How stomach cancer is diagnosed

Endoscopy/Endoscopic ultrasound

This is the most common test used to diagnose stomach cancer. An endoscope is a thin, flexible tube with a light and camera at the end. During an endoscopy, the doctor or nurse endoscopist can see inside your gullet (oesophagus) and stomach. They can also take photographs and a sample of tissue (biopsy) to be examined under a microscope.

Sometimes the endoscopy tube has an ultrasound probe at the end, which allows an ultrasound scan| to be done of the stomach and surrounding structures to be done. This is known as an endoscopic ultrasound. An endoscopic ultrasound can also look at and take samples of lymph nodes to help with staging.

The stomach has to be empty before an endoscopy, so you’ll be asked not to eat or drink anything for at least four hours beforehand. Most people have a sedative before an endoscopy to make them feel relaxed and drowsy. This is given as an injection into a vein in your hand. A local anaesthetic spray may also be used to numb the back of your throat.

You’ll need to lie on your left side on a couch and swallow the first part of the endoscope. It will then be guided further down your gullet, and into your stomach. Once the endoscope is in place, some air will be put down it. This makes it easier to see all areas of your stomach. When the test is over, the endoscope is gently pulled out.

An endoscopy takes about 10 minutes. It can be uncomfortable but it’s not painful. The effects of the sedative should only last a few hours. You’ll then be able to go home. You shouldn’t drive for 24 hours afterwards and you should arrange for someone to drive or travel home with you. Some people have a sore throat after their endoscopy. This is normal and should get better after a few days.

Barium meal

This test is occasionally used to diagnose stomach cancer and is done in the hospital x-ray department. It involves drinking a white, chalky liquid (barium) that helps the gullet and stomach show up on an x-ray.

The stomach needs to be empty before a barium meal, so it’s important not to eat or drink anything for at least four hours before it.

You’ll be given some barium to drink and asked to lie on a couch. You may also be given some granules and a liquid that acts like a fizzy drink and briefly makes your stomach swell.

The doctor will watch on the x-ray screen as the barium passes through your stomach. To get a clear picture, the room will be darkened. The couch will be tipped in several different positions to allow the barium to flow through the stomach.

A barium meal usually takes less than an hour and may be slightly uncomfortable. The doctor, and often a nurse, will be in the room with you and will be able to answer any questions you may have.

Most people feel fine afterwards, but it may be a good idea for a relative or friend to travel home with you.

Your stools are likely to be very pale for a few days until all the barium has passed out of your system. Sometimes the barium causes constipation, so you may need to take a laxative for a couple of days. Drinking plenty of fluids will also help.

You may have further tests| to see if the cancer has spread outside the stomach or to other parts of the body.