Diagnosis & staging
The stomach is part of your digestive system. It releases acid and enzymes to break down and digest food. It also squeezes the food which helps with digestion.
Over 50% (50 out of 100) of early-stage cases of stomach cancer can be cured.
- Mild pain in your stomach area that is worse when you eat.
- Nausea (feeling queasy) or vomiting.
- Heartburn or indigestion.
- Loss of appetite.
- Bloating, especially after meals.
- Black stools (poop) or stools like look like tar.
- Fatigue (extreme tiredness) or weakness.
- Weight loss you cannot explain.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose stomach cancer include:
- Blood tests: to look for anemia (low iron in your blood)
- Endoscopy: an endoscope is a flexible, lighted tube with a small camera on the end. A doctor puts the endoscope into your mouth, down your esophagus and into your stomach. A doctor will use the camera to look at your stomach. The doctor may take a small tissue sample from your stomach.
- Biopsy: a doctor removes a small piece of tissue from your stomach. A pathologist looks at the tissue under a microscope to see if there is cancer in the tissue.
- CT (computed tomography) scan: to see how large the tumour is and if the cancer has spread to other parts of your body.
- Laparoscopy: a laparoscope is a long, thin tube with a light and a video camera (laparoscope) on the end. It is put into your abdomen (the space that your stomach and intestines are in) through a small cut (typically in your belly button). The laparoscope lets your doctor see if the cancer has spread within the abdomen and to take biopsy (piece of tissue).
For more information on tests used to diagnose cancer: BC Cancer Library screening and diagnosis pathfinder.
- Adenocarcinomas: 90-95% (90-95 out of 100) of stomach cancers. Start in the gland cells that line the inside of the stomach.
- Gastric lymphoma: 4% (4 out of 100) of stomach cancers. These are usually non-Hodgkin lymphomas.
- Carcinoid Tumour: 3% (3 out of 100) of stomach cancers. These start in the hormone-making cells of the stomach.
- Gastrointestinal Stromal Tumour (GIST): A rare kind of stomach cancer that starts in the cells in the wall of the stomach.
- Most often starts in the lower part of the stomach, closest to the small intestine.
- Has often spread at the time of diagnosis.
- Commonly spreads to the gastrointestinal organs, lungs, bones, uterus, and ovaries.
Over 50% (50 out of 100) of early-stage cases of stomach cancer can be cured.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
Stage 1A: Tumour (cancer growth) is only in the inner layer of the stomach wall.
Stage 1B has one of the following:
- Tumour is in the inner layer of the stomach wall and has spread to 1 to 6 lymph nodes.
- Tumour has spread to the outer muscle layer of the stomach wall, but has not spread to the lymph nodes or other organs.
Stage 2 has one of the following:
- Tumour is in the inner layer of the stomach and has spread to 7 to 15 lymph nodes or other organs.
- Tumour has spread to the outer muscle layer of the stomach wall and has spread to 1 to 6 lymph nodes.
- Tumour has grown through the stomach wall, but has not spread to any lymph nodes or other organs.
Stage 3A has one of the following:
- Tumour has spread to the outer muscle layer of the stomach and has spread to 7 to 15 lymph nodes, but not to other organs.
- Tumour has grown through the stomach wall and has spread to 1 to 6 lymph nodes, but not to other organs.
- Tumour has spread to nearby organs, but has not spread to any lymph nodes or distant organs.
Stage 3B: Tumour has grown through the stomach wall and has spread to 7 to 15 lymph nodes.
Stage 4 has one of the following:
- Cancer has spread to distant organs.
- Cancer has spread to more than 15 lymph nodes.
- Cancer has spread to nearby organs and to at least 1 lymph node.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing. A pathologist will give the cancer a grade after looking at the cells under a microscope.
Stomach cancer can be grade 1, 2, 3 or 4. The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.
