How Is Cancer Diagnosed?

Cancer is known to be a lethal disease and every year more than 10 million people die due to cancer alone on this globe. So to overcome the high rate of mortality of this deadly disease few things are extremely important. This list begins with the question “How is cancer diagnosed?”

As diagnosis is the only conformational way to know whether a person is suffering from cancer or not. The signs and symptoms are not very distinctive indicators, till the late stages of the cancer. Many cancers are also silent in nature like pancreatic cancer, ovarian cancer, lung cancer, etc. So solely depending on signs and symptoms leads to diagnosis of cancer in the last stages and in these stages mode of treatment is mostly palliative in nature rather than curative. 

Before we go into details about the treatment of cancer, let us learn “How is cancer diagnosed?” Well, the diagnosis usually begins when a doctor finds a clinical relation between the signs and symptoms (physical examination) after going through the personal history of the patient. After this a doctor may recommend a patient for a different investigative procedure,  which helps in knowing “ how to diagnose cancer”. This investigative procedure includes:

1. Laboratory tests — this include various types of blood tests, urine tests or/and other lab tests. The level of certain chemicals in these tests may indicate the probability of cancer. Cancer markers (tumor markers) are also identified through lab tests only. 

2. Imaging Tests — they are commonly known as Scans. Many people wonder “ how is cancer diagnosed?” with these imaging tests. Well, these imaging tests create a picture of the organs/ areas which helps in visualizing the internal body and seeing if there is any abnormal growth of cells called tumor or cancerous cell growth. The different type of imaging techniques used in diagnosis of cancer are

• CT Scan
• MRI
• Nuclear Scan
• Bone Scan
• PET Scan
• Ultrasound
• X-rays

3. Biopsy — Well biopsy is defined as a procedure in which the doctor removes a sample of tissue which is studied under a microscope by a Pathologist. Now obtaining biopsy sample is also crucial which can be done in following ways :

a.) With a Needle — in this method a needle is used and tissue or fluid is aspirated. This is commonly applied Bone marrow, spinal cord, breast, liver and prostate biopsies.

b.) Endoscopy — is basically a process in which we see the internal body using a thin tube fitted with a camera known as an Endoscope. Endoscope is inserted in natural openings of the human body like the mouth, nostrils (Bronchoscopy)  or anus (Colonoscopy).

c.) Surgery — surgery performed in biopsy is of two types: Excisional biopsy { in this the whole abnormal cells along with little bit of normal tissue is removed by surgery} and Incisional Biopsy {in this only a part of abnormal cell growth is removed by the surgeon}.

Biopsy may or may not need sedative application. The application of sedative can be Local, regional or general.

Suggested Read – What Is Cancer? Its Types And Causes

Types of Cancer Treatment

Well once the diagnosis is established the next step which needs to be taken care of is that of the treatment. The treatment of cancer depends on many factors like the stage of cancer, type of cancer, age, gender, other coexisting diseases, etc. The course of the treatment is decided by the physician which is based on the Biomarker testing.

Biomarker testing is also known as tumor profiling or tumor genetic testing. Biomarker testing is a very crucial part of precision medicine (personalized medicine). Precision medicine is defined as medical care in which different aspects of disease like prevention, diagnosis and treatment all are customized according to the genes, proteins and other substances present in the diseased individual. Although achieving precision medicine in every case of cancer is not a piece of cake.

Let’s now learn different types of treatment:

1. Chemotherapy — In this type of cancer treatment drugs are used to kill cancer cells. It is used in various types of cancers. It is usually combined with other treatments to get best possible results. If chemotherapy is used before a surgery to reduce the size of the tumor then it is called Neoadjuvant Chemotherapy. If it is used to destroy cancer cells post surgery or radiation therapy then it is called Adjuvant Chemotherapy.

2. Immunotherapy — This therapy is based on the immune system and it is a type of biological therapy. Biological therapy uses substances made from living organisms to treat cancer. In immune system cells there are Tumor infiltrating Lymphocytes TILs that help in fighting cancerous cells. So if a cancer patient has TILs in a tumor then he will respond better to the treatment.

3. Radiation Therapy — in this type of cancer treatment high doses of radiations are used to kill the cancer cells thus help in shrinking tumor size. Well high doses of radiation either kill the cells or damage the DNA therefore the growth of cancer cells slows down. This process can take days or weeks to show its effects.

There are two types of radiation therapy which depend on factors like: type of cancer, tumor size, tumor location/placement, patients medical history, age, which normal tissue near tumor cells is present, other existing illness and ailments, etc.

i.) External Beam Radiation Therapy: in this method an external dose of radiation is aimed at the specific part of the body to kill the cancerous cells.

ii.) Internal Radiation Therapy: in this, the radiation source is put inside the body ( solid source or liquid source). If the source is solid then it is referred as Brachytherapy and if its liquid then it is called Systemic radiation therapy.

4. Surgery — surgery as a treatment is performed when cancer has not spread. So usually surgeons remove tumors from a particular part of the body. The surgery can be an open or minimally invasive surgery.

5. Hormone Therapy — this treatment is most commonly used for treating breast and prostate cancer. It works by either slowing down the process of growth of cancer cells or may reduce symptoms.

6. Hyperthermia — this is not a widely used treatment but still when cancer cells are heated at a temperature of 113 F it kills or damages the cancer cells. For heating microwaves, radio waves, lasers, etc are used. It is applied on a small part of the body (Local Hyperthermia); large parts of the body like the leg, arm, back, etc (Regional hyperthermia) or to the whole body (Whole body hyperthermia).

Also Read – Cancer Is Dangerous And Deadly

7. Photodynamic Therapy — in this therapy the drug used is activated by a photosensitizer agent, to kill the cancer cells. The light is obtained from lasers or LEDs. It is used for a specific part of the body only, not for the whole body.

8. Stem Cell Transplant —  it’s not a direct form of treatment, in this treatment stem cells are restored that grow into blood cells which are destroyed due to chemotherapy and radiotherapy. The transplant is divided into three types: Autologous (stem cells come from the patient itself), Allogenic (stem cells come from another person) and Syngeneic (stem cells from identical twins).

Side Effects Of Cancer Treatment

The treatment of cancer is not as simple as it looks. It comes with many challenges and side effects of these treatments are one such major issue. The most common side effects are listed below:

• Anemia
• Appetite loss
• Fatigue
• Pain
• Swelling (edema)
• Hair loss (alopecia)
• Constipation / Diarrhea
• Nausea and vomiting
• Delirium
• Weight changes
• Sexual health disturbed in male and females
• Peripheral neuropathy
• Sleep problems
• Urinary and bladder issues
• Skin changes

Many more side effects are present depending on the treatment. The intensity of side effects also depends on a patient’s overall health also. Because of this, the same treatment for cancer in different people shows varied side effects. In late stages of cancer the treatments performed are more intense and rigorous depending on the type of cancer.  Sometimes in silent cases cancer treatment is started in the very last stages as the problem was diagnosed late due to absence of signs and symptoms. So in such cases the treatment is meant to provide relief to the patient rather than to achieve cure which is not possible in late stages of cancer.