DIAGNOSIS OF GASTRIC CARCINOMA

• MEDICAL HISTORY AND PHYSICAL EXAM • UPPER ENDOSCOPY Endoscope passed down throat to stomach and checked for any signs of cancer. If

suspicious a piece can be collected(biopsy). In endoscope stomach cancer looks like an ulcer , a mushroom shaped or protruding mass, or diffuse , flat, thickened areas of mucosa known as linitis plastia.

sometimes in cases of heriditary diffuse stomach cancers cannot be seen during endoscopy.

• ENDOSCOPIC ULTRASOUND In this a small transducer is placed on the tip of an endoscope. The doctor can see

the layers of stomach wall, as well as the nearby lymph nodes and other structures just outside the stomach. The picture quality is better than a standard ultrasound because of shorter distance of the sound waves to travel.

• BIOPSY

• Biopsies are obtained mainly through endoscopy and are sent to labs to be seen under the microscope. The sample contain cancer , and if they do, what kind it is ( for example , adenocarcinoma, carcinoid gastrointestinal stromal tumor). If a sample contains adenocarcinoma cells, it may be tested to see if it has too much of a growth promoting protein called HER2/neu. If they are HER2 positive can be treated with drugs that target the HER2/neu protein , such as trastuzumab.

• IMAGING TESTS 1. UPPER GASTROINTESTINAL SERIES For this test, the patient drinks white chalky solution containing barium . The barium

coats the lining of the oesophagus ,stomach, and the small intestine. Several x rays are taken and since x rays cant pass through the coating of barium , this will outline any abnormalities.

2.COMPUTED TOMOGRAPHY CT scans can show the stomach clearly and can often confirm the location of cancer.

It also shows the organs in the vicinity of stomach like liver , lymph nodes and distant organs where cancer might have spread. It helps to determine the extent of cancer and whether surgery may be a good treatment option.

3. MAGNETIC RESONANCE IMAGING Used for more information, but used less often.

4. POSITION EMISSION TOMOGRAPHY In this , a radioactive substance is injected into vein. Because cancer cells grow

faster than normal cells , they take up the radioactive substance. PET is useful if the doctor thinks that the cancer has spread but dosent know where.

5. CHEST X RAY It can be used to chack if cancer has spread to the lungs.

• OTHER TESTS LAPROSCOPY It is done if stomach cancer has already been found out. Used to detect even

small tumors . Doctors do this beore any other surgery or chemotherapy or radiation to confirm a stomach cancer is still only in the stomach and can be removed completely with surgery.

• LAB TESTS CBC for anemia fecal occult blood test to look for stool in blood

COMPLICATIONS

• Complications of gastric carinoma include malnutrition malabsorption bowel obstruction gastrointestinal bleeding’ chemotherapy side effects -anorexia -bone marrow damage -constipation and diarrhoea -hair loss -increased risk of infection -mouth sores -nausea and vomiting -weakness or fatigue

• POST OPERATION COMPLICATIONS OF GASTRECTOMY

wound infection leaking from where the stomach has been closed or reattached. stricture chest infection internal bleeding blockage of the small intestines acid reflux vitamin deficiency particularly vit B12, C, and D, obtained from the food you eat. anemia due to deficiency of vit B12 brittle bones and weakened muscles due to vit D infection. weight loss , eating even a small meal makes them uncomfortably full.