Gastric Adeno

Dr. Pothuri uses a step-by-step approach:

Medical History and Exam

He begins by detailing your epigastric pain-onset, location, character, timing, aggravating or relieving factors-and asks about associated symptoms such as nausea, vomiting, unintentional weight loss and early satiety. He reviews personal and family risk factors, including H. pylori infection, dietary habits, smoking, alcohol use and a history of gastritis or gastric polyps.

Blood Tests

Laboratory studies include:

• Complete blood count (CBC) to check for anemia from chronic bleeding
• Liver function tests to evaluate metastasis or liver involvement
• H. pylori serology or stool antigen to identify infection
• Tumor markers (CEA, CA 19-9) when indicated

Endoscopy and Biopsy

• Upper endoscopy (EGD) to directly visualize the gastric lining and pinpoint lesions
• Targeted biopsies of any suspicious areas to obtain tissue for histopathology and confirm adenocarcinoma

Imaging Studies

• Contrast-enhanced CT scan of the chest, abdomen and pelvis to stage the tumor and detect lymph node or distant spread
• Endoscopic ultrasound (EUS) to assess tumor depth (T-stage) and regional lymph node involvement (N-stage)
• PET/CT scan in select cases to identify occult metastases or guide treatment planning

Genetic and Molecular Testing (if needed)

For advanced or inoperable tumors, Dr. Pothuri may order HER2/neu testing, PD-L1 expression or other molecular markers to tailor targeted therapies or immunotherapy.