Diagnosing Cancer

Symptoms

When a tumor or lump grows to a noticeable size it may be time to evaluate certain occurrences. You want to know is it pressing on nearby tissue. This is signaled through the presence of pain. It may have grown into blood vessels in the area. This may be evidenced by the presence of bleeding. You want to no if you or your physician can feel the tumor or lump. Notice if the lump has changed the way in which some of your bodily functions normally operate. Do you have trouble swallowing, which is called dysphasia? This may indicate a tumor on the esophagus. Chronic hoarseness or change in your voice may indicate a tumor in the larynx.

The American Caner Society has given us seven early warning signals that everyone should become aware of and whose acronyms signal us to take caution:

1. Change in the bowel or bladder habits.
2. A sore that does not heal.
3. Unusual bleeding or discharge.
4. Thickening or a lump in the breast or elsewhere.
5. Indigestion or difficulty in swallowing.
6. Obvious change in a wart or mole.
7. Nagging cough or hoarseness.

Physical Examination

If you have noticed anything approaching these symptoms you need to have a properly trained physician examine you. If they are not sure or have any questions they may order you to undergo certain tests that will assist them in determining the situation more accurately. Even if you do not suspect cancer, it is just good practice and healthy living to have a yearly physical examination by your family physician. Each physician will, undoubted, have their our routine in which they regularly examine each of their patients in a certain pattern or way. It is your responsibility to inform them of your concerns and request the appropriate testing. Bring to their attention anything you are concerned about or have noticed.

There are certain things that need to be examined if cancer is suspected. Even if some symptoms are slight or not as evidenced, you can request them to be looked at more closely. Request your physician to take any of these exams:

1. The nose and throat are examined. There is a quick and painless mirror examination of the larynx.
2. The lymph node areas of the body that can be felt such as the neck above the collarbone, under the arms and in the groin should be checked.
3. Specific attention is paid to the breasts in women and men and the prostate gland in men.
4. The abdomen is carefully pushed and probed to detect enlargement of any abnormal organs, especially the liver and spleen.
5. Examination of the pelvic area in women. This should include a Pap smear, which is helpful in detecting cancers of the cervix, uterus and ovaries.
6. A probing of the rectum of both men and women is an essential part of the physical examination

The physician should ask you questions about the functions of your body. You may need to ask them your own set of questions as well. Don’t be shy not to ask questions of your own. It may help to clear your mind and handle confusions and shed light on what may be bothering you. It is essential for you to become as informed as possible about your body.

There are some self-examining techniques that you may need to become familiar with depending on which sex you are and which kind of cancer you are looking to become more aware of. These techniques may assist in early diagnosis and may save lives:

Breast Cancer Self-test

It is important to examine your breasts each month. For women this should be at the same time each month of your menstrual cycle yet not during your menstrual cycle. This is simple procedure. First while looking into a mirror so that you can both breasts, raise your hands over your head and press them together. Note the shape of your breasts. Place your hands on your hips and apply pressure. You are looking for any dimpling of the skin, nipples that may seem to be out of alignment horizontally, one breast that seems different than the other. Or any thickening skin which may look red and scaly on the breasts or nipples.

With your hands still raised begin to inspect your breasts one at a time with your hand. Firmly feel around to see if you detect any lumps or hard masses around the breast, armpit or nipple. You are looking for any lymph nodes that may be swollen or sore. Note any kinds of discomfort or pain. The cancer in these areas can lie beneath skin or mussel tissue so you need to examine every area. When you have finished with one breast examine the other just as thoroughly.

Next lie down and examine your self in the same way as you did before note any shifts or changes as well. Lumps that were not detectable before may show up now. Squeeze each nipple to see if you have any discharge either blood, watery yellow or pick in color.

If you find anything, report this to your doctor immediately and have a formal test completed. Early detection is very important. So make sure you complete this on a regular basis.

Colon Cancer Self-test

There is a test kit you can purchase at most drug stores for detecting blood in the stool. Blood in your stool can be an early warning sign of colon cancer. Some tests are simple and include placing a piece of chemically treated paper into your toilet after a bowel movement. If the paper turns blue it is indicating that you have blood in your stool.

Should your test results show that you have blood in your stool, have your physician examine you immediately. The presence of blood does not necessarily mean that you have cancer. There are other reasons for testing positive; these may include having hemorrhoids or diverticulitis, polyps, ulcers or having an inflamed colon. Consuming too much red meat while having any of these conditions can cause rectal bleeding. Statistics show that about 10 out of 100 tested, actually may have cancer.

Testicular Cancer Self-test

With your fingers use both hands and gently roll each testicle between your thumb and the other fingers. You are checking to notice any hard lumps or nodules. If you find any that you suspect show them to your physician. It is best to perform this test after a hot shower or bath when the scrum is more relaxed. Early detection is important.

The best chance to diagnose cancer early enough for proper and accurate treatment depends upon the person suspecting these symptoms to be thoughtful, perceptive and aware that something new has happened to his or her body. This is especially in regards to the appearance of one of these symptoms.

Skin Cancer Self-test

Examine your arms and legs on a regular basis. You are looking for any tumor or lumps under the skin. Bring these to your physicians attention, note anything resembling a wart or an ulceration that does not seem to heal, moles that change color or size, flat sores lesions that look like moles. If you have a number of moles or growths make a body chart and plot the progress of each one. You want to catch any suspected problems early enough for proper treatment.

Men need to examine their own thighs and legs for any of these possible skin formations. There is a very high incidence of men with skin growths that go undetected and not treated. Some of these can and often are cancerous. Become aware of any changes on shape, size or color.

Just beyond this, if you have any suspicions of these upon the back side of your body that you can not readily examine yourself or see, have a friend or relative describe it to you and by all means bring them to your physician’s attention and have them examine them as well. Early detection once again is critical in some cases.

Blood Tests

There are two basic blood testing procedures that help in the diagnosis of cancer. There are non-specific tests; these indicate illness or disease but can not specify which one. With these no specific diagnosis can be made; they merely help to pin point areas for further testing. These are the general non-specific tests and the areas they examine:

Alkaline Phosphate	elevated in bone and liver disease
SGOT and SGPT	elevated if there is liver damage
Bilirubin	elevated in liver disease, especially with bile obstruction
LDH	elevated in many diseases, including cancer
Uric acid	elevated in gout, cancers of the blood and lymph nodes and after cancer treatment
Creatinine and BUN	elevated in kidney disease
Calcium	elevated in cancer that has spread to the bone, with tumors that produce parathyroid hormone-like protein and in multiple myeloma, as well as in some non-malignant diseases
Electrolytes	These levels are useful in metabolic endocrine disease and for monitoring both nutritional status and the effects of treatment. These will include elevated levels of sodium, potassium, carbine dioxide and chloride
Amylase	used to assess pancreatic disease

Then there are specific tests. These test for elements that may produce tumors. For example, one such chemical that is called a tumor marker is carcinoembryonic antigen (CEA).

There are often tests for several kinds at once. Not all cancers produce these markers. A physician who strongly suspects one of these will order the following tests:

CEA	elevated in cancers of the colon, rectum, lung, breast and pancreas
CA-125	elevated in cancers of the ovary and uterus
CA-19-9	elevated in cancers of the colon, pancreas, stomach and liver
CA-15-3	elevated in breast cancer
Alpha fatoprotein (AFP)	elevated in primary liver cancer and some cancers of the testis
Human chorionic gonadotropin (HCG)	elevated in some cancers of the testis and ovary and some lung cancers. It is also elevated during pregnancy
Prostatic acid phosphatase (PAP)	markedly elevated in some cases of prostate cancer
Prostate specific antigen (PSA)	helpful in diagnosing prostate cancer, especially in detecting recurrent disease
Serum protein electrophoresis	abnormal gamma globulin (monoclonal “spike”) is found in multiple myeloma
Serum protein immunelectrophoresis (lgG, lgA, lgM)	Similar to the previous serum except it can classify the type of abnormal gamma globulin present

Tests of Fluids and Stool

The human body produces urine and stool that can reveal clues about disease. There are also other fluids that can be analyzed to detect cancer cells.

A urinalysis is part of a good checkup. In the presence of cancer, too many red blood cells may indicate bleeding, and possibly a tumor. This may be due to some other cause; if tumor cells are found, other tests will be requested.

A physical or x-ray examination may reveal the presence of fluid in the chest cavity, abdomen or joints. A needle can be inserted into these areas and fluid drawn out for examination. Request that there is a search for possible cancerous cells as well.

A lumbar puncture, also known as a spinal tap, is a special procedure to remove a small amount of fluid from the spinal canal. It involves the insertion of a needle between the vertebrae, after you’ve been given a local anesthetic. Tests can identify any infection or cancer.

Blood found in the stool is often caused by hemorrhoids, but a benign or pre-malignant tumor called a polyp may be present. There may also be cancer cells and a hidden cancer is always a possibility.

Imaging Techniques

In the case of most kinds of cancer, if there are symptoms, a doctor may order an imaging scan or even a series of scans that will enable them to pinpoint specifics about your condition. Often surgery is required during some of these procedures in order to obtain samples which can determine if there is a tumor or any cancerous tissues and/or cells. This will also assist in finding out what type of tumor may be present to allow a more accurate diagnosis and treatment.

X-rays

This technique involves passing a small amount of electromagnetic radiation through a specific area of the body and onto film. This produces a two-dimensional picture of the structures inside the body. A fluoroscope might also be used. This lets the physician see a continuous, moving image. In this procedure, the x-ray beam strikes a small florescent screen and the image is amplified through a video system.

Nuclear Scans

            Radioactive isotopes that emit gamma rays can produce an image on photographic film

           or on a scintillation detector. Some of these isotopes are generally given by injection.

           They are organ specific, meaning they are concentrated in that portion of the body

           suspected of possessing cancer cells or tissue. The scan will show spots or areas that

           may indicate cancer cells or a tumor.

Angiography:

            This is a very useful way to study the blood vessels in a specific area of the body. This

            includes taking an x-ray picture of blood vessels by injecting a radio-opaque agent into

            the blood vessels being examined. From this an angiogram may be taken to determine a

            tumor’s blood supply before surgery, to place a catheter or infusion pump or to

            determine the site for other intra-arterial procedures.

Computerized tomography (CT) Scans:

            The CT machine scans the area being investigated such as the chest, brain, abdomen or

            other body area, by taking x-rays of one thin layer of tissue after another. A computer

            puts the images together to a cross-section of the area. Total body scans are also given.

           The x-rays used or more powerful then those of ordinary x-rays.

Magnetic Resonance Imaging (MRI):

            An MRI scan can complement or even supplement a CT scan. The MRI does not involve

           x-rays. It is a scanner using a powerful magnetic field to make certain particles in the

           body vibrate. Very sophisticated computers measure the reaction and produces the

           image. An MRI is not suitable for implanted devices such as pacemakers, clip on pumps.

           They can be affected by the strong magnetic field.

Ultrasound:

            Involves spreading a thin coat of jelly over a particular area of the skin, then bouncing

            high-frequency sound waves through the skin into the internal organs. It works on the

            principle as the sonar used by the navy. The sound bounces back and is analyzed. It can

            detect various kinds of tumors or even gall stones.

Endoscopy:

            These are used in various ways and consist of flexible fiber-optic telescopes on the end

           of soft tubing. The fibers and tubing are inserted into the throat or anal area or through

           injection to view a part of the internal area of the body. In this way the physician can

           view first hand what is happening. This can be monitored or recorded for future

           reference.

Cytological Studies

Cytology is the study of cells. In relation to cancer this means to examine the cellar material removed from the body. This can be perform ed through natural means such as phlegm that is coughed up or by scrapping cells from the area or organs suspected of cancer. These cells are then stained with dye and examined under a microscope to see what pattern of cell growth is present. A pathologist will also examine the slides and either diagnoses cancer or reports a strong suspicion of cancer if these are present.

Bone Marrow Analysis

The procedure is simple and brief. It can be done in a doctor’s office using a local anesthetic. A needle is inserted into the breastbone or the pelvic bone, both of which are just under the skin and easily accessed. A small amount of fluid bone marrow is drawn into the syringe. This is then examined under a slide in a microscope for evidence of leukemia, lymphoma or any other cancer cells.

Biopsies

This is where the physician attempts to find some of the cells of the suspected tissue that is thought to possible be cancer. There are two types of Biopsies. One an incisional biopsy, which involves cutting into a portion of the tumor, then stitching the area closed. The other is an excisional biopsy, which involves removing the entire tumor. Then there are needles that can be inserted into the suspected tissue and have cells extracted. One is called a fine needle aspiration where a syringe is inserted into the suspected area to extract cell samples. The other is called a cutting needle or core biopsy. This is where a very small part of the suspected tissue is cut away by the needle and extracted from the body. Both offer tissue or cell samples to examine under a microscope for cancer cells or tissue.