When a relative is diagnosed with a disease called cancer it’s a tough thing to accept. Most of my patients during their first visit come very confused about the diagnosis and they usually have many questions. I thought of writing this to guide my readers about the diagnosis of Cancer.

What is Cancer?

As we had read in biology the cell divides and that’s how a organ is formed. During the course of our life the cells divide and new cells are formed, at the same time the old cells die and are also removed from our body. The cell division is controlled by many mechanisms but when the control mechanism fells the cells divide in geometric progression. In the process the bulk of cells increase and is called as cancer. They are also notorious to spread to other parts of the body by direct invasion, blood and lymph.

As said by one of my teacher, cancer is not a single disease but it’s a group of diseases as it can affect any part of the body and every cancer has different characteristics, pathogenesis, prognosis and treatment.  There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start.

Cancer types can be grouped into broader categories. The main categories of cancer include:

• Carcinoma – cancer that begins in the skin or in tissues that line or cover internal organs.
• Sarcoma – cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
• Leukemia – cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
• Lymphoma and myeloma – cancers that begin in the cells of the immune system( Lymphoid cells and plasma calls).
• Central nervous system cancers – cancers that begin in the tissues of the brain and spinal cord.

Diagnosis of Cancer:

Diagnosis of cancer is usually made by help of Histopathology. It is a test done by pathologists after collecting some tissue from the tumor site. Excepting few sites where it is not possible to do biopsy it is mandatory to have a histopathology diagnosis before starting cancer treatment.

Tissue diagnosis can be achieved by

• Fine needle Aspiration Cytology( FNAC)
• Biopsy

• Tru Cut/Core Biopsy
• Incisional/Excisional Biopsy.

Fine Needle Aspiration Cytology is collection of tissue with help of a wide gauge needle. When the lesion is felt by touch, the sample can be collected by piercing needle to the lesion. If the site is deep in the abdomen or lungs etc then the sample can be collected by Ultrasound or CT scan guided FNAC (done by Intervention Radiologist). Similarly Biopsy is collection of gross sample with help of a wide bore needle as in tru-cut biopsy or collecting more sample by a minor surgical procedure (Incisional/Excisional Biopsy).

It is very important to have a very experienced and well trained person to collect the sample as in many instances the sample is inadequate to comment by the pathologist. The pathologist is the person who would gross the sample and examine under microscope to give a final diagnosis. It is most important and in fact neglected fact that the pathologist has to be very intelligent well versed with subject and also should have the infrastructure to give a proper diagnosis.

Immuno-histochemistry (IHC)

It is the process of detecting antigens (e.g., proteins) in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in the tissue. It is done from the biopsy specimen. A battery of IHC tests is done and it helps to come to a final decision about the type of cancer and also it has got prognostic significance for a specific type of cancer. The IHC test is not available in all the pathology labs and all pathologists are not well versed with the IHC testing. It is very important to ask your surgeon to send it to the pathologist who does IHC and is good in the subject.

When any one is informed with the diagnosis of cancer it should be pathologically confirmed and when ever possible ( Where ever applicable) must be confirmed by IHC.

 For more information on cancer staging plz visit the following link http://drsumandas.wordpress.com/2013/01/20/cancer-staging-a-brief-guide/

Related articles

• https://drsumandas.wordpress.com/2013/01/20/cancer-staging-a-brief-guide/
• https://drsumandas.wordpress.com/2012/09/07/oral-cavity-ulcer-when-to-consult-an-oncologist-cancer-specialist/
• https://drsumandas.wordpress.com/2012/08/16/emotional-outcomes-after-cancer-diagnosis-ways-to-overcome-it/
• Will there be freedom from biopsies in cancer diagnosis? (drsumantasaha.wordpress.com)
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