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In order to diagnose cancer, your doctor will conduct a physical examination, take your medical history and ask you about symptoms and risk factors. Your doctor will also order blood and urine tests to check for any conditions that may be related to cancer. If your doctor finds anything out of the ordinary, he will order more diagnostic tests to detect the presence of cancer and see how far it has spread in the body. These tests may include:
Some cancers are diagnosed with routine screening tests even before symptoms develop. The guidelines for screening are always changing, so it is important to talk with your doctor about which screening tests are appropriate for you based on your age and medical history. Some of these screening tests include:
A mammogram is an X-ray of the breast. Doctors use mammograms to screen for breast cancer in women with no symptoms, and to help diagnose the disease in women with breast lumps or other signs and symptoms of the disease.
In this procedure the doctor uses a cotton swab to scrape cells from the surface of the cervix. The doctor then sends these cells to a laboratory to be examined under a microscope for any abnormalities.
Your doctor performs this test to check for any signs of blood in the stool. Bloody stools are a symptom of colorectal cancer and may be caused by bleeding polyps or cancer inside the colon. Your doctor will collect a stool sample and send it to a lab to be analyzed with chemicals.
The doctor uses a colonoscope (narrow, flexible tube with a camera and light on the end) to examine the inner lining of your large intestine and remove any polyps before they can become malignant. The doctor can also remove a tissue sample for biopsy during this procedure.
Doctors use this test to screen for prostate cancer in men without symptoms and to help diagnose the disease when symptoms are present. PSA is a protein produced by the prostate that is found in the semen and blood. This test measures the amount of PSA in the blood. Higher-than-normal amounts of PSA may be caused by cancer or other conditions such as BPH and prostatitis. High PSA levels may also mean the cancer has spread outside of the prostate to other parts of the body.
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Doctors use low-dose CT scans to screen patients who are at high risk for lung cancer. Low-dose CT scans use much lower amounts of radiation than standard CT scans. High-risk patients include people over the age of 55 who have smoked a pack a day for at least 30 years. You are also considered high-risk if you are over the age of 50, you have smoked a pack a day for at least 20 years, and you also have additional risk factors.
An ultrasound is a quick, easy, and painless method to test for liver cancer. During this procedure, a transducer is placed directly on the skin of your abdomen. The transducer then bounces sound waves off of your internal organs in order to create echoes that form a picture. Not only can an ultrasound indicate the presence of a tumor, it can also show the tumor’s shape, size, and number of tumors.
Your doctor will thoroughly examine your skin and ask about your general health, lifestyle, and family history. You may need to see a dermatologist (skin doctor), who will use a dermatoscope, a magnifying lens with a light, to look at the skin more closely. If your doctor thinks a spot may be melanoma, he will perform a biopsy to be certain.
Doctors use laboratory tests to test samples of blood, urine, and other bodily fluids. These tests allow them to assess your general health and look for any conditions that may be related to cancer. Doctors may also use laboratory tests to determine the characteristics of the cancer and to diagnose specific types of cancer.
A CBC measures the levels of a person's blood cells, including red blood cells, white blood cells, and platelets. A CBC can be used to help diagnose certain cancers of the blood, such as leukemia and lymphoma, to determine if cancer has spread to the bone marrow, and to see how well you respond to cancer treatments.
Tumor markers are substances found in higher than normal amounts in a person's blood or urine when they have a specific type of cancer. Some tumor marker tests include the prostate specific antigen (PSA) test to diagnose prostate cancer or the alpha fetoprotein (AFP) level to help diagnose liver cancer or testicular cancer. By themselves, tumor markers can rarely confirm a diagnosis of cancer, but they can be helpful in monitoring response to treatment of certain types of cancers.
Genomic testing refers to new tests that are available to obtain information about the molecular characteristics of a tumor. Cancer is a disease caused by certain changes in the genes that control how our cells grow and function. Genes are made up of DNA and carry instructions for making proteins that control how our cells behave. Changes, such as mutations in the genes or an alteration in the number of genes, can cause cells to make too many proteins or cause proteins to not function properly. These proteins can cause normal cells to grow out of control and become cancerous.
Genomic testing can identify specific genetic changes in the DNA of cells that cause cancer cells to grow and multiply. By identifying the genetic changes in the DNA of your cancer cells, doctors can recommend new targeted therapies that attack the specific mutations causing your cancer to grow.
Imaging tests produce detailed images of the inside of your body, allowing doctors to detect cancer and see whether it has spread. These tests help doctors determine the size and location of the tumor, but do not provide a definite diagnosis.
This test uses electromagnetic radiation to produce images of your organs and the inside of your body. X-rays are most helpful in looking at bones or lungs.
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A computed tomography (CT) scan uses X-rays to produce a more detailed image of your body. For this test, a camera rotates around your body taking pictures, and produces cross-sectional images of your body. It allows doctors to pinpoint the exact location of the tumor and check for cancer spread.
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MRI scans use radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. This test is very useful for examining specific areas of the body, especially the soft tissues in the head and neck region.
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For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream. This substance collects in the malignant (cancerous) cells in the patient's body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of cancer in the patient's body.
A doctor injects a radioactive substance into your bloodstream and allows it to collect inside your body. The doctor then uses a machine to measure the radioactivity and take pictures of your bones and organs.
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A bone scan can show if the cancer has spread to your bones. A bone scan provides a picture of all of the bones in the body, and allows doctors to detect small areas of cancer cells not visible on standard X-Rays.
During this procedure, a transducer is placed directly on the skin. The transducer then bounces sound waves off of your internal organs in order to create echoes that form a picture. Not only can an ultrasound indicate the presence of a tumor, it can also show the tumor's shape, size, and number of tumors.
Doctors perform biopsies when diagnostic tests and imaging tests show an abnormality that might be cancer. During a biopsy, the doctor removes a tissue sample from the suspicious area and has it examined under a microscope. A biopsy is the only way to be certain if cancer is present.
Your doctor may use a needle to extract tissue samples from a suspicious area. Doctors commonly use needle biopsies on tumors that can be felt through the skin. If you can't see or feel your tumor through the skin, your doctor may use a CT scan or MRI to guide the needle to the abnormality. Here are the most common types of needle biopsy:
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A thin, hollow needle attached to a syringe is used to extract a tissue sample from a suspicious area.
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A larger needle is used to remove a small cylinder of tissue from an abnormality.
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A small incision is made and a hollow probe is inserted into the abnormal tissue. The probe sucks a cylinder of tissue in through a hole in the probe, and a rotating knife cuts the tissue. Vacuum-assisted biopsies are most commonly used to diagnose breast cancer.
In a surgical biopsy, the doctor makes an incision and removes the abnormal tissue using a surgical knife (scalpel). There are two procedures for surgical biopsies: incisional and excisional.
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The doctor removes only a part of the suspected tumor for examination. Doctors often perform incisional biopsies to diagnose soft tissue sarcomas.
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The doctor removes the entire lump or mass for examination. Doctors usually only perform excisional biopsies to remove small tumors and enlarged lymph nodes.
Doctors use skin biopsies to determine if various forms of skin cancer are present. The doctor removes a sample of skin to be examined under a microscope. There are several types of skin biopsies, depending on the type of skin cancer suspected.
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The doctor removes only the outer layers of the skin to be examined under a microscope. This technique is commonly used to diagnose basal cell and squamous cell carcinomas.
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The doctor removes a cylinder of tissue from deeper layers of skin. This technique is commonly used to diagnose melanoma and to determine how deeply it has grown.
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The doctor uses a device called an endoscope, a flexible, narrow tube with a camera and a light on the end, to examine areas inside the body. The doctor will usually pass the endoscope through your mouth, nose, rectum, urinary tract, or a small incision in your skin, depending on the part of the body he examines. The doctor can pass special instruments through the endoscope to remove tissue samples for examination.
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The doctor uses a long needle to remove a sample of bone marrow from your hip bone. Bone marrow biopsies are commonly used to diagnose cancers of the blood, such as leukemia, lymphoma, and multiple myeloma.
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Sentinel lymph node biopsies are performed during surgical resection of certain tumors to examine whether the cancer has spread to the lymph nodes. The surgeon injects a dye that drains to the first lymph nodes (sentinel lymph nodes) and then removes these sentinel nodes and examines them under a microscope to determine if they contain cancer cells. If they do not, it is unlikely that the cancer has spread beyond them to other lymph nodes.
