Diagnosing cancer is the procedures and tests that determine whether cancer is present. The diagnostic journey often begins with an unusual finding on a screening procedure, such as a MAMMOGRAM or PROSTATE SPECIFIC ANTIGEN (PSA)BLOOD test, or diagnostic procedure done for another purpose such as an X-RAY or a complete blood count (CBC). Sometimes the person identifies symptoms, such as the presence of a lump or rectal bleeding.
The initial doctor’s evaluation includes a thorough ROUTINE MEDICAL EXAMINATION with specific focus on the abnormal findings; comprehensive PERSONAL HEALTH HISTORY; and appropriate diagnostic tests, which may include any combination of blood tests, X-rays, COMPUTED TOMOGRAPHY (CT) SCAN, POSITRON EMISSION TOMOGRAPHY (PET) SCAN, MAGNETIC RESONANCE IMAGING (MRI), ULTRASOUND, and biopsy.
Biopsy provides the definitive diagnosis for cancer, giving the pathologist the opportunity to examine tissue structure and cell composition. Depending on the location, size, and characteristics of a tumor, the doctor may remove a small sample of tissue or remove the entire tumor. Common methods for sampling tumors include
- fine-needle aspiration, in which the doctor inserts a small needle into the tumor to withdraw a sample of fluid and cells
- core-needle biopsy, in which the doctor inserts a larger needle into the tumor to extract a core of solid tissue
- ENDOSCOPY, in which the doctor inserts an endoscope into the body through a natural opening to examine suspicious tissues and remove samples
- incisional biopsy, in which the surgeon removes a portion of the tumor to obtain a representative tissue sample
- excisional biopsy, in which the surgeon removes the entire tumor
The pathologist then determines, from the diagnostic tests, imaging procedures, and biopsy findings, the cancer’s stage and grade-assessments of how extensive the presence of the cancer in the body and how aggressive the growth of the cancer cells. Though most cancers fit within the standard parameters of STAGING AND GRADING OF CANCER, some do not. The doctor may then present the circumstances and diagnostic findings to a review panel of physician specialists, often called the “tumor board,” for additional input and assessment. All of these evaluations then help guide the CANCER TREATMENT OPTIONS AND DECISIONS.