Tests for stomach cancer

Usually you begin by seeing your GP who will examine you and ask about your general health. Your doctor will ask you about your symptoms. This will include what they are, when you get them and whether anything you do makes them better or worse.

Your doctor will ask you to lie down for a physical examination. The doctor will feel your tummy (abdomen). It may feel tender, or it may be possible to feel a lump. After your examination, your doctor may refer you to hospital for tests such as endoscopy or to see a specialist.

The specialist will ask about your medical history and symptoms. They will then examine you by feeling your abdomen. You may have blood tests and a chest X-ray to check your general health. Then they will arrange other tests for you in the outpatient department.

Endoscopy is the most commonly used test to diagnose stomach cancer. An endoscope is a long tube with a light and camera inside. You swallow part of the tube to allow the doctor or nurse endoscopist to look at the inside of the foodpipe (oesophagus), stomach and the first part of the small bowel (the duodenum). They will take tissue samples (biopsies) of any abnormal looking areas.

You can have this test as an outpatient. But you should take someone with you to take you home. You won't be able to eat or drink for about 8 hours before the test so that your stomach and duodenum are empty. When you get to the clinic, the nurse will ask you to change into a hospital gown. When you are lying comfortably you will have an injection to make you very drowsy.

Once you are drowsy and relaxed, the doctor will pass the endoscope tube down your throat into your stomach. The doctor will examine the lining of the stomach for any abnormal looking areas. This examination can show whether you have a stomach ulcer as well as helping to diagnose stomach cancer. If there are any abnormal areas, the doctor will take biopsies to send to the laboratory. In the laboratory a pathologist checks the biopsy under the microscope for cancer cells.

Sometimes the endoscopy tube has an ultrasound probe at the end. It takes an ultrasound scan of the stomach and surrounding area. This is called an endoscopic ultrasound.

Once the test is over you will need to rest for a while. Because of the sedative, you may not remember anything about the test once it is over. You should be able to go home the same day but should not drive as you will be drowsy from the sedative.

A barium meal is a type of X-ray investigation. This test is not commonly used now for stomach cancer. You can have it as an outpatient. You won't be able to eat or drink anything for six hours before you have your test.

When you get to the X-ray department, the nurse will ask you to change into a hospital gown. When the test is about to begin, you will have

• An injection to relax the muscles of your digestive system
• A white liquid to drink

The white liquid is the barium meal. It is this chalky liquid that shows up on the X-rays. After you've drunk the barium, you lie down on the X-ray couch. Your doctor will watch on an X-ray screen as the barium passes through your stomach and duodenum. Any growths or ulcers will show up on the screen. The couch will be tipped into different positions during the test to make the barium flow where the doctor wants it to go.

The whole test takes about an hour. You should be able to go home straight after the test. You can eat and drink normally as soon as the test is over. But some people feel sick for a while afterwards. You may find the barium makes you constipated. Your bowel motions will be white for a day or so as your body gets rid of the barium.

Your specialist will give you an appointment to come back to the hospital when your test results have come through. The results may take a little time and you are bound to feel anxious. It may help if you ask your specialist how long the results are likely to take so that you have some idea of how long you will have to wait.

While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. Look in the general cancer information section for an organisation that can give you information about support groups or counselling services near you.