Stomach cancer can be a silent enemy. Often, it doesn’t make a grand entrance with loud symptoms. Instead, it whispers—slow digestion, a little bloating, perhaps a loss of appetite. So how do doctors catch it before it becomes a real threat? That’s where endoscopy and biopsy come in.
But what exactly are these procedures? Are they painful? Are they safe? Let’s break it all down so you know what to expect and why they’re essential tools in the fight against stomach cancer.
What Is Endoscopy and How Does It Work?
Imagine a flexible camera tube gently exploring your digestive system. That’s basically what an endoscopy is—a procedure where a doctor uses a long, thin, flexible tube called an endoscope to see the inside of your esophagus, stomach, and small intestine.
The tip of the endoscope has a light and a camera, giving real-time visuals on a screen. This allows doctors to check for:
- Abnormal growths
- Inflammation
- Ulcers
- Suspicious lesions
There are a few types of endoscopy, but when we talk about stomach cancer, the most common is the upper gastrointestinal (GI) endoscopy, also known as a gastroscopy.
Why Endoscopy Is Crucial for Detecting Stomach Cancer
Stomach cancer doesn’t usually show symptoms until it’s more advanced. By the time someone feels really unwell, the cancer might already be spreading. Scary thought, right?
That’s why endoscopy is a game changer. It allows doctors to spot trouble early, sometimes even before symptoms appear. Unlike CT scans or X-rays, endoscopy gives a direct, detailed view. It’s like watching a live video feed of the inside of your stomach.
And here’s something important: Visuals aren’t everything. That’s why doctors often pair endoscopy with another vital step—biopsy.
Step-by-Step: What Happens During an Upper Endoscopy
Worried about what to expect? Don’t be. The whole procedure is usually quick, and most patients don’t remember much of it.
Here’s a step-by-step rundown:
- Preparation: You’ll be asked not to eat or drink for at least 6–8 hours beforehand. This keeps your stomach empty for a clear view.
- Sedation: You’ll typically be given a sedative through an IV line. You won’t be fully asleep, but you’ll feel relaxed—and probably a bit drowsy.
- Throat Spray: A numbing spray is used to make the tube more comfortable as it passes down your throat.
- The Procedure: The doctor gently guides the endoscope down your throat. It might feel a little odd, but it shouldn’t hurt. The entire process takes around 15–30 minutes.
- Recovery: You’ll rest for a short while after. Most people are good to go home within an hour or two.
Sounds manageable, right?
What Is a Biopsy and Why Is It Done During Endoscopy?
During the endoscopy, if the doctor sees anything unusual—a suspicious bump, a discoloured area, or a growth—they’ll take a biopsy.
But what does that mean?
A biopsy is a small tissue sample taken from the stomach lining. Don’t worry—it’s painless. The tissue is then sent to a lab, where pathologists look at it under a microscope to see if there are any cancerous or precancerous cells.
Why is this important?
Because not every bump is cancer. And sometimes, what looks normal might be hiding something sinister. The biopsy confirms the diagnosis—no guesswork, just science.
How Accurate Are Endoscopy and Biopsy for Diagnosing Stomach Cancer?
Let’s be honest—no test is perfect. But when it comes to diagnosing stomach cancer, endoscopy with biopsy is the gold standard.
Studies have shown that:
- Upper endoscopy has very high sensitivity for detecting visible lesions
- Biopsy confirms the nature of the tissue with over 90% accuracy, depending on the location and type of cancer
Still, false negatives can happen, especially if:
- The lesion is small or hidden
- Not enough tissue is taken
- The biopsy misses the exact cancerous spot
In these cases, doctors may recommend a repeat endoscopy or additional imaging.
Are There Any Risks with Endoscopy or Biopsy?
Like any medical procedure, endoscopy and biopsy come with some risks—but they’re generally very low.
Common side effects include:
- Sore throat for a day or two
- Feeling bloated from air used during the procedure
- Drowsiness from the sedative
Rare but possible complications:
- Bleeding from the biopsy site
- Infection (extremely rare)
- Perforation (a small tear in the GI tract lining, seen in about 1 in 2,500 cases)
If you experience chest pain, fever, trouble swallowing, or vomiting blood after the procedure, you should seek help immediately.
What Happens After the Procedure?
Once it’s done, you’ll rest in a recovery area until the sedative wears off. Most people feel completely normal by the next day.
You won’t be allowed to drive, so make sure someone can take you home.
The doctor will:
- Share what they saw during the endoscopy
- Let you know if they took a biopsy
- Explain when and how you’ll get the results (usually within a week)
If the biopsy shows cancer cells, the next step might include staging tests, scans, and a discussion about treatment options.
Alternatives or Complementary Tests to Endoscopy and Biopsy
Wondering if there’s another way? Well, there are some tests, but none are quite as direct or detailed as an endoscopy.
Possible alternatives or additions include:
- Barium swallow X-ray: You swallow a chalky liquid that coats the stomach, then X-rays are taken. Less accurate than endoscopy.
- CT scan: Offers a broader picture and can detect tumors that may have spread.
- PET scan: Often used for staging or assessing response to treatment.
- Blood tests: May check for anemia or tumour markers, but can’t diagnose cancer on their own.
Endoscopy remains the first-line investigation when stomach cancer is suspected.
When Should You Consider Getting an Endoscopy?
Not everyone with indigestion needs an endoscopy. So how do you know when it’s time?
Here are red flags that warrant further investigation:
- Unexplained weight loss
- Difficulty swallowing
- Ongoing nausea or vomiting
- Black, tarry stools (suggesting bleeding)
- Feeling full after a few bites
- Persistent upper abdominal pain
- A family history of stomach cancer
If you’re over 40 and have these symptoms—especially in high-risk areas like East Asia—it’s worth discussing an endoscopy with your doctor.
Preparing for Your Endoscopy: Tips for a Smooth Experience
A little preparation goes a long way. Here’s how to get ready:
- Don’t eat or drink for 6–8 hours before your procedure.
- Let your doctor know about any medications, especially blood thinners, diabetes meds, or allergies.
- Arrange for a ride home. You won’t be allowed to drive.
- Dress comfortably and try to relax. Many patients say the anticipation is worse than the procedure itself.
Conclusion: A Window Into Your Stomach’s Health
Endoscopy and biopsy aren’t just technical medical procedures—they’re life-saving tools. They help doctors catch stomach cancer before it spreads, giving patients a better shot at recovery and survival.
If you’re experiencing persistent digestive symptoms, don’t ignore them. A simple camera and a small tissue sample might just change the course of your health—for the better.
References
- “Upper Endoscopy (EGD)” – American Society for Gastrointestinal Endoscopy (ASGE), 2023. https://www.asge.org/home/for-patients/patient-information/understanding-upper-endoscopy
- “Stomach Cancer: Diagnosis” – American Cancer Society, 2023. https://www.cancer.org/cancer/stomach-cancer/detection-diagnosis-staging/how-diagnosed.html
- “Endoscopy for Diagnosing Gastric Cancer” – National Library of Medicine, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179225
- “Gastroscopy Explained” – NHS UK, 2024. https://www.nhs.uk/conditions/gastroscopy