Diagnostic Procedures for Cancer: Overview

When symptoms suggest cancer, your doctor may advise any of these procedures to help diagnose it:

• A full health history—both family and personal
• Thorough physical exam
• Pelvic exam of the uterus, vagina, ovaries, bladder, and rectum
• Pap test at the time of pelvic exam
• Rectal exam of the prostate

Other procedures that may be done are:

• Imaging tests. These include:
  
  • X-ray. Images of bones, certain organs, and tissues are made with a controlled beam of radiation.
  • CT scan. Also known as computed tomography scan, this test uses X-rays and a computer to make detailed images of the body. It shows details of the bones, muscles, fat, and organs. A contrast material may be given before the test to increase scan details.
  • Radionuclide imaging or nuclear medicine scan. A small amount of radioactive substance is injected into the vein. A machine then measures levels of radioactivity in certain tissues or organs. It finds any abnormal areas or tumors. Some examples are bone scans and positron emission tomography (PET) scans. PET scans are often combined with a CT scan (PET/CT scan) to improve detail in areas of increased cell activity.
  • Ultrasound. This test uses high-frequency sound waves to make an image on a screen of organs or tissues, such as the uterus, liver, kidneys and breasts.
  • MRI. This test uses strong magnetic fields and radio waves to give detailed views of organs and internal structures without the use of X-rays. MRI scans can give different information than standard X-rays, ultrasound, and CT scans. A contrast material may be given for clearer pictures. This is especially helpful for potential brain and spinal cord tumors.
• Endoscopy. A doctor uses a flexible tube with a lens or tiny camera and a light on the end. This endoscope is connected to a computer screen. It allows the doctor to see inside the hollow organs. These include the esophagus, stomach, intestines, bladder, or uterus. Biopsy samples (tiny pieces of tissue) can be taken through the tube for more testing.
• Lab tests. These are done to look at blood, urine, other fluids, or tumor tissue from a biopsy or cells from a cytology test.
• Biopsy and cytology tests. This test removes a sample of tissue. A pathologist examines the tissue in a lab. A biopsy can be done using several different procedures depending on the location of the tumor and its size. Endoscopy, needle biopsy with image guidance, and surgical biopsy are a few examples of how a biopsy can be done. Cytology tests only look at a few or cluster of cells, instead of a tissue sample.

For most types of cancer, exams and imaging tests might suggest a person has cancer. But a biopsy is always needed to confirm the diagnosis.

Once the cancer is diagnosed, an evaluation will be made to find out the extent (stage) of the cancer. This is often done with some of the imaging tests described above.