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Stomach Cancer Diagnosis

Because stomach cancer often does not have symptoms until it has spread to other parts of the body or has symptoms that are mistaken for other conditions, it can be challenging to diagnose. 

However, it is important for stomach cancer to be diagnosed as soon and as accurately as possible. This helps increase your odds for successful treatment and lowers the chance of side effects.

The experts at MD Anderson are among the most skilled and experienced in diagnosing and staging stomach cancer. They use specialized advanced technology with pinpoint focus and reliable outcomes.

Precise Diagnostic Tools

In addition to standard diagnostic procedures, MD Anderson offers endoscopic ultrasound, which gives specially trained doctors the ability to look inside the stomach and examine its walls for stomach cancer or pre-cancerous changes. This test, which is not available at many cancer centers, also allows physicians to view and biopsy the lymph nodes around the stomach.

Because stomach cancer can spread inside the abdomen and often is not detectable by any other means, specialists at MD Anderson often perform staging laparoscopies, minimally invasive procedures to see if tumors have spread in abdomen.

Researchers at MD Anderson were involved in recent studies to differentiate between gastrointestinal stromal tumor (GIST) and leiomyosarcoma (LMS) with near perfect accuracy. This will have wider application in more individualized diagnosis and treatment of stomach cancer and other types of cancer.

Stomach Cancer Diagnostic Tests

If you have symptoms that may signal stomach cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family medical history.

If stomach cancer is suspected, early tests may include:

  • X-rays of the gastrointestinal tract
  • Testing a stool sample for traces of blood

In addition, one or more of the following tests may be used to find out if you have stomach cancer, if it has spread or if treatment is working.

Biopsy: A biopsy is the removal of tissue to examine under a microscope. Different methods are available to obtain the tissue, depending on where it is located. In stomach cancer, biopsies usually are performed by endoscopy. An endoscope is inserted through the mouth, nose or an incision into the esophagus and stomach. The endoscope has a tool to remove tissue samples for examination.

Imaging tests, which may include:

  • CT or CAT (computed axial tomography) scans
  • PET (positron emission tomography) scans
  • MRI (Magnetic resonance imaging)
  • Chest and dental X-rays

Endoscopic ultrasound: Using specialized equipment, doctors insert an endoscope equipped with a small ultrasound device into the stomach. It produces sound waves that produce an image on a video screen.

Barium swallow: Also called an upper GI (gastrointestinal) series, this set of X-rays of the esophagus and stomach may be used to look for stomach cancer.

Blood tests, which may include:

  • Complete blood count (CBC) to look for anemia (low level of red blood cells) that may be caused by internal bleeding
  • β-hCG (beta-human chorionic gonadotropin), CA-125 and CEA(carcinoembryonic antigen) assays that measure certain chemicals in the blood

Why Choose MD Anderson?

  • Most-advanced stomach cancer treatment options, including minimally invasive surgery, targeted therapies, gene therapy and laser therapy
  • Highly skilled and experienced surgeons
  • Advanced procedures that preserve as much stomach as possible
  • Latest diagnostic equipment and techniques, including endoscopic ultrasound
  • Clinical trials of new treatments for stomach cancer

Stomach Cancer Knowledge Center

Treatment at MD Anderson

Stomach cancer is treated in our:

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Stomach Cancer Staging

If you are diagnosed with stomach cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer. Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.

Stages of Stomach Cancer

(source: National Cancer Institute)

Stage 0: Abnormal cells are found in the inside lining of the mucosal (innermost) layer of the stomach wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I: Stomach cancer has formed. Stage I is divided into stage IA and stage IB, depending on where the cancer has spread.

  • Stage IA: Cancer has spread completely through the mucosal (innermost) layer of the stomach wall
  • Stage IB: Cancer has spread to either:
    • Completely through the mucosal (innermost) layer of the stomach wall and is found in up to six lymph nodes near the tumor
    • The muscularis (middle) layer of the stomach wall

Stage II: Stomach cancer has spread to one of the following:

  • Through the mucosal (innermost) layer of the stomach wall and to seven to 15 lymph nodes near the tumor
  • The muscularis (middle) layer of the stomach wall and to up to six lymph nodes near the tumor
  • The serosal (outermost) layer of the stomach wall but not to lymph nodes or other organs

Stage III is divided into stage IIIA and stage IIIB depending on where the cancer has spread: 

Stage IIIA: Stomach cancer has spread to the:

  • Muscularis (middle) layer of the stomach wall and seven to 15 lymph nodes near the tumor
  • Serosal (outermost) layer of the stomach wall and one to six lymph nodes near the tumor
  • Organs next to the stomach but not to lymph nodes or other parts of the body

Stage IIIB: Stomach cancer has spread to the serosal (outermost) layer of the stomach wall and seven to 15 lymph nodes near the tumor.

Stage IV: Stomach cancer has spread to one of the following:

  • Organs next to the stomach and to at least one lymph node
  • More than 15 lymph nodes
  • Other parts of the body

Getting a Second Opinion at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging every type of stomach cancers. We welcome the opportunity to provide second opinions for stomach cancer.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center