Stomach Cancer - Describe Your Experience

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How is staging determined?

If the biopsy shows that you have stomach cancer, your doctor needs to learn the stage (extent) of the disease to help you choose the best treatment.

Staging is a careful attempt to find out the following:

  • How deeply the tumor invades the wall of the stomach
  • Whether the stomach tumor has invaded nearby tissues
  • Whether the cancer has spread and, if so, to what parts of the body.

When stomach cancer spreads, cancer cells may be found in nearby lymph nodes, the liver, the pancreas, esophagus, intestine, or other organs. Your doctor may order blood tests and other tests to check these areas:

  • Chest x-ray: An x-ray of your chest can show whether cancer has spread to the lungs.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your organs. You may receive an injection of dye. The dye makes abnormal areas easier to see. Tumors in your liver, pancreas, or elsewhere in the body can show up on a CT scan.
  • Endoscopic ultrasound: Your doctor passes a thin, lighted tube (endoscope) down your throat. A probe at the end of the tube sends out sound waves that you cannot hear. The waves bounce off tissues in your stomach and other organs. A computer creates a picture from the echoes. The picture can show how deeply the cancer has invaded the wall of the stomach. Your doctor may use a needle to take tissue samples of lymph nodes.
  • PET Scan: A small amount of radioactive sugar is injected into a vein. A short time later, a series of pictures are taken to look for the radioactivity. Cancer cells use sugar differently that normal tissues and can concentrate the radioactive sugar. The test is usually done in conjunction with a CT scan to help define the extent of the stomach cancer.
  • Laparoscopy: A surgeon makes small incisions (cuts) in your abdomen. The surgeon inserts a thin, lighted tube (laparoscope) into the abdomen. The surgeon may remove lymph nodes or take tissue samples for biopsy.

Sometimes staging is not complete until after surgery to remove the tumor and nearby lymph nodes.

When stomach cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if stomach cancer spreads to the liver, the cancer cells in the liver are actually stomach cancer cells. The disease is metastatic stomach cancer, not liver cancer. For that reason, it is treated as stomach cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.

These are the stages of stomach cancer:

  • Stage 0: The tumor is found only in the inner layer of the stomach. Stage 0 is also called carcinoma in situ.
  • Stage I is one of the following:
    • The tumor has invaded only the submucosa. Cancer cells may be found in up to 6 lymph nodes.
    • Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have not spread to lymph nodes or other organs.
  • Stage II is one of the following:
    • The tumor has invaded only the submucosa. Cancer cells have spread to 7 to 15 lymph nodes.
    • Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 1 to 6 lymph nodes.
    • Or, the tumor has penetrated the outer layer of the stomach. Cancer cells have not spread to lymph nodes or other organs.
  • Stage III is one of the following:
    • The tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 7 to 15 lymph nodes.
    • Or, the tumor has penetrated the outer layer. Cancer cells have spread to 1 to 15 lymph nodes.
    • Or, the tumor has invaded nearby organs, such as the liver, colon, or spleen. Cancer cells have not spread to lymph nodes or to distant organs.
  • Stage IV is one of the following:
    • Cancer cells have spread to more than 15 lymph nodes.
    • Or, the tumor has invaded nearby organs and at least 1 lymph node.
    • Or, cancer cells have spread to distant organs.
Return to Stomach Cancer

See what others are saying

Comment from: A,Gurule, 35-44 Female (Caregiver) Published: March 20

Back in November, 2013 my younger brother was having stomach pains. He went to his doctor to get checked. The only test they did was a blood test. They told him that he just had an ulcer and treated him for an ulcer. December and January went by, he had lost weight but we didn"t think anything of it, because he was trying to lose weight. February 5, 2014 he lost sight in his left eye. They took him to the hospital and they thought he had a stroke. They sent him to one of the main hospitals in our state. They ran more tests and found that he had a tumor in his brain. They did some test and he started feeling a little better, he got his vision back and started talking better and eating. They still didn"t know what kind of tumor it was or where it originated. They did more test and found out later that it was stage 4 stomach cancer. They set up treatments of radiation and chemotherapy to try and prolong his life. They sent him home over the weekend. His first night home he took a turn for the worse. They took him up for his first radiation treatment and the doctor decided to double his treatments. By his third treatment he was up talking and was drinking and eating a little. His first week he would go two steps forward and then ten steps back. It went the same for his second week, until his poor body went into shock from the treatment and he passed away on February 26, 2014. We found out that day that they should have never doubled his radiation, and that was the reason his body went into shock. I want to get his story out, because he was diagnosed with helicobacter pylori and if they would have done an endoscopy of his stomach in November they would have caught the cancer in time. He was only 36 and was never sick. He was the healthiest person I knew. He never drank, never did any drugs and never smoked. We also found out later that our great grandma had stomach cancer and our aunt had stomach cancer when she passed away last year. If you have stomach problems please get checked. This cancer is ranked 2 in the United States.

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Comment from: Mark, 55-64 Male (Patient) Published: March 31

I was diagnosed with stomach cancer in November 2015 in the upper part of my stomach. It was classified as stage 2 and no spread. I underwent chemotherapy treatment already. The cancer shrunk in half after chemotherapy and I wonder why doctors wants to remove the whole stomach and not a part. I found it difficult to accept to live without a stomach. I have read about the side effects after surgery. The doctors said that this is a preventive procedure but I am not satisfied with the answer. I will check second opinion with other surgeons. What worries me is how fast the cancer is growing. They want to operate as soon as possible but I am not in a hurry, I would rather check other opinions first. Again I don't want to defer the treatment too long, to be on the safe side.

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