Detection & Diagnosis of cancer
 

*History & Physical Examination
In order to detect and diagnose cancer, a detailed history should be taken first from the patient to analyze his or her complaints  followed by complete physical examination. During this examination, the physician examines all body systems including head and neck, chest, heart, abdomen, pelvis and extremities. Careful examination of the lymph nodes has to be done. Lymph nodes are small glands present throughout the body in the neck, under the arms, in the abdomen and groin. They present the primary defense mechanism  against harmful bacteria and viruses. Enlargement of these lymph nodes may signify the presence of underlying malignancy. However, Lymph node enlargement can also be seen with benign causes. Examination of breast in case of females and prostate in case of males is almost always performed as well. If the doctor suspects any abnormality after reviewing the symptoms and performing physical examination, he may order other tests to confirm diagnosis. These include biopsy, images, blood tests.

*Biopsy
It is one of the most important and accurate tests in diagnosis of cancer. A biopsy is a procedure in which a piece of tissue from an area of suspected cancer is removed from the body and examined under the microscope. There are several types of biopsies. Fine needle biopsy is the simplest and the least reliable method. It is done by removing small piece of the suspected mass. It is usually done under local anesthesia. Core biopsy is the second type of biopsy in which a needle is inserted in the suspected mass and a bigger part is removed. This type of biopsy can be done under local anesthesia. Surgical biopsy is another type in which the entire suspected mass is removed. It is usually preferred being more accurate. It can be done under local anesthesia but general anesthesia  is sometimes needed. The tissue then is examined by a pathologist under the microscope and then provide the oncology physician with a detailed report.

*Images (CT, MRI, Bone scan)
Imaging tests are tests that provide pictures of the inside of the body. Most of them are painless and don't require anesthesia

CT scan takes x-rays from different angles around the body then the obtained pictures are combined using a computer to give a detailed image. It is important to detect lesions inside the body that cannot be detected on examination or simple x-ray.
MRI differs from CT scan in using magnets and radio frequency waves instead of x-rays. It provides more clear image and more detailed information about tissues and organs that is not available from other imaging techniques.
Bone scan is done to determine whether the tumor has spread to the bones or not. It is performed by intravenous injection of a small amount of a radioactive marker. This marker takes a couple of hours to be up taken in any region with high bone activity or turnover. So, after 2-3 hours of radioactive marker injection, the patient is placed through a scanner to determine any abnormal uptake. High uptake is also seen in cases of fracture and infection. Differentiation may require CT or MRI to confirm diagnosis. 

*Blood Tests & Tumor Markers
Blood tests are performed to determine the exact status of the blood cells. Changes in number and shape of blood cells are seen with several types of cancer. Blood tests also include liver and kidney function tests. These tests give an indication about the status of the liver and kidneys and whether they are healthy or not. This is simply done by the introduction of a needle into a peripheral vein  and taking a 5cc blood sample.
Tumor markers are certain proteins (sometimes hormones) normally circulating in the normal blood circulation. Levels of these proteins increase in the blood in case of presence of a malignant tumor (cancer) inside the body. They are used to follow the course of the disease, to measure the effect of the treatment and detection of recurrence.

*Bone Marrow Examination
It is the material found inside our bones containing the stem cells or in other words the mother cells which are immature cells. These immature cells develop over certain period of time into three types of mature cells which are the red blood cells, white blood cells and platelets. These cells are normally found in our circulation and have vital functions to perform. In certain cancers as blood malignancies, abnormal cancerous cells can be detected in the bone marrow. Simply a needle is inserted in the hip bone and small sample is withdrawn. The procedure is sometimes  painful during bone marrow withdrawal. Local anesthesia is applied, however in some settings, general anesthesia is required. The sample is examined by a pathologist under the microscope and provide the oncologist with a detailed report.

*Others
The previously mentioned tests are the most commonly used to diagnose cancer. However, others can be done to either confirm or rule out diagnosis. These include endoscopy and other sophisticated imaging studies as gallium scan. Also other tests may be ordered to evaluate the health of organs that could be affected by treatment, including heart and lung studies.

OTHER RELATED TOPICS:

Oncology FAQ's:
Common Terms and Questions.

Learn more about chemotherapy:
Chemotherapy ........ A monster No more                               

From A-Z in Breast Cancer 

What is Lymphoma ..??
We are targeting cure

Early detection & screening  programs:  
Breast, Cervix, Colon & Prostate cancer           

Copyright © 2004 [Cairo Oncology Center]. All rights reserved.
Revised: 07/28/05.