Cancer diagnosis: tests, methods, examinations
In vain the skeptics say that in our country, and around the world, the malignancy hidden in the depths of the body, cannot be cured. Diagnosis of cancer and other oncological processes conducted at a nascent stage of the tumor, the vast majority of cases provides a 100% treatment effect. Significant progress also can be achieved when the tumor takes place, but have not spread through the lymph vessels or bloodstream to distant organs. In short, not all that bad if you know not to forget about the existence of methods of early diagnosis of cancer.
The first signals
Periodic annual (or 2 times per year) preventive examinations in addition to tolerance to a particular work, provide for detection of occult disease to ensure a timely start of therapy. The cancer fall into this category, because it is in the initial stages, as a rule, does not manifest itself. No symptoms, a person continues to consider himself healthy, and then, like a bolt from the blue, receives a cancer diagnosis. To avoid such hassles in the list of mandatory tests (General analysis of blood and urine, biochemistry, ECG, chest x-ray) for certain categories of people (gender, age, predisposition, occupational hazard) included additional studies that detect cancer in the early stages of its development:
- Special tests for cancer (tumor markers);
- Gynecological examination and smear for cytological examination (cervical cancer);
- Mammography (breast cancer);
- EGD fibrogastroduodenoscopy with biopsy (cancer of the stomach, 12 duodenal ulcer);
- Computed tomography (CT), multislice computed tomography (MSCT);
- Magnetic resonance imaging (MRI).
However, we can say that the expansion of the survey methods on cancer reduces the importance of the traditional diagnostic measures or eliminate them altogether. Everyone knows that General blood count (KLA), though not belong to the specific tests that often first begins to indicate the wrong behavior of the cells of the body.
Common blood changes little in cancer of various localizations. However, some indicators still suggest a doctor at the thought of the body hidden neoplastic process even in the early stages of the disease:
In cases of malignant diseases of blood (leukemia) a General analysis will be the first and main marker. The need for rapid initiation of treatment of the disease, which the people erroneously referred to as blood cancer (leukemia less), provide some indicators of peripheral blood:
- Huge or unacceptably low number of individual elements;
- Exit to the periphery, young forms;
- The change in percentage and absolute values of cells leukocyte levels (the shift formula);
- The decrease in hemoglobin level;
- ESR acceleration.
In some cases, able to detect cancer and urinalysis, however, this applies to tumours of certain localizations (kidney, bladder, ureters). In the urine, hematuria (presence of blood), which may be insignificant, and the presence of atypical cells in the sediment. This pattern requires explanation, what is the cytological examination of urine.
To suspect or even to identify cancer is sometimes possible by biochemical analysis of blood:
Thus, the diagnosis of cancer may begin in some special examination, and the usual analyses that each of us takes during the annual preventive examination.
When targeted screening for cancer, the approach is usually more stringent. Traditional laboratory and instrumental methods of diagnosis are shifted to second place, conceding superiority to the tests that detects cancer.
A blood test that detects cancer
To identify cancer with a special laboratory tests, called analysis tests for tumor markers. Exam, when the doctor doubt creeps in against the flawless health of the patient, as well as prophylactically in the presence of hereditary predisposition to cancer or other risk factors. Tumor markers are antigens that are at the origin of the cancer of the hearth are beginning to be produced by tumor cells, so their blood increases significantly. A brief list of common tumor markers that detect cancer of different localization:
- AFP (alpha-fetoprotein) – the «old» marker, as it was open in the middle of last century, capable of detecting hepatocellular carcinoma, tumors of the stomach and intestines;
- REA (removeability antigen) is very common in gynecological practice, helps to find cancer of the uterus, ovary, breast;
- CA-125 is the main purpose of this test is to find early ovarian cancer, although we can not say that it is completely «indifferent» to other organs (liver, lungs, Breasts, intestines);
- SA-15-3 – this indicator mainly serves to identify breast cancer, but simultaneously determines the presence of tumors in the ovaries, the pancreas, the intestines;
- CA-19-9. The remit of this analysis is not limited to finding pancreatic cancer. With the development of tumor in any organ of the gastrointestinal tract (GIT) the marker level will begin to rise constantly.
- CA-242 is a task similar to the CA-19-9, but because of its high sensitivity cancer of the stomach and intestines it identifies at the earliest stages of development;
- PSA (prostate specific antigen) is a marker of various changes of the prostate tissue (prostate). This is the main analysis for men looking for the cause of the unpleasant symptoms of elderly age.
Thus, it is best Oncology shows the analysis for tumor markers, but we should not think that the number of laboratory tests limited to the above antigens, it is much more possible they are more sensitive but also more expensive, they are made in specialized laboratories and, in addition, is used for monitoring the course of treatment. Here are the most famous tests, information about other blood tests that can determine cancer, can be found on our website in the article about a specific type of tumor.
The study of cells and tissues
Cytological diagnosis is a study of the cellular composition of different tissues and biological liquids of an organism.
To this end, the material intended for study is placed on a glass slide, so called smear, dried, and then stained by Romanovsky-Giemsa or Papanicolaou. For studies in immersion oil, the drug should be dry, so the glass after painting again dried and viewed under a microscope at low and high magnification. Such an analysis allows us to detect oncologic processes, localized in many organs:
Similar, but still different from the method of Cytology — histology. Take pieces of tissue involves a pathomorphological study. Most often, it definitively establishes a diagnosis and differencial tumor. However, if cytological analysis is ready on the day of sampling and can be used for screening, histology this is not happening. Preparation of the histological preparation process is quite time-consuming, requiring the use of specific equipment.
Quite informative in this respect the study considered the immunohistochemistry, which in recent years increasingly complements the traditional methods of diagnosis of cancer. For immunohistochemical analyses, almost nothing is impossible, they are able to identify different types of low — and undifferentiated tumours. Unfortunately, laboratory facilities for immunohistochemistry are quite expensive, so not every medical facility can afford such a luxury. While only individual cancer centres and hospitals located usually in large cities of the Russian Federation.
Tools and high-tech equipment
Modern diagnostic techniques allow us to look inside the human body and see a tumor in seemingly impossible places, however, the existence of a variety of diagnostic methods the procedure is painless, non-invasive and harmless, and those that require training are not only desirable body, but the psyche of the patient. Any penetration in the body can be accompanied by unpleasant sensations, which the patient is heard, so it is already pre-starts to be afraid of.
However, this will not help, I suppose, but that fear was premature and unnecessary, to be acquainted with the main methods used to diagnose cancer:
- X-ray methods. Often used to diagnose x-rays, as it allows us to see pathology in real time, not in the picture as the x-rays, which is more suitable for screening. However, such methods as x-ray mammography used to detect breast cancer, and R-graphy of the stomach (barium) are among the best in the first stage of diagnostic search. The x-ray method — computed tomography (CT) for the detection of cancer is often used with contrast, which gives the opportunity to clearly contribute neoplasm. The procedure of KT does not deliver unpleasant surprises, moreover, modern equipment MSCT (multislice computed tomography) not only matches the most informative to date method – MRI, but also has a number of advantages, for example, for fat patients. The movement of the x-ray tube for spiral CT can significantly speed up the research, reducing radiation exposure, and the minimum size of detectable tumors — 2-3 mm.
- Widespread, many patients favorite, absolutely painless, does not cause negative emotions ultrasound. Unpleasant memories ultrasound can cause only women who have had abdominal or transvaginal examination of organs of small pelvis, or in men, faced with the study of the state of prostate rectal sensor. Full bladder in the first case, and a viewing of the prostate through the rectum in the second do not give the opportunity to focus on something other than the ongoing manipulation.
- Endoscopic methods (laparoscopy, cystoscopy, laryngoscopy, hysteroscopy, fibrogastroduodenoscopy, etc.), implemented using special optical devices, allowing a doctor to examine pathological changes in almost any organ. In addition, these methods are able to perform not only diagnostic functions, it is no secret that many tumors in the first stage of its development, localized in the abdominal cavity, remarkably removed endoscopic access. However, it should be noted that endoscopic diagnosis almost always has a sequel in the form of histological analysis. Taken during the procedure, pieces of suspicious tissue (biopsy) is sent for preparation of the drug, which is viewed by a pathologist (a pathologist). The doctor makes a final diagnosis of cancer or not to cancer the human body.
- Magnetic resonance imaging (MRI) is harmless and painless, one negative for some segments of the population terribly expensive, moreover, does not belong to the mandatory equipment of small hospitals. To pass this examination to the patient at least need to go to the regional center. Some difficulties in MRI can occur in individuals with excess weight or fear of enclosed space.
Separate localization of cancer is a separate search
Screening for cancer should be comprehensive, but it does not mean that the patient will visit haphazard all the rooms in a row. Different neoplastic processes involve specific methods of diagnosis, that is, each search is performed using tests that detect specific cancer localization. To the reader it was more clear, here are a few examples.
Diagnosis of tumours, which differ by fast growth and early metastasis is always difficult. And after lung cancer it is this category of malignancy and is, therefore, an annual chest x-rays do not always keep pace with the development of the tumor. Cancer of this localization at the initial stage are only a small proportion of patients, while stage 3-4 is more than half of the identified tumors. However, given the leading position of lung cancer prevalence and mortality, we are searching for new methods of diagnosis and actively used old:
Definition of risk groups (gender, habits, occupational hazard, history – the presence of cancer in close relatives);
Most methods of studying lung x – ray, which, unfortunately, define cancer, when already showing symptoms, and it is 3 or even stage 4.
Breast cancer often affect women after 40, so no wonder in many countries, an annual mammogram is one of the mandatory examinations for cancer. In addition, radiographic method, with the aim not to miss a neoplastic process use other diagnostic methods, such as:
- Cancer show tumor marker CA-15-3 and levels of certain hormones (estrogen);
- Regular ultrasonic inspection (USI) a breast cancer helps to detect the tumor at an early stage;
- Conducted in a timely puncture with cytological examination in many cases allows not only to identify cancer, but also keep the body;
Diagnostic search, you can attract ductography with contrast;
- Histological analysis was present in all cases after receiving the piece of affected tissue;
- Sometimes early diagnosis of cancer is not without such popular methods as CT and MRI;
- In large cancer centers use the latest achievements of molecular genetics (the definition of mutant genes responsible for the development of breast cancer).
Many for prevention of breast cancer can make the consciousness and responsibility of the woman, which is literally at school are taught to monitor their health, to carry out self-examination and do not postpone visit to the doctor in case of detection of suspicious tumors in the gland.
Often the idea of the presence of tumor in the digestive tract induces ultrasonic examination of the abdominal cavity, on the basis of which the diagnosis is in question (lesion + fluid in the abdominal cavity). To clarify the picture and not to miss gastric cancer patient is assigned:
Fibrogastroduodenoscopy (EGD) with biopsy (size, growth form, location, morphological features of the tumor, if there is one). By the way, esophagogastroduodenoscopy reveals lesions not only of the gastric mucosa and 12 duodenal ulcer. In addition, sent to the histology of biopsy material in any case is investigated in relation to H. pylori infection is associated with neoplastic processes localized in this zone. In short, a patient with Helicobacter pylori, may not be fully calm my stomach in the future, even if at the moment the signs of a tumor are absent. Preventive treatment aimed at the elimination of infection will help prevent an unpleasant surprise.
If you have a suspicion that the malignant tumor affected intestine, and stomach cancer, the patient initially propose:
- To pass a stool occult blood test and blood tests for tumor markers (CA-19-9);
- To explore the abdominal cavity by ultrasound (ultrasound);
- Undergo radiographic screening for cancer (with barium contrast).
Depending on the order in which the intestine may be localized swelling, are assigned to other instrumental methods:
Barium enema is able to learn a lot about the large intestine: its length, the topography, elasticity, tumor development in the colon;
Early diagnosis of pancreatic cancer is always difficult. Characteristic scarce symptoms (sometimes abdominal pain, some weight loss, change in color of skin) that people usually attribute to the manifestations of the violation of the diet. Laboratory parameters (Alt, AST, bilirubin, alkaline phosphatase, amylase) change is not so much to think about the worst, and tumor marker (CA-19-9) at the first stage will not respond. Besides, not all people pass biochemical tests regularly, so in most cases, pancreatic cancer is detected when it is identifying does not cause difficulties.
Passed patient tests (ultrasound, CT, MRI, positron emission tomography (PET), based on the introduction into a vein of a radioactive glucose, which will react the tumor cells) does not give grounds to establish the diagnosis «cancer» for this assertion it is necessary to get some number of hard-to-reach tissue. Typically, this task is performed by other methods:
- Percutaneous fine-needle aspiration biopsy of the pancreas under ultrasound control;
Pankreatikographie endoscopic retrograde (ERCP) – the introduction of the optical tube into the lumen of duodenum 12, which will see the tumor and take tissue analysis;
- Endoscopic ultrasound (introduction of the ultrasonic sensor into the small intestine at the level of the pancreas and sampling of biopsy material);
- Laparoscopy is the most informative, but is associated with certain risks, it is still surgery, however small. Laparoscopically selected pieces of fabric in all the right places, and, in addition, examines the state of other abdominal organs and, in case of an oncological process, define the degree of prevalence of the tumor.
Liver cancer does not relate to common types of neoplasias that require screening. However, given the excessive enthusiasm of some segments of the population of alcohol and the prevalence of hepatitis (especially dangerous the hepatitis C virus), contributing to the development of primary hepatocellular carcinoma, the early diagnosis of this pathology should say a few words.
People with risk of developing the cancer process in the liver parenchyma must be alert and periodically on its own initiative to pass a minimum amount of research:
These methods will help to detect the tumor in the liver, but did not establish the degree of malignancy. A similar problem can be solved only by percutaneous fine-needle liver biopsy – procedure, coupled with a certain risk, after all, is deposited in the liver, the blood, and damage to the vessels could face massive bleeding.
Uterus and ovaries
Methods of diagnosing tumoral diseases of female genital sphere, perhaps the most famous of all:
- Gynecological examination in the mirrors;
- Cytological examination;
- Ultrasound diagnosis of abdominal and vaginal sensor;
- Separate diagnostic curettage with subsequent histological analysis;
- Aspiration biopsy of the uterine cavity (Cytology + histology);
- Colposcopy (cervical cancer);
- Hysteroscopy for the diagnosis of cervical cancer (suspected neoplastic process, localized in the cervix, this study is contraindicated).
Compared to the diagnosis of cancer of the uterus, the search ovarian tumors raises difficulties, especially in the early stages of the disease or in the case of metastatic lesions. Algorithm for the diagnosis of ovarian cancer consists of the following activities:
In the diagnosis of ovarian cancer can include such methods, which would seem to relate to the brand of other organs:
- Abdominal ultrasound, breast, thyroid;
- Gastroscopy, barium enema;
- R-scopy of the chest.
Such extension of the survey due to the finding of metastases of ovarian cancer.
Clinically at stage 1-2 prostate cancer is not particularly evident. Often makes men think about age and statistics showing a high prevalence of neoplasia in this localization. Diagnostic search usually starts screening studies:
A blood test for the tumor marker prostate specific antigen (PSA, PSA);
If there is a reason the patient is prescribed a special diagnostic procedure:
- Transrectal ultrasound examination (true’s) or, better yet, true’s with color Doppler mapping;
- Multifocal needle biopsy is the most reliable method of diagnosis of prostate cancer to date.
Diagnosis of kidney cancer usually begins with conventional lab tests. At the first stage of the search Oncology shows General analysis of blood: increased erythrocyte sedimentation rate, hemoglobin and number of erythrocytes (due to increased erythropoietin production) and urinalysis (presence of blood and atypical cells in the sediment). Do not stay aside and biochemical parameters: the concentration of calcium and transaminases, which are particularly sensitive, not only concerning liver tumors, but also quickly react to tumors in other parenchymatous organs.
Considerable importance in determining the presence of tumor in the kidney are:
In the diagnosis of kidney cancer there is no hope for tumor markers. However, sometimes pass CEA, but it does not matter in this regard.
We may not remember all the methods of diagnosis of cancer of different localization and detail about them, because each facility has its own Arsenal of equipment and a staff of experts, moreover, it is not always necessary to resort to expensive procedures such as MRI. So much to show the General tests, biochemical tests, x-rays, designated for preventive purposes. Early diagnosis in most cases depends on the person, his relationship to their health. Should not irritated if on any visit, the doctor will require the results of fluorography or data of a pelvic exam, he’s just trying to remind you that our health is in our hands.