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Staging
To plan the best treatment, your doctor needs to know the extent
(stage) of the
disease. The stage is based on whether the tumor has invaded nearby tissues,
whether the cancer has spread, and if so, to what parts of the body. Stomach
cancer can spread to the lymph nodes, liver, pancreas, and other organs. The
doctor may order tests to check these areas:
-
Blood tests: The lab does a
complete blood count
to check for
anemia.
Blood tests also show how well your liver is working.
-
Chest x-ray:
An x-ray machine takes pictures of your lungs.
The doctor can then study these pictures on film. Tumors in your lungs can show
up on the x-ray.
-
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:
The 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.
-
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.
These are the stages of stomach cancer:
-
Stage 0: The cancer is found only in the inner layer of the stomach. It is
carcinoma in situ.
-
Stage I is one of the following:
-
The tumor has invaded only the submucosa. (The picture in section 2
shows the layers of the stomach.) 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 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.
-
Recurrent cancer:
The cancer has come back (recurred) after a period of time
when it could not be detected. It may recur in the stomach or in another part
of the body.
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