Which of the following diagnostic tests may be performed to determine if a client has gastric cancer?
A. Barium enema
B. Colonoscopy
C. Gastroscopy
D. Serum chemistry levels
Correct Answer: C. Gastroscopy
A gastroscopy will allow direct visualization of the tumor. Patients presenting with any symptoms suspicious for gastric cancer should undergo an upper endoscopy over barium study (except for limited plastic presenting as leather-flask appearance). Although upper endoscopy is more invasive and costly, it offers tissue diagnosis by direct biopsy of esophageal, gastric, or duodenal lesions.
Option A: A barium enema is a radiographic (X-ray) examination of the lower gastrointestinal (GI) tract. The large intestine, including the rectum, is made visible on X-ray film by filling the colon with a liquid suspension called barium sulfate (barium). Barium highlights certain areas in the body to create a clearer picture.
Option B: A colonoscopy would help diagnose colon cancer. Synchronous or metachronous colorectal cancer is reportedly detected in approximately 1% of patients with gastric cancer. Therefore, screening colonoscopy before surgical interventions for the stomach is now well established.
Option D: Serum chemistry levels don’t contribute data useful to the assessment of gastric cancer. Staging pre-preoperative evaluations include chest and abdominal imaging to rule out metastasis and to determine surgical resectability. Abdominopelvic computerized tomography is performed early to rule out gross metastatic disease but does not accurately assess T, N, and small peritoneal metastases with an overall accuracy of 42% to 82%.
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