Tests
A number of different tests can be performed to assess people
who might have gastric cancer, to make the diagnosis and to make
further assessments to plan treatment. Our cancer care is provided
as part of a regional network. Patients may therefore have
different tests in different hospitals. For example, a patient may
have an upper GI endosocpy in Weston, a PET-CT scan at Southmead
Hospital in Bristol, and an EUS in the Bristol Royal Infirmary. As
far as possible, we will minimise the number of trips and travel
distances required. However, we also need to make sure we gather
the correct information from the different tests available to make
the right treatment decision for each patient.
Upper GI endoscopy
Usually one of the first tests for people with symptoms of
gastric cancer (see the 'About' page) is an upper GI endoscopy
(often referred to as an OGD). This is a common procedure involving
the insertion of a thin tube with a camera on the end through the
mouth into the oesophagus, stomach and first part of the small
bowel called the duodenum. This test is important to look for a
range of problems such as acid damage or an ulcer. It is a very
routine procedure, but as with any test there are benefits and
risks, even though the risks are very low. More information on this
procedure, its benefits and risks are available
here.
Computed Tomography (CT)
A CT scan is usually the first of a series of specific tests
that are done to assess the cancer itself and look for any spread
to glands or lymph nodes, and other organs around the body. Having
a CT scan involves lying down on a narrow bed which moves through
an open ring, like a big doughnut. The scan itself usually takes a
few minutes. It involves exposure to x-rays, a form of ionising
radiation. Doctors always minimise the amount of radiation to which
patients are exposed. For people with gastric cancer, the benefits
of this test and the information it provides to plan treatment
outweigh its risks.
Positron Emission Tomography (PET)-CT
This is a special type of CT. It is another way of looking for
spread of cancer to glands or lymph nodes and to other organs. It
involves a special injection of a radioactive, sugar-based dye
which is combined with a CT scan. The dose of this radioactive dye
is very low. The test is very similar to having a normal CT, as
described above.
Staging laparoscopy
This test involves a small operation that is done under a
general anaesthetic, using key-hole surgery to have a look inside
the tummy or abdomen. It usually requires 3 small incisions. It is
performed to look for any evidence of spread of the cancer within
the space around the different organs in the abdomen. During the
operation, a sample of fluid is often taken to help look for cells
that have spread that can only be seen with a microscope, and any
abnormal areas that are seen may also be sampled or biopsied. These
samples have to be sent off to a laboratory to be examined, which
takes 1-2 weeks, so the result is not available straight after the
operation. Most people go home the same day. As with any operation,
there are some risks which your doctor will explain to you.
Other tests
Occasionally, other tests are required. These may be required to
look at specific areas identified by the above tests. For example,
the scans may detect an abnormal area on the lower bowel. This may
then mean that a telescope examination of the lower bowel is
required to know exactly what is going on at the abnormal area. In
addition, tests may be required to help assess fitness for
treatments. These include tests to examine how well the heart or
lungs are working, to know if a person is fit enough to have major
surgery. Your doctor will explain any additional tests and why they
may be needed.
