Cancer is a disease where body cells start to grow and divide abnormally. These cancerous cells then outnumber the healthy cells and begin destroying the tissues. The exact cause of cancer is unknown, and there is no permanent cure. Cancer can happen in any part of the body. There are many tests available to diagnose cancer.

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In this article, we will be looking at various tests to diagnose cancer. A patient doesn’t have to undergo all the diagnostic tests, as many of the tests depend on the type of cancer. For example, a leukemia person won’t undergo a mammogram as it is used for diagnosing breast cancer. For leukemia, a person would undergo a series of blood tests.

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Tests to Diagnose Cancer

The following are the general tests to identify the presence of cancer. A patient has to undergo all these tests, irrespective of its type.

General Tests

1. Physical Examination

Your medical practitioner will look for physical signs of cancer, such as skin discoloration, dark patches, lumps, or enlargement of an organ.

2. Imaging tests

These tests involve creating an image of the internal system using X-rays to examine your bones and internal organs in a non-invasive manner. Many tests come under imaging tests, such as:

• X-rays: An X-ray is a quick, painless test that produces images of the structures inside your body — particularly your bones.

• Computerized Tomography (CT) Scan: A CT scan combines X-ray images taken from different angles around your body. It uses computer processing to create cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside your body. One can quickly identify the location of any internal injury or tumors with a CT scan. It is one of the tests to detect cancer and determine the effectiveness of cancer treatments.

• Magnetic Resonance Imaging (MRI): MRI is a medical imaging technique that uses a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body. MRI produces high-resolution 3-D images that can be viewed from different angles to identify diseases such as cancer and its stage.

• Positron Emission Tomography (PET) Scan:A PET scan is an imaging test that can help reveal your tissues and organs’ metabolic or biochemical function. It uses a radioactive drug called a tracer to show both atypical and typical metabolic activity. The tracer will then collect into areas of your body with higher metabolic or biochemical activity levels. This often pinpoints the location of the disease. It is often combined with imaging tests such as MRI or CT scans.

3. Biopsy

A biopsy is one of the most critical tests to diagnose cancer. A small tissue from the affected body area is taken and examined under a microscope to look for cancer cells. While normal cells show uniformity in their size and organization, cancer cells show no proper shape and are haphazardly placed. Common types of biopsies are:

• Fine Needle Aspiration: A very fine needle is used to collect tissue/fluid samples for examination.
• Core Needle Biopsy: A thicker needle collects a larger tissue sample for examination.
• Surgical Biopsy: Tissues that doctors think are cancerous are removed via surgery.
• Shave Biopsy: A tissue sample is scraped from the skin’s surface for examination.
• Punch Biopsy: A circular instrument is pushed through the skin’s surface and takes a sample of tissue from below the skin’s surface. These are used most commonly for skin biopsy.

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Cancer-specific tests

The following tests are done based on the type of cancer one may have. They are:

1. Breast Cancer

• Mammogram: It is a diagnostic test that uses low-energy X-rays to create images of the human breast. It is done to look for early signs of breast cancer.
• Ultrasonography: Sound waves are used to take pictures of your breast tissues to diagnose breast lumps.
• Sentinel Lymph Node Biopsy: Sentinel lymph nodes are surgically removed to look for cancer cells.
• Axillary Lymph Node Dissection: In this, 10 to 40 lymph nodes are removed from under the arm and checked for cancer spread.

Read more on Breast Cancer here.

2. Uterine Cancer

• Endometrial biopsy: A thin tube is inserted through the cervix into the uterus to remove a sample of uterine tissue via suction. It is examined under a microscope to look for cancer cells.
• Transvaginal ultrasound: An ultrasound wand is inserted into the uterus via the cervix to look at the lining of the uterus. If the lining seems too thin, your doctor may ask you to undergo more tests.
• Dilation and curettage (D&C): It is a procedure that removes a large sample from the outer lining of the uterus. The sample is then checked to look for cancer cells.
• Hysteroscopy: A hysteroscopy looks inside the uterus for polyps or cancer-related growth.
• Pap test: A tissue sample from the cervix is examined to look for early changes in the cells that can lead to cancer.

3. Liver Cancer

• Laparoscopy: A thin, flexible tube (laparoscope) is inserted inside the abdomen through keyhole incisions to examine the inside of the body. With medical advancements, laparoscopy has become rare for diagnosing liver cancer.
• Angiogram: It is an X-ray image of our blood vessels, created by injecting dye into the bloodstream so the blood vessels of the liver show up on the X-ray.
• AFP Tumor Marker Test: It is a blood test to examine alpha-fetoprotein levels. High levels of AFP indicate liver cancer.

4. Ovarian Cancer

• CA 125 test: It is done to check the presence of cancer antigen 125, a protein often found on the surface of ovarian cancer cells.
• Genetic testing: A blood test is done to look for changes at the genetic level that can increase the risk of ovarian cancer.

Other tests to diagnose ovarian cancer includes Transvaginal Ultrasound and Surgical biopsy.

5. Lymphoma

• Blood tests: These include blood smear, complete blood count, Erythrocyte sedimentation rate, Lactate dehydrogenase, etc.
• Bone Marrow Aspiration and Biopsy: The aspiration takes a small liquid sample with a needle, while the biopsy takes a solid tissue sample to look for signs of lymphoma. Bone marrow aspiration and biopsy are often taken from the pelvic bone.
• Lymph Node biopsy: A lymphoma starts in the lymphatic system; lymph nodes close to the skin are removed and checked for cancer cells.

Read more on Lymphoma here.

6. Colorectal Cancer

Colorectal cancer includes colon and rectal cancer. The various tests to diagnose colorectal cancer are:

• Colonoscopy: A doctor uses a colonoscope to look for polyps, cancers, swollen tissues, or ulcers inside your colon.
• Flexible Sigmoidoscopy: It is a procedure that uses a sigmoidoscope or scope to look inside your lower colon for cancer or other ailments.
• CT Colonography: Virtual colonoscopy produces 2-D or 3-D images of the colon or rectum to look for cancer or other conditions affecting the area.
• Anoscope: It uses an anoscope to examine the anal canal.
• Mismatch Repair defect (dMMR) test: This is done to check whether the patient is eligible for immunotherapy. It is also done to rule out Lynch syndrome.
• Blood tests: It is done to look for carcinoembryonic antigen, or CEA, produced by colon cancer cells.

7. Pancreatic Cancer

• Endoscopy: An endoscope is inserted in your esophagus to look for tumors or other cell formations.
• CA19-9 test: It is done to check the presence of cancer antigen 19-9, a protein often found in people having pancreatic cancer.

Read more on Pancreatic cancer here.

8. Bone marrow cancer

BMA-B is one of the most important tests to diagnose bone marrow cancer. This one test is enough to give you a proper confirmation.

• Bone Marrow Aspiration and Biopsy: The aspiration takes a small liquid sample with a needle, while the biopsy takes a solid tissue sample to look for signs of lymphoma. Bone marrow aspiration and biopsy are often taken from the pelvic bone. It is done to check whether the bone marrow is producing healthy cells.

9. Lung cancer

• Bronchoscopy: A bronchoscope is inserted in your windpipe to look for tumors or other cell formations.
• Thoracoscopy: Small incisions are made on the chest to examine a particular area of your chest and take tissue and fluid samples.
• Mediastinoscopy: A small incision is made at the bottom of the neck to pass a thin tube through it. The area between your lungs is then examined, and cells from the lymph nodes are collected to look for cancer cells.
• Sputum cytology: If you have cough-producing sputum, then the sputum can be examined under a microscope for lung cancer cells.

10. Prostate Cancer

• Transrectal ultrasonography: It is a procedure that uses high-energy sound waves to create an image of the prostate gland. It is used to look for tumors or cancer cells.
• Prostate-specific antigen (PSA) test: A blood test that looks for elevated levels of PSA in a person’s bloodstream as that would indicate prostate cancer.

Reach more on Prostate cancer here.

11. Stomach Cancer

• Barium swallow: The patient swallows a liquid containing barium which then coats the lining of the esophagus, stomach, and intestines, so tumors or other abnormalities are easier to see on the X-ray.
• Biomarker testing of the tumor: This test checks human epidermal growth factor receptor 2 (HER2) levels, a protein made by stomach cancer tumors.

The tests to diagnose stomach cancer also includes Endoscopy and Endoscopic ultrasound.

12. Esophageal cancer

• PD-L1 and microsatellite instability (MSI) testing: It is done to check the mismatch repair deficiency. This test is beneficial in identifying the cancer stage and whether the patient is eligible for immunotherapy.
• Esophagus-gastric-duodenoscopy: EGD uses a thin, flexible tube to examine the lining of the esophagus.

Other tests to diagnose esophageal cancer are esophagram, endoscopic ultrasound, bronchoscopy, and HER2 testing.

These are some of the most important tests to diagnose cancer. Before proceeding with any test, make sure to have a thorough discussion with your medical practitioner. There are times when you may not be required to undergo a series of tests. But there can be times where you will have to undergo all of them

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