October 2020

How do doctors diagnose cancer, and what are the tests included in it?

Cancer Diagnosis

When any patient comes with a particular symptom, a thorough history is taken.

What are the symptoms of the patient, what are the problems of the patient?

A clinical examination is done to check whether there is any problem with the oral cavity, or in the breast, or in the abdomen.

The patient must be examined in detail. If there is any suspicion of cancer, other tests are performed.

The first test most of the time will be normal sonography, x-ray, or some type of scan, or mammography for the breast.

So first, we will have some vague idea of whether there is a lump or tumor, either yes or no.

Then we confirm it with a biopsy.

A needle is used to take some tissue samples from the lump, and we send it to the pathology laboratory.

The pathologist will tell us whether these look like a cancerous cell or non-cancerous cell.

Once cancer is diagnosed, the sub-types of cancer or sub-classification of cancer is done.

Additional tests called immunohistochemistry, or molecular histobiology, or molecular analysis are then done.

These are different tests that help to confirm the type of cancer. Then comes the very important: stage of cancer.

The stage of cancer

Anyone of the following tests is performed: CT scan, sometimes an MRI, sometimes a PET Scan (Positron Emission Tomography) scan.

This is a very important scan as far as cancer treatment is concerned because, in one scan, it gives us an idea about the whole cancer process.

Is the tumor only at a localized place, or it has gone from one organ to another organ, or it has spread to multiple other organs?

Using the positron emission tomography scan, the patient is injected with FDG ( fluorodeoxyglucose), and there are a special camera and special software.

The chemical goes into the body. Cancer cells are very active, and the metabolism is very high wherever the cancer cells are.

So in a PET scan, we will come to know whether there is only one tumor, or there are multiple tumors. Has it spread to the other organs?

The extent of the disease can be determined with the whole-body PET scan.

Sometimes an endoscopy for upper GI (gastrointestinal) tumors and sometimes colonoscopy for colorectal cancer.

There are a few other different tests that are used per the requirements for that particular type of cancer.

After the testing is completed, an accurate diagnosis is made that this particular patient has this particular cancer. Then the stage of cancer is determined because unless and until we define the problem, we cannot treat the problem.

So now we have come to the conclusion that this patient has a specific type of cancer and the stage, and then the next phase will be the treatment for the patient.

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