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Oncology

Hope beyond what we see

Oncology’s success is significantly dependent on the diagnosis and treatment of cancer. An entire array of diagnostic methods has to be applied in order to make differential diagnosis about whether a person is suffering from cancer, what kind of cancer it is, which stage it is and whether it has disseminated. Major diagnostics in oncology are:
  1. Imaging Tests
  • X-rays: Used generally for the detection of bone and other tissue abnormalities.
  • CT Scan: Computed Tomography—detailed axial images of the body determine the tumours, their extent and location.
  • MRI: Detailed pictures are formed by magnetic fields and radio waves; it is especially useful in detecting brain, spinal cord, or soft tissue tumours.
  • Ultrasound: It creates images of the organs on the inside by sound waves and can help direct a biopsy using a needle
  • Positron Emission Tomography (PET) Scan: It locates cancer through areas of high metabolic activity along with the CT scan.
  • Mammography: An X-ray specially designed to catch site cancers in breasts.

  1. Laboratory Tests
  • Blood Tests: Other than the complete blood count, there are tests for liver function and tumour markers, such as PSA for prostate cancer and CA-125 for ovarian cancer, that may indicate abnormalities which may indicate cancer.
  • Urine Tests: These reveal the cancer cells or other substances which are signs of some type of cancer.

  1. Biopsy
  • Needle Biopsy: A needle needs to be inserted to collect a small amount of tissue from the area that looks abnormal.
  • Surgical Biopsy: It is a more invasive process where a portion or the whole tumor is surgically removed.
  • Endoscopic Biopsy: Tissues are sampled through endoscopy, which is a process of introducing a thin tube with a camera into the body to reach organs like lungs, colon, or stomach.

  1. Genetic and Molecular Testing
  • Genomic Testing: The DNA content of the tumour cells is studied for some mutations to permit targeted treatment.
  • Immunohistochemistry IHC: It detects certain proteins in cancer cells to know what the type of cancer is and detects possible treatment options.
  • Flow cytometry: This technique studies the features of the cancer cells in blood or bone marrow; it is commonly used in Leukemia and Lymphoma.

  1. Cytogenetic Analysis
  • Karyotyping: It scrutinizes chromosomes of cells and structural abnormalities linked to specific types of cancers.
  • Fluorescence In Situ Hybridization (FISH): This is applied in detecting specific DNA sequences on chromosomes and thereby locating genetic changes in cancer cells.

  1. Bone Marrow Aspiration and Biopsy
  • This method entails diagnosing blood cancer, such as leukemia and lymphoma, by extracting bone marrow tissue for examination.

  1. Endoscopic Procedures
  • Colonoscopy: Imaging of colon and rectum for detection of colorectal cancer.
  • Bronchoscopy: Examines the trachea, bronchi, and lungs for lung cancer.
  • Cystoscopy: Examines the bladder for cancer in the bladder.

  1. Lumbar Puncture (Spinal Tap)
  • It is used to obtain CSF (colony-stimulating factor) to be tested for cancer cells. This can be done in cancers that are likely to spread to the CNS (central nervous system).

  1. Sentinel Lymph Node Biopsy
  • Identifies the first lymph node(s) that the cancer is likely to spread to. This is mainly used in breast cancer and melanoma.

  1. Molecular Imaging
  • SPECT: Single Photon Emission Computed Tomography: It’s like a PET (Positron emission tomography) scan but utilizes other radiotracers. It is mostly indicated for bone metastase detection.

  1. Histopathological Examination
  • This process involves assessing tissues under a microscope to determine the exact type and grade of cancer.

  1. Liquid Biopsy
  • Non-invasive test to detect DNA with cancer or cancerous cells. This new tool is becoming increasingly applied to follow-up and monitor treatment response in cancer patients.

These diagnostic tools detect the optimal treatment plan to be implemented, observe the response of the cancer patient to the therapy, and diagnose recurring cases of the disease. The decision on which diagnostic tests should be conducted is decided by the nature of the cancer, which part of the body it is located, and the patient’s overall health condition.

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