What is a Cancer Diagnosis?

Detecting cancer is different then diagnosing cancer. If a doctor or patient notices symptoms or abnormalities, such as a lump or growth, these can be used to detect cancer. However after being detected, the cancer must still be diagnosed.

Diagnosis is the process of identifying the type of cancer.A diagnosis is made by investigating the signs and symptoms to find if they are caused by cancer and if so what kind of cancer it is. This is done using a variety of tests. For example, if a patient notices a lump they may detect breast cancer. The cancer must still be evaluated carefully using a variety of tests to diagnose it accurately. The diagnosis will describe what kind of breast cancer the patient has (i.e. if it starts in the breast ducts it is “ductal”. If it starts in the lobes it is “lobular”). It will also find how advanced the cancer is.

What is a Cancer Stage?

After diagnosing a cancer, the next step is to accurately show what stage the cancer is in. Stages are used to describe the spread of cancer. Cancers such as leukemia cannot be staged. Different stages of cancer may use different treatment. You need to know the stage of your cancer so you and your healthcare team can rate and discuss your treatment options.

There are many staging systems, although the most common is TNM . “T” refers to the tumor size. “N” refers to the number of lymph nodes. “M” refers to metastasis. TNM uses these three aspects to measure the extent of the disease and assign a stage, usually between 0-4. Usually, the lower the stage, the better the treatment prognosis (outcome).

• Stage 0 – pre cancer

• Stage 1 – a small cancer that is only found in the organ where it originated

• Stage 2 – a larger cancer,which may also have spread into the lymph nodes

• Stage 3 – a larger cancer, which has also spread into the lymph nodes

• Stage 4 – a cancer, which has spread into a different organ from where it originated

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How is Prognosis Determined?

Prognosis refers to the probable course the cancer will take and the likely outcome. There are factors which can be identified to decide if a prognosis is better or worse. Identifying these factors can help you and your doctor better plan your treatment. Many factors help decide your prognosis, including:

• Patient’s physical fitness

• Patient’s age

• The stage of the cancer

• The size of the cancer

• The size of the cancer

• How aggressive your cancer is (cancer cells that grow and divide quickly are considered to be more aggressive)

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Your doctor will decide your prognosis by evaluating all the possible factors.

Recently it has been recognized, that a cancers genetic makeup is an important factor in determining prognosis. For example, there are genes, which are associated with a tendency to recur or an aggressive course. Identifying these genes in a cancers early stage could be an sign of a poor prognosis. Some research has even suggested that a cancer’s genetic makeup could be more important than the cancer’s stage when it comes to determining prognosis.

How is Cancer Diagnosed?

Cancer is diagnosed using various tests, which provide information about abnormal cells. These cells may have been detected during self-examination, medical examination, or through reported symptoms. In Order to find if the cells are non-cancerous (non-malignant) or cancerous malignant, more information must be gathered about the cells. If the cancer cells are malignant, this information will be used to find how serious (aggressive) theses particular cells are. The growth and spread of aggressive cancers is more rapid than less-aggressive cancers which are referred to as “indolent”. There are many types of tests that are designed specifically to test cancer:

• A pathology report is based on observation of abnormal cells under a microscope.

• Diagnostic imaging involves visualization of abnormal masses using high tech machines that create images, such as x-rays, computed tomography (CT), positron emission test (PET), magnetic resonance imaging (MRI), and joined PET/CT.

• Blood tests measure substances in the blood that may show how advanced the cancer is or other problems related to the cancer.

• Tumor marker tests detect substances in blood, urine, or other tissues that occur in higher than normal levels with certain cancers.

• Special laboratory evaluation of DNA involves the identification of the genetic make-up—the DNA—of the abnormal cells.

How Does Diagnosis Determine Treatment?

Historically, the type and stage of cancer has been identified using a combination of diagnostic imaging and pathological assessment(laboratory evaluation that uses a microscope). This then determines the treatment. The stage identifies how much the cancer has spread and how extensive it is. Usually staging involves determining what size the primary tumor is and evaluating whether it has remained in the tissue where it started. Staging also determines if the cancer has invaded other nearby tissues or organs, and if the cancer has spread to other distant areas of the body. There is a predetermined scale that uses numbers and letters to name the stage, such as stage I, II, IIIa, IIIb, IV, etc. Higher letter and number combinations show a more extensive spread, which means the condition is more serious. The disease stage is often used to select the treatment. Very aggressive treatment is often used higher stage cancers, while lower stage cancers typically receive less aggressive treatment.

However, there is research indicating that determining how aggressive a cancer is by identifying its stage may not be the most accurate technique. For example, there are late stage cancers that may stay in remission and some early stage cancers that may progress or even recur after treatment. The findings show that the chance of a certain cancer progressing and/or recurring may be better indicated using factors other than the cancers spread at diagnosis or how it when viewed under a microscope.

The study of humans entire genetic material, which is called genomics, provides tools which are invaluable for identifying a cancers genetic components. The human genome consists of 30,000 to 70,000 genes. The groundwork for understanding the role genes play in our health and in our disease was laid by mapping the human genome. Although cancer includes many different types of diseases, all cancers share a similar aspect: damage to DNA that results in the uncontrolled growth of cells. We may gain valuable prognostic information by identifying involved in each cancers capacity to spread and grow.

The genetic makeup of cancers may be able to better predict the outcome and aggressiveness of a cancer as special laboratory techniques are improved. They may become better predictors than the cancers stage which in the past has been the choice for diagnostic indicator. It is likely that genetic information will play a larger role in directing treatment. To be specific, the genes involved with each cancer could show if the treatment used should be a more aggressive one or a less aggressive one.