Positron emission Tomography ;

Positron emission Tomography;

Cancer-Cancer cells have a higher metabolic rate than non-cancerous cells. Because of this high level of chemical activity, cancer cells show up as bright spots on PET scans. For this reason, PET scans are useful for detecting new or recurrent cancers.

Positron emission tomography scanning is an advanced technique for imaging body tissues and organs. One characteristic of living tissue is the metabolism of sugar. Prior to a PET scan, a substance containing a type of sugar attached to a radioactive isotope (a molecule that emits radiation) is injected into the patient’s vein. The cancer cells “take up” the sugar and attached isotope, which emits positively charged, low energy radiation (positrons) that create the production of gamma rays that can be detected by the PET machine to produce a picture. If no gamma rays are detected in the scanned area, it is unlikely that the mass in question contains living cancer cells.

Gastroscopy: A gastroscopy is an examination performed through an endoscope, which is a flexible tube inserted through the esophagus that allows the physician to visualize, photograph and biopsy (sample) the cancer. All patients have a gastroscopy with a biopsy to determine the histology or appearance of the cancer under the microscope.

Laparoscopy:

surgeon puts a thin tube with a light and a camera (laparoscope) through a small cut in your abdomen. They'll check the area around the stomach and take tissue samples

(biopsies)

Laparoscopy is a procedure that involves the insertion of an endoscope through a small incision in the abdomen. Laparoscopy is an important tool for staging and has proven to be more reliable than CT scanning in detecting spread of cancer to the liver and the lining of the abdomen (peritoneum).

The current methods of clinical staging of patients with gastric cancer are not perfect and are constantly changing as new and more reliable tests are developed. At this point, the results of surgery are much more reliable in determining the extent of cancer spread than tests performed before surgery. In order to learn more about the most recent information available concerning the treatment of gastric cancer, click on the appropriate stage.

Stage 0: Cancer in situ is cancer that is limited to the surface layer of cells lining the stomach, which is called the epithelium.

Stage IA: Cancer invades beneath the surface layer of cells, but not into the muscle wall and there is no lymph node or distant spread of cancer.

Stage IB: Cancer invades beneath the surface layer of cells, with spread to 1-2 lymph nodes, or invades into the muscle of the wall of the stomach without regional lymph node or distant spread of cancer.

Stage II: Cancer invades beneath the surface, with spread to 3 or more lymph nodes; into the muscle of the wall of the stomach, with spread to 1-6 lymph nodes; into the next-to-the-last layer of the stomach, with spread to no more than 2 lymph nodes; or into the outermost layer of the stomach but not to the lymph nodes.

Stage III: Cancer has spread to adjacent structures and/or regional lymph nodes.

Stage IIIA: Cancer invades the muscle of the wall of the stomach and 7 or more lymph nodes, the next-to-the-last layer of the stomach and 3-6 lymph nodes, or the outermost layer of the stomach (the serosa) and 1-2 lymph nodes.

Stage IIIB: Cancer invades the next-to-the-last layer of the stomach and 7 or more lymph nodes, the outermost layer of the stomach and 3-6 lymph nodes, or adjacent structures and few (1-2) or no lymph nodes.

Stage IIIC: Cancer involves the outermost layer of the stomach and 7 or more lymph nodes, or adjacent structures and 3 or more lymph nodes.

Stage IV – Metastatic: Cancer has spread to distant sites.

International TNM Classification of Stomach Cancer (4th ed. ) T is a primary tumor.

Tx - not enough data to assess the primary tumor.

Maintenance - primary tumor is not determined.

Tis (carcinoma in situ) is a preinvasive carcinoma: an intraepithelial tumor without invasion of its own mucous membrane plate.

T1 - the tumor infiltrates the stomach wall to the submucous layer

T2 - the tumor infiltrates the stomach wall to the subserous membrane.

TK - the tumor germinates the serous membrane (visceral peritoneum) without invasion into neighboring structures.

T4 - the tumor extends to neighboring structures.

N - regional lymph nodes.

Nx - not enough data to assess regional lymph nodes.

No. - there are no signs of metastatic damage to regional lymph nodes.

N1 - there are metastases in the perigastral lymph nodes no further than 3 cm from the edge of the primary tumor.

N2 - there are metastases in the perigastral lymph nodes at a distance of more than 3 cm from the edge of the primary tumor or in lymph nodes located along the left gastrointestinal, general liver, spleen or ventricular arteries.

M - remote metastases.

Moss - not enough data to determine distant metastases.

MO - there are no signs of remote metastases.

Ml - there are remote metastases

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