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The most important screening tool remains the medical history: the character of the complaints and any specific symptoms (fatigue, weight loss, unexplained anemia, fever of unknown origin, paraneoplastic phenomena and other signs). Sometimes a physical examination will reveal the location of a malignancy. Diagnostic methods include: Biopsy or Resection; these are methods by which suspicious neoplastic growths can be removed in part or in whole, and evaluated by a pathologist to determine malignancy Endoscopy, either upper or lower gastrointestinal, cystoscopy, bronchoscopy, or nasendoscopy; X-rays, CT scanning, MRI scanning, PET scan, ultrasound and other radiological techniques; Scintigraphy, Single Photon Emission Computed Tomography, Positron emission tomography and other methods of nuclear medicine; Blood tests, including tumor markers, which can increase the suspicion of certain types of tumors or even be pathognomonic of a particular disease, as well as complete blood counts in the cases of blood and bone cancers. Apart from diagnoses, these modalities (especially imaging by CT scanning) are often used to determine operability, i.e. whether it is surgically possible to remove a tumor in its entirety. Generally, a tissue diagnosis (from a biopsy) is considered essential for the proper identification of cancer. When this is not possible, "empirical therapy" (without an exact diagnosis) may be given, based on the available evidence (e.g. history, x-rays and scans.) Occasionally, a metastatic lump or pathological lymph node is found (typically in the neck) for which a primary tumor cannot be found. This situation is referred to as "carcinoma of unknown primary", and again, treatment is empirical based on past experience of the most likely origin. |
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