Diagnosis of Cancer Peer Reviewed Discussion

Diagnosis of Cancer

There is a wide array of tools that are used to diagnose cancer. The most common methods are:

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where samples of the tumor are removed during surgery or during less invasive procedures and examined under a microscope for presence of cancer cells.

Endoscopy — a flexible plastic tube with a camera on its end is inserted into body organs and cavities taking a picture of the suspicious area. There are various types of scopes each used for a specific area. For instance, a laparoscope is used for the abdominal cavity whilst a colonoscope is used for the colon.

Diagnostic imagining — this includes methods such as MRIs, x-rays, CAT scans, ultrasounds, and PET scans that are separately or additionally used to locate the locations and extent of the cancer.

Blood tests — Some tumor marketers (i.e. substances related by tumors) can be indicated in the blood. Higher than normal prostrate specific antigen levels for instance can indicate cancer. However, blood tests by themselves are inconclusive (MD Anderson Cancer Center).

Staging of cancer

Staging is the process of discovering the extent of cancer in the body and its localization. This tells the physician the stage of growth that the specific cancer is in order to predict the person’s diagnosis and to plan the treatment. Early stage breast cancer, for instance, may just need surgery and radiation, whereas a more advanced stage may need chemotherapy. Knowing the stage also helps doctors predict the course of the cancer.

The stage is generally based on three main factors that are called T, N, and M. T refers to the size of the primary (or original tumor) and analysis of whether or not it has spread into neighboring tissue. M refers to whether or not the cancer has spread to nearby lymph nodes; whereas m refers to the situation of the cancer affecting distant areas of the body.

Some cancers, depending on their body origin, are not staged this way. For instance, leukemia impacts the blood and bone marrow and does so throughout the body therefore the T, N, M staging is irrelevant. Similarly, too, Cerebral-based cancers only spread to other parts of the brain not to lymph nodes or distant parts of the body; hence they too are not staged with this acronym.

Staging occurs at the time of diagnosis and is represented by two types: (1) clinical staging — that estimates the extent of cancer based on the exams and tests used and (2) Pathologic staging – that employs information extracted during surgery in order to determine the type and extent of cancer.

Other factors that determine the stage include: Grade (degree of abnormality of the cancer); cell type of cancer; tumor location; and tumor marker levels.

The stage of a cancer remains constant over time even if the cancer progresses, returns, or seems to be in remission. Even when restaging occurs (i.e. when post-treatment tests are employed to discover the extent of the effect), does the former staging rarely, if ever, change (American Cancer Society)

Complications of cancer

Cancer may impact the patient in numerous ways ranging from physical, emotional, social, intellectual and spiritual functioning and extending to his vocational life where he may lose his job as a result as well as effecting his family and friends.

Cancers may also cause the person to be alienated from his friends due to the feeling that he is afflicted in ways that they are not and that he or she is, accordingly, different to they. He may also be humiliated by his having the disease or may be avoided by others who do not know how to approach the patient or are discomfited by doing so, particularly since cancer indicates mortality and mortality is one aspect of life’s facts that individuals generally like to avoid.

Other feelings of inferiority and shame are caused by loss of autonomy and independence, vulnerability, and mutilation and most frightening of all is the fear of death. Clinical depression can easily become an outcome.

Some may also experience psychiatric disorder as a result, with the Psychological Collaborative Oncology Group finding that 47% of patients who had been diagnosed with cancer fell into psychiatric disorder with two thirds having depressed or anxious moods whilst one third experienced major depression, delirium, anxiety disorder, or some other major mental illness (Sandoval-Cros, 1999)

Methods to lessen physical and psychological effects.

The three most common types of effects causing physical and psychological consequences are anxiety disorders, depressive disorders, and delirium. Methods used for reduction of their symptoms can be spread to other negative areas too.

Drugs can be used for anxiety. These include benzodiazepines such as lorzepam or clonazapem. Busiprone can be helpful too and severe anxiety can be treated with other, more intensive drugs. Progressive muscle relaxation, meditation, biofeedback, and hypnosis are also effective.

Treatment for depression consists of a mixture of psychotherapy (family, group (e.g. support groups), or individual) and pharmacotherapy. Cognitive-behavioral psychotherapy is particularly helpful for depression where the individual is pointed to a sense of self-efficacy helping him regain his sense of independence and esteem as well as cognitively review his situation in more helpful ways. The therapist also helps the patient (and family) integrate the illness in their lives in order to better cope with it. Social support and other resources are dug up and worked on.

Antidepressants may be offered too which consist of serotenergic agents and psychostimulants. All drugs may have side effects such as insomnia and apathy.

Symptomatic treatment for delirium consists of using neuroleptic agents (e.g. haloperidol) that serve to control agitation and hallucinations and antianxiety agents (e.g. lorazapem) that serve to reduce anxiety (Sandoval-Cros, 1999).

Side effects of treatment

Other side effects of cancer treatment may include permanent change or damage to organs of body, including heart, lugs, nerves, and kidneys, from chemotherapy. Chemotherapy may also introduce a second cancer that may emerge much later.

Common effects of chemotherapy include: nausea and vomiting; fatigue; hair loss; pain; anemia; infection; blood clotting problems; mouth, gum, and throat problems; diarrhea and constipation; nerve and muscle effects; effects on skin and nails; radiation recall; kidney and bladder effects; flue-like symptoms; fluid retention, and effects on sexual organs and sexuality (MedicineNet.com). No wonder, many cancer patients become depressed.

References

American Cancer Society Staging www.cancer.org/Treatment/UnderstandingYourDiagnosis/staging

MD Anderson Cancer Center: Diagnostic tests www.mdanderson.org/…/diagnostic-tests/index.html

MedicineNet.com: Chemotherapy and cancer treatment, coping with side effects www.medicinenet.com/script/main/art.asp?articlekey=21716

Sandoval-Cros CJ. (1999) Common psychological problems in the cancer patient Moffitt Cancer Center

http://www.moffitt.org/moffittapps/ccj/v6n5/dept6.htm


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