To accurately diagnose cancer, the patient has to undergo a complete evaluation involving a thorough physical and history examination combined with diagnostic testing. Many tests are necessary so as to avoid misdiagnosis of another disease, infection, or if the symptoms are just mimicking cancer.

Effective diagnostic testing of cancer is used to eliminate or confirm any presence of disease, monitor the process of the disease, and plan for and evaluate the treatment’s effectiveness. It might also be necessary to repeat the testing if the sample collected was not of good quality, if the patient’s condition has changed, or there is an abnormal test result that needs to be confirmed.

Procedures for diagnosing cancer include:

• Physical exams
• Lab tests
• Imaging tests
• Biopsy

Physical Exams

A physical exam for cancer diagnosis involves the physician feeling areas of the body for lumps that may indicate cancer. During this exam, the physician might look for abnormalities such as enlargement of an organ or changes in skin color, which may be an indication of skin cancer.

Lab Tests

Low or high levels of certain chemical components in the body could be an indication of cancer. Laboratory tests of urine, blood, or other body fluids that measure these chemical components can help physicians in diagnosing cancer. The components that are measured include blood glucose, enzymes, electrolytes, lipids (fats), hormones, other metabolic substances, and proteins.

Some of the common lab tests for diagnosing cancer include:

• Blood tests
• Complete blood count (CBC)
• Urinalysis
• Tumor markers. These are substances produced by cancer cells or other body cells in response to cancer.

Imaging Tests

Imaging tests provide pictures allowing your physician to examine your internal organs and bones in a noninvasive way. Imaging tests include:

• X-ray: This uses a low dose of radiation to create pictures of inside the body.
• CT Scan: This uses an x-ray machine linked to a computer to take a variety of pictures of the internal organs and bones from different angles creating detailed 3D images.
• MRI: An MRI uses radio waves and a powerful magnet to take images of your body in slices. It can show differences between healthy and unhealthy tissue. Before an MRI a special dye known as contrast agent can sometimes be injected into your vein. The contrast agent can make tumors to be brighter in the images.
• Nuclear scan: Also known as the radionuclide scan uses radioactive material to take images of inside your body. Before the scan, you’re injected with a small amount of radioactive material also known as a tracer. It flows through the bloodstream and collects in certain organs or bones.
• Bone scans: This is a type of nuclear scan that checks for damage or abnormal areas in the bones. It is used to diagnose bone cancer or metastatic bone tumors (cancer that has spread to the bones. A small amount of radioactive material is injected into the vein. It then collects in abnormal areas in the bine as it travels through the bloodstream.
• PET scan: This is also a type of nuclear scan and it takes detailed 3D images of inside the body where glucose is taken up. Cancer cells often take up more glucose than healthy normal cells.
• Ultrasound: This uses high energy sound waves that echo off tissue inside the body and a computer uses these echoes to create images known as sonogram.

Biopsy

A biopsy involves a physician collecting a sample of cells for testing in a lab. Once collected the cells are looked at under a microscope. Normal cells are uniform, with the same sizes, and orderly organization. Cancer cells on the other hand are less orderly, with varying sizes, and have no organization.

There are different ways to obtain a sample and they include:

• Fine needle aspiration biopsy: A needle is used to withdraw fluid or tissue. This technique is especially used for spinal taps, bone marrow aspirations, and some prostrate, breast, and liver biopsies.
• Endoscopic biopsy: This involves using a thin, lighted tube known as an endoscope to examine inside the body. They go through the natural openings of the body such as the anus or mouth. If an abnormal tissue is spotted during the exam, it is removed along with some of the surrounding normal tissue via the endoscope.
• Surgery: This involves a surgeon removing an area of abnormal cells during a surgery. It might be excisional or incisional biopsy. Excisional biopsy is the entire removal of the abnormal cells and some of the normal surrounding cells. Incisional biopsy is the removal of just a part of the abnormal cells.

 Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service. From initial consultation through to final diagnosis, treatment and beyond. Our multidisciplinary team of expert doctors and nurses, and technologists led by Dr Hassan Ghazal – an American triple board-certified Consultant Medical Oncologist and a Consultant Clinical Hematologist with more than 3 decades of clinical experience, are here to offer tailored management and treatment of your condition, and to answer any questions that you may have throughout your time with us. Whatever you need us for, we’re only a phone-call away.