Download Staging Investigations

Staging Investigations
To determine the best way to treat your cancer, we need more
information. We need to know the exact position, size and any spread to
other areas. This is called ‘staging’. In order to do this you will need to
have some more tests. These tests are briefly described in this leaflet.
You might not need all of the tests but some might need to be done more
than once.
Endoscopic Ultrasound
This procedure is similar to the endoscopy, but the tube has an
ultrasound probe built into it. By using the ultrasonic waves, a picture is
formed which allows the operator to get a clearer idea of whether the
cancer has spread and how far. This procedure is done at the cancer
centre, and it is usual to have sedation.
Positron Emission Tomography (PET) CT Scan
This is a specialised scan, this helps to identify if there are any “hotspots”
in your body. You will be given an injection prior to the scan (this is
usually a mildly radioactive solution) This will help to inform the Doctors
about the organs in your body so they can advise about the best
treatment plan for you. The scanning department will get in touch with
you about the date and time of your appointment and will advise you of
any special preparations needed before the scan, such as stopping
eating and drinking. This is usually done as an outpatient procedure, and
most people are able to go home once the scan is complete. You should
plan to be at the hospital for 2-3 hours (but the scan does not take all of
that time).
Staging Laparoscopy
A tube called a laparoscope is passed through a small cut near your
belly button. It is done to see if the cancer has spread to other
areas in the upper abdomen. This operation is usually done under a
general anaesthetic and might require an over night stay in hospital.
CardioPulmonary Exercise Tests
These tests are used to determine how your heart and lungs
respond to exercise. It comprises of monitoring your heart and lung
function / breathing whilst you exercise on a bike. Your blood
pressure and oxygen levels will also be monitored. The exercising
part of the test lasts for 10-15 minutes but you should plan to be at
the hospital for an hour. Suitable clothing should be worn.
How we stage cancers
The staging widely used is the TNM staging.
T stands for tumour and how far the primary tumour has grown.
N stands for lymph nodes and whether cancer is present in them.
M stands for metastases and whether the cancer has spread to
other organs.
When staging cancers, there are numbers given alongside the
TNM. For example:
T1 indicates that the cancer is within the stomach wall. T3 means
that it has grown through the wall and T4 means that it is seen in
other structures.
N0 indicates that there is no spread to the lymph nodes. N1 means
that some local nodes are affected and N2 means that there is
more extensive lymph node involvement.
M0 indicates that there are no metastases. M1 means that there are
metastases.
Why do we stage cancers?
By determining the stage of your cancer we are able to give advice
about the best and most appropriate treatment for you. By using
standard terms to describe the staging of the cancer we ensure that
everyone involved understands the same things.
Once staging has been completed.
Once the tests are completed, your results will be discussed at the
multidisciplinary team meeting and treatment plan will be suggested.
You should then have an appointment to discuss the treatment.
The Staging of Oesophageal
and Gastric Cancers
Preparations for these tests
Details of any special preparations required will be sent to you with your
appointment.
Any questions?
You might have questions to ask or you may want further information.
Please contact the Upper GI Nurse Specialist on 01322 428100
Extension 4844 or ask the switchboard to bleep 602.
Penny MacFarlane Upper GI Clinical Nurse Specialist
01322 428100 EXT 4844 Bleep 602
Darent Valley Hospital
Darenth Wood Road
Dartford Kent
DA2 8DA
Telephone: 01322 428100
www.dvh.nhs.uk
Produced in Partnership with the Kent CNSs
08/05 Reviewed 01/10 v3 next review 2012