Prevention and Diagnosis

• If you have a symptom or your screening test result suggests cancer, the doctor must find out whether it is due to cancer or some other cause. Along with your personal and family medical history the doctor also may order laboratory tests, scans, or other procedures. Lab tests are an important tool to help the doctors come to a final diagnosis and appropriate treatment protocol.
• Imaging Procedures: Imaging procedures create pictures of areas inside your body that help the doctor see whether a tumour is present. These pictures can be made in several ways:
  • X-rays: X-rays use low doses of radiation to create pictures of the inside of your body.
  • Ultrasound: An ultrasound device sends out sound waves that people cannot hear. The waves bounce off tissues inside your body like an echo. A computer uses these echoes to create a picture of areas inside your body. This picture is called a sonogram.
  • CT Scan An x-ray machine linked to a computer takes a series of detailed pictures of your organs. You may receive a dye or other contrast material to highlight areas inside the body. Contrast material helps make these pictures easier to read.
  • MRI: A strong magnet linked to a computer is used to make detailed pictures of areas in your body. Your doctor can view these pictures on a monitor and print them on film.
  • Nuclear Scan: For this scan, you receive an injection of a small amount of radioactive material, which is sometimes called a tracer. It flows through your bloodstream and collects in certain bones or organs. A machine called a scanner detects and measures the radioactivity. The scanner creates pictures of bones or organs on a computer screen or on film.
  • PET Scan: For this scan, you receive an injection of a tracer. Then, a machine makes 3-D pictures that show where the tracer collects in the body. These scans show how organs and tissues are working.
  • Biopsy: In most cases, doctors need to do a biopsy to confirm a diagnosis of cancer. A biopsy is a procedure in which the doctor removes a sample of tissue. A pathologist then looks at the tissue under a microscope to see if it is cancer. The sample may be removed in several ways:
    • With a needle: (FNAC – Fine Needle Aspiration Cytology) The doctor uses a needle to withdraw tissue or fluid.
    • With an endoscope: The doctor looks at areas inside the body using a thin, lighted tube called an endoscope. The scope is inserted through a natural opening, such as the mouth. Then, the doctor uses a special tool to remove tissue or cells through the tube.
    • With surgery: Surgery may be excisional or incisional.
      • In an excisional biopsy, the surgeon removes the entire tumor. Often some of the normal tissue around the tumor also is removed to create clear margins.
      • In an incisional biopsy, the surgeon removes just part of the tumor.

About 1 – 3% of patients develop a second cancer different from the original one, called a second primary. However, a cancer can reappear at any time during survivorship, the most common time being from five to nine years after completion of treatment. This makes it very important for cancer survivors to maintain good follow-up health care. Lifetime monitoring by health care providers who are knowledgeable about survivorship care is recommended.

• Some of the factors that affect prognosis include:
• The type of cancer and where it is in your body
  • The stage of the cancer, which refers to the size of the cancer and if it has spread to other parts of your body
  • The cancer’s grade, which refers to how aggressive the cancer cells look under a microscope. Grade provides clues about how quickly the cancer is likely to grow and spread.
  • The patients age and how healthy they were before cancer. How you respond to treatment.