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Diagnosing cancer

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Description
There are a few different ways to diagnose cancer; and with most degenerative health conditions, it is better to catch the disease in its earliest stages. Thus, early diagnosis is essential. The methods for diagnosis has improved with technological developments.

Biopsy

A biopsy leads to the definitive diagnosis of most cancer malignancies. It requires the removal of cells and/or pieces of tissue for examination by a pathologist. The tissue diagnosis indicates the type of cell that is proliferating, its severity (degree of dysplasia), its extent and size, and - sometimes with help from cytogenetics and immunohistochemistry - prognostic and therapeutic determinants.

Biopsy can be curative if the whole lesion is removed; in this case, the borders of the sample are examined closely to see if all malignant tissue has truly been excised.

The nature of the biopsy depends on the organ that is sampled. Many biopsies (such as those of the skin, breast or liver) can happen on an outpatient basis. Biopsies of other organs are performed under anesthesia and require surgery.

Screening

Cancer screening is the widespread uses of tests to detect cancers in the population. It is often an inexpensive, noninvasive procedure. If signs of cancer are detected, more definitive and invasive followup tests are performed to confirm the diagnosis.

Screening for cancer can lead to earlier diagnosis. Early diagnosis may lead to extended life. A number of different screening tests have been developed. Colon cancer can be detected through fecal occult blood testing and colonoscopy, which reduces both colon cancer incidence and mortality, presumably through the detection and removal of precancerous polyps. Similarly, cervical cytology testing (using the Pap smear) leads to the identification and excision of precancerous lesions. Over time, such testing has been followed by a dramatic reduction of cervical cancer incidence and mortality. Breast cancers can be detected by breast self-examination and regular screening mammograms. Testicular self-examination – is recommended for men from the age of 15 years to detect testicular cancer. Prostate cancer can be screened for by a digital rectal exam along with annual prostate specific antigen blood testing.

Screening for cancer is controversial in cases when it is not yet known if this test actually saves lives. The controversy arises when it is not clear if the benefits of screening outweigh the risks of follow-up diagnostic tests and cancer treatments. For example: when screening for prostate cancer, the PSA test may detect small cancers that would never become life threatening, but once detected will lead to treatment. This situation, called overdiagnosis, puts men at risk for complications from unnecessary treatment such as surgery or radiation. Followup procedures used to diagnose prostate cancer (prostate biopsy) may cause side effects, including bleeding and infection. Prostate cancer treatment may cause incontinence (inability to control urine flow) and erectile dysfunction (erections inadequate for intercourse). For these reasons, it is important that the benefits and risks of diagnostic procedures and treatment be taken into account when considering whether to undertake cancer screening.

Use of medical imaging to search for cancer in people without clear symptoms is similarly marred with problems. There is a significant risk of detection of an incidentaloma - a benign lesion that may be interpreted as a malignancy and be subjected to potentially dangerous investigations.

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