alone or in combination to treat stomach cancer.
Surgery
A surgical oncologist – a doctor who specializes in cancer operations—will perform an operation to remove the tumor and other areas that are affected by cancer.
Laparoscopy – The surgical oncologist uses a small telescope inserted into the abdomen to look for small areas of disease not seen on the usual tests. Sometimes a small tube can be inserted into the intestines to supplement the patient’s diet while being treated with chemotherapy and/or radiation.
Subtotal gastrectomy – Removal of the part of the stomach that contains cancer, nearby lymph nodes, parts of other tissues and organs near the tumor. The spleen may also be removed.
Total gastrectomy – Removal of the entire stomach, nearby lymph nodes, parts of the esophagus, small intestines and other tissues near the tumor. The spleen may also be removed. After surgery to remove the tumor and affected stomach, a surgical oncologist will reconstruct the gastrointestinal tract to allow for a normal diet.
If the tumor is blocking the opening to the stomach but the cancer cannot be completely removed by standard surgery, the following procedures may be used:
Endoluminal stent placement – A procedure to insert a thin, expandable tube called a stent to keep a passage open for nutrition.
Electrocautery – An electrical current that creates heat used to remove lesions or control bleeding.
Radiation Therapy (“Radiotherapy”):
Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:
- Kill cancer cells
- Prevent cancer cells from developing or recurring
- Improve many of the symptoms caused by cancer
Radiation therapy can be:
- Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
- Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
- Almost as effective as surgery in people who are not fit enough for an operation
- Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)
Chemotherapy and other drug-based treatments:
Anti-cancer drug treatments – Chemotherapy—and new “targeted therapies”—involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.
View current stomach cancer clinical trials available at UCCC.
Anti-cancer drug treatments may involve:
- Single drugs or combinations of drugs
- Intravenous injections or tablets/capsules
- Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
- Taking some drugs every day or only on a few days within the cycles
- Taking other medicines to reduce or eliminate side effects associated with chemotherapy
- Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
- Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials
Chemotherapy and targeted therapies can:
- Be given before surgery to make the operation easier
- Be given in combination with radiotherapy to make both treatments more effective
- Be given after surgery to reduce the chances of cancer coming back
- Successfully control advanced cancer and many cancer-related symptoms
Clinical Trials
The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:
- New drugs
- New combinations of therapies
- New treatment delivery methods
Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center—one of only 39 in the United States—your treatment will always include the latest and most comprehensive care options.
Learn more about clinical trials at UCCC.
Other types of treatments being tested in clinical trials include:
Biologic therapy (biotherapy or immunotherapy) – A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.