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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.