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Monday, January 24, 2022
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    Should screening test for stomach cancer have broader use?


    Dear Dr. Roach: I read with interest your recent column regarding the benefit of a colonoscopy for detecting colon cancer. I am 58 and started experiencing frequent light nausea about two months ago, a few days after getting my first Moderna vaccine. My doctor had me get a blood test. It was generally normal except the liver’s enzyme activity level was very high. That led to a second, liver-focused blood test, an abdominal ultrasound, an abdominal CT scan, followed by a colonoscopy and endoscopy. The last test’s biopsy determined that I have stomach cancer, and a liver biopsy, torso PET scan, chemotherapy and immunotherapy are next.

    If the cancer has spread to the liver, which appears likely, then I have stage IV stomach cancer, which may be fatal. I am not aware of any family history of stomach cancer. Why aren’t endoscopies a recommended test for all age 50+ individuals, as colonoscopies are? I might have a much better survival prognosis if they were. Has any doctor found a way to beat stage IV stomach cancer?

    M.S.

    Dear M.S.: I am very sorry to hear about your diagnosis, and wish you well with your treatment. The prognosis for stage IV stomach cancer is not good, but recent advances with immunotherapy and chemotherapy should give you hope.

    Successful screening for cancer requires two factors: a cancer that is detectable at a time when it can be successfully treated, and a screening test that is safe and accurate at detecting early cancer.

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