Diagnosing Cancer - All about it
1. Complete blood count (CBC): In this, blood is collected from the vein in the forearm under hygienic conditions. A CBC can be done at any good quality lab and costs around Rs 500.
Results: Generally, malignancies will cause the hemoglobin levels to fall. A mild rise in white blood cells (WBCs) is noted in many cancers, but a very high rise should signal underlying blood cancer. Most blood cancers also show a fall in platelet counts.
2. Cytology: If cancer of external body parts like breast, prostate, cervical, mouth, etc is suspected, cytology is usually recommended. For example, breast cancer, the most common cancer in women, is characterized by a swelling in the breast. In such a case, a needle is inserted into the swollen area, the sample is smeared on the slide and then examined under the microscope to look for cancerous growth. Similar procedures can be adopted for visible suspicious swellings in other parts of the body. The natural secretions (blood, saliva or semen) can also be collected, and the cells examined, which is termed as exfoliative cytology. A FNAC (fine-needle aspiration cytology) usually costs around Rs 500 and is done at most hospitals. The cost of an ultrasound-guided FNAC is around Rs 1000.
Results: In case of lung cancer, sputum is collected; pap smear is recommended for cervical cancer and gastric secretions collected through an endoscope are examined to rule out stomach cancer. For deep-seated swellings, ultrasound guided needle aspiration can be done where the swelling can be visualised using ultrasound and a needle inserted in the swelling and the sample is examined under the microscope.
3. Histopathology: This is the gold standard for detection of cancer and requires hospitalisation of the patient. In this, anaesthesia is given to the patients with precautions and a piece of the suspected cancerous tissue is taken and processed. The sample tissue is then made into a slide and studied under a microscope to look for the presence of cancerous growth. Most hospitals have a well-equipped histopathology lab and usually charge Rs 1000 per test.
Results: This is an elaborate procedure, and you will have to wait a minimum of 48 hours for the reports, as the tissue collected has to be processed. Many a times, certain special stains have to be used to establish the exact nature of cancerous cells. This technique is called immunohistochemistry (IHC) and is a breakthrough in the field of cancer. IHC is done only at specialized centres and costs around 1000 per test.
4. Tumour Markers: Secreted by cancerous cells, tumour markers are not found in the blood of healthy individuals. The pathologist draws blood from the forearm and the sample is detected for the presence of tumour markers. These tests are available at specialized centres and a single tumour marker detection usually costs between Rs 800 to Rs 1000.
Results: A high value does not help in the diagnosis of cancer but aids to monitor the response to treatment. CA-125 (Cancer Antigen-125), a tumour marker, is raised in the case of ovarian cancer while blood levels of tumour marker CEA (carcinoembryonic antigen) is high in colon cancer. If your results indicate high PSA levels, it may signal prostate cancer. These values require interpretation by an expert because they may also rise in non-cancerous disease as well.
5. Flow Cytometry: It is an advanced investigation procedure where blood samples are subjected to various tests and help identify the type of blood cancer. This test is available only at specialised centres.
Results: It helps in typing of blood cancers and thus, aids in deciding the course of treatment.
6. Radiological Investigations: The radiological investigations that are routinely done to diagnose cancer include –
X-ray: These include X-ray that can be taken without any preparation. It helps in the detection of bone cancers and joints.
Ultrasound: It helps in the diagnosis of cancer of the abdomen.
CT scan: It can be plain or contrast-enhanced CT scan. Contrast CT is done after injecting a contrast or dye (by mixing it in a sweetened solution). However, before undergoing this test, you need to get tested for urea and creatinine value. This is done in specialised centres and costs around Rs 2000 to Rs 3000.
MRI: A MRI or magnetic resonance imaging is a wonderful technique to see soft tissues. It usually takes an hour or more to perform the procedure and costs around Rs 5000 to Rs 8000. more