Diagnosis
Understanding Cancer

There are many ways to diagnose cancer, depending on the type suspected. Because treatment depends on pinpointing the exact type of cancer and the degree to which it has spread, your doctor will determine which tools to use and may use more than one tool to achieve the highest degree of accuracy. General diagnostic tools include:

• Diagnostic Imaging: Technological advances in the past few years have allowed doctors to look into the body in ways never before possible. By using one or more of the imaging tools now available, doctors can often gain a clear picture without invasive surgery. Sutter Cancer Centers offer a complete range of the latest technology available, covered in detail in the Diagnostic Procedures section of this Web site.


• Laboratory Testing: Tests of blood, urine and cell scrapings (as in Pap smears) can often help doctors find malignant cells or detect markers left by certain types of tumors. As researchers continue to refine the ability to spot biologic substances associated with cancer, more laboratory tests will become available for cancer detection. However, even with blood-related cancers such as leukemia and myeloma, doctors do not rely on laboratory tests alone. Diagnostic imaging and biopsies are performed as well to determine if the laboratory results are accurate and, if so, the precise location and extent of malignancy.


• Biopsy: A small sample of suspect tissue is surgically removed and examined under a microscope to determine if cancerous cells are present. To minimize surgery, doctors often use scopes with small cameras that allow them to move through certain organs suspected to have cancer, such as the colon or esophagus or to insert the cameras through very small incisions. When suspect tissue is located, the scopes can remove small amounts of tissue for examination. Variations of surgical removal include stereotactic core biopsy for breast cancer where a hollow needle is directed into the tumor to remove a sample. Fine-needle aspiration may also be used to extract a fluid sample from a fluid-filled tumor. Advances in computed-tomography (CT) imaging have opened another avenue for doctors to perform core sample biopsies and fine-needle aspirations, especially when suspect tissue is located near the intestines, major nerves or arteries. CT scans showing the tissue and the location of the needle allow surgeons to place the needle carefully and remove a tissue sample or fluid for examination.


• Bone Marrow Biopsy: Testing for blood-related cancers (leukemia, lymphoma or myeloma) may be done be removing a small amount of bone marrow, the spongy tissue within the bone where all blood cells are formed. Bone marrow is most often removed from the hip bone by inserting a hollow needle and extracting a small amount of marrow for examination. The term biopsy is used when doctors sample the marrow tissue. Sampling of liquid bone marrow is often done at the same time and is referred to as bone marrow aspiration. For more information, see our Health Information section on bone marrow aspiration and biopsy.