Stomach Cancer

For most types of cancer, a biopsy is the only sure way for a doctor to know if an area of ​​the body has cancer. In a biopsy, the doctor takes a small sample of tissue for histological examination that will be sent to a pathology laboratory.

The following list describes diagnostic options for this type of cancer. Not all of the options listed below are used for every person. Your doctor will consider the following factors when choosing a diagnostic test:

• The type of cancer suspected
• Your symptoms
• Your age and general health status
• The results of previous medical examinations

Biopsy.
A biopsy is the removal of a small amount of tissue for histological examination under a microscope by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose diseases (histological examination).

Molecular testing of the tumor.
Your doctor may recommend laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. The results of these tests can help determine your treatment options by revealing the molecular profile of the cancer.

For stomach cancer, a PD-L1 test and a microsatellite instability (MSI / MMR) test may be performed. The results of these tests help your clinical doctor (Oncologist) find out if immunotherapy is a therapeutic option.

Endoscopy.
An endoscopy allows a doctor (Gastroenterologist) to see the inside of the stomach with a thin, flexible tube called a gastroscope or endoscope. The doctor may remove a sample of tissue as a biopsy during an endoscopy for a pathologist to check for cancer (biopsy histological examination).

Endoscopic ultrasound.
This test is similar to an endoscopy, but the gastroscope has a small ultrasound probe on the end. An ultrasound uses sound waves to create a picture of the internal organs. An ultrasound image of the stomach wall helps doctors determine how far the cancer has spread in the stomach, as well as evaluate nearby lymph nodes, tissues, and organs, such as the liver or adrenal glands.

Radiography.

Barium test.
In a barium swallow, a person swallows a liquid containing barium and a series of X-rays are taken. The barium deposits on the lining of the esophagus, stomach, and intestines, making tumors or other abnormalities easier to see on the X-ray.

Computed tomography (CT) scan.
A CT scan makes pictures of the inside of the body using X-rays taken from different angles. A computer combines these pictures into a detailed, three-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the size of a tumor. Sometimes, a special dye called a contrast agent is given before the scan to provide better detail in the image. This dye is usually given either as a liquid to swallow or as an injection into the patient’s vein.

Magnetic resonance imaging (MRI).
An MRI uses magnetic fields, not X-rays, to produce detailed images of the body. An MRI can be used to measure the size of a tumor. A special dye called a contrast agent is given before the scan to create a clearer image. This dye is usually injected into the patient’s vein.

Positron emission tomography (PET) or PET-CT scan.
A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. A PET scan is a way to create images of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy, it absorbs more of the radioactive substance. A detector then detects this substance to produce images of the inside of the body.

Laparoscopy.
A laparoscopy is a minor surgical procedure in which the surgeon inserts a thin, flexible tube called a laparoscope into the abdominal cavity. It is used to see if cancer has spread to the abdominal cavity or liver. A CT or PET scan often cannot find cancer that has spread to these areas.

People with stomach cancer may experience the following symptoms. Sometimes, people with stomach cancer do not have any of these changes. Or, the cause may be a different medical condition that is not cancer.

Stomach cancer is usually not found in its early stages because it often does not cause specific symptoms. When symptoms do occur, they may be vague and may include those listed below. It is important to remember that these symptoms can also be caused by many other diseases, such as a viral stomach infection or an ulcer.

• Indigestion or heartburn
• Abdominal pain or discomfort
• Nausea and vomiting, especially vomiting shortly after eating
• Diarrhea or constipation
• Stomach bloating after meals
• Loss of appetite
• Sensation of food getting stuck in the throat while eating

Symptoms of advanced stomach cancer may include:

• Weakness and fatigue
• Vomiting blood or blood in the stool
• Unexplained weight loss

If you are concerned about any changes you are experiencing, contact your doctor.

Molecular examination of the tumor.

Researchers are looking at genetic changes in tumor cells to identify specific genes, proteins, and other factors unique to the tumor. Patients with different types of tumors with the same gene mutation can participate in “clinical trials” whose main objective is finding treatments that target this genetic change.

Targeted therapy.

For stomach cancer, a PD-L1 test and a microsatellite instability (MSI / MMR) test may be performed. The results of these tests help your clinical doctor (Oncologist) find out if immunotherapy is a therapeutic option.

Immunotherapy.

Immunotherapy is a growing field of research for stomach cancer. Researchers are looking at different types of immunotherapy that block the CTLA4 and / or PD-1 pathways. A tumor may use these pathways to successfully avoid the body’s immune system. Immunotherapy that blocks these pathways allows the immune system to detect and destroy cancer.

If you have been diagnosed with stomach cancer (diagnosis based on histology), you are likely to be eligible for molecular profiling of your cancer. This molecular test aims to detect whether your tumor has microsatellite instability (MSI/MMR) or protein expression abnormalities (PD-L1, HER2, CLDN18), which are closely associated with the cancer’s response to the treatment that will be chosen.

Based on the determination of the molecular profile, the Oncologist is given the opportunity to choose the optimal treatment regimen, depending on the stage of the tumor.

Consult your Oncologist for the best option for you.

The tests are performed on the surgical specimen (paraffin cubes) or the biopsy material (paraffin cube) from which your histological examination was performed or on the aspiration material (FNAB, EBUS) from which your cytological examination was performed. In our fully integrated Laboratory, the pathologist selects the most appropriate & representative paraffin cube, ensuring that the most appropriate sample will be used for the tests. Qualitative and quantitative parameters are checked.

In case your sample is not already at Microdiagnostics archive, please contact us immediately so that we can arrange for its safe and rapid transport to our laboratory. You will also need to quickly and easily complete the Consent Form.

Most of the time, the sample material we are called upon to handle is small because it has resulted from a minimally invasive method (needle biopsy, fluid aspiration, paraffin block with minimal material).

In our laboratory, Pathologists check in a timely manner whether the material to be examined is sufficient. If so, then a management algorithm is followed, with the aim of achieving the performance of multiple tests on the material (Immunohistochemistry, real-time PCR, NGS) in order to fully check the molecular profile of your tumor (proteins, genes, histological Grading).

In this case, and once sample enrichment manipulations have been exhausted, we contact your clinician to discuss alternative approaches in order to obtain the desired information to select the optimal treatment for you. Some examples:

• Performing an alternative test (e.g. Immunohistochemistry instead of PCR, or choosing Next Generation Sequencing (NGS)
• Performing Immunohistochemistry instead of FISH (Fluorescent In Situ Hybridization) and tubulin
• Possible blood sampling instead of tissue testing (liquid biopsy)
• Possible option to take a new biopsy or puncture

Contact us at 2310 23 22 72 and we will immediately assist you in quickly transporting the sample to our laboratory.

By cash, bank deposit, using a bank card or by online interbank deposit.

One of the primary concerns at Microdiagnostics is the protection of your personal data as well as the strict observance of the conditions for the protection of your genetic material and medical results.

In full compliance with the General Data Protection Regulation (GDPR), we ensure that any test conducted is done with your knowledge and consent and we do not communicate results over the phone.