Diagnosis

Patients with gastric cancer may experience symptoms related to food intake and digestion. A commonly heard complaint is unintended weight loss. Other symptoms are; decreased appetite, a bloated feeling after eating small portions of food, pain in the upper abdomen, nausea, vomiting (blood), heartburn, and dark red or black stools. Most symptoms often occur in an advanced stage of the disease.

In order to investigate the cause of the symptoms, a camera connected to a tube will be placed in the oesophagus and stomach. This procedure is called “gastroscopy”. In addition, other In addition, other diagnostic investigations are performed to determine the stage of the disease.

You can read more about these diagnostic instruments by clicking the links below.

Gastroscopy

GastroscopyDuring gastroscopy a thin flexible tube with a camera is inserted through the mouth into the oesophagus and stomach. The inside of the oesophagus and stomach can be examined and changes in the mucosa and tumors can be detected. In addition, small tissue samples (biopsies) can be taken during gastroscopy. These samples will be analysed with the use of a microscope in order to determine the origin of the tumor. A gastroscopy does not cause much pain and takes about 15 minutes. It is possible to receive sedation for the procedure.


Endoscopic Ultrasound

Endoscopic Ultrasound (EUS) of the stomach

Endoscopic Ultrasound (EUS) of the stomach

Endoscopic Ultrasound, abreviated as EUS, is a procedure in which an ultrasonic device is inserted into the oesophagus and stomach to visualize the different layers of the oesophagus and stomach.

Ingrowth of tumor in the surrounding structures can be detected as well. The stage of the disease can be determined based on these findings.

CT-scan

CT-scan of the stomach

CT-scan of the stomach

A CT-scan (computed tomography) is performed to search for any metastases in other organs and to see tumor growth into surrounding structures. Cross-sections of the body are visualized with the use of X-ray images. The location, size and extent of the tumor can be determined. Metastases to liver and lymph nodes of the intestine can be examined. The patient lies on a table that moves slowly through the opening of the CT-scanner. The test is not painful. In order to obtain good quality images, it is often necessary to use contrast fluid. For this purpose, a small amount of contrast medium is injected the arm (infusion). Some patients may experience nausea after this investigation.

MRI-scan

MRI-scanner

MRI-scanner

An MRI (magnetic resonance imaging) scan can be performed in addition to a CT scan. The purpose of an MRI scan is to detect any metastases. The gastrointestinal organs of the human body can be displayed in image slices based on differences in magnetic fields in the tissues. As a result, abnormalities in organs and enlarged lymph nodes can be visualized. Similar to a CT-scan, the patient lies on a table in a tube (MRI) that moves slowly. This test is not painful, but requires that the patient lies still. In case a patient has metal objects such as a pacemaker inside the body, it is too dangerous to make the scan due to the magnetic force of the MRI scanner. Another type of investigation will be preferred.

PET-scan

In some cases, usually when other diagnostics are inconclusive, a PET scan (positron emission tomography) is carried out. An advantage of this study is that the entire body is displayed. A small amount of radio-active sugar is intravenously administered, so that tissues that consume this sugar can be visualised. Cancer cells consume a lot of this sugar, so the location of these cells will be visible at the monitor.

After administration of sugar a rest period of one hour follows, in which the sugar can spread through the body and can be detected through the scan. The radioactive sugar has no side effects and is not harmful. Making the scan is not painful. For this study, the patient must be sober.

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