Cancer diagnosis method

1. {
Cancer diagnosis –
Biochemistry & Genetic
Dr. P. Suganya
Assistant Professor
Sri Kaliswari College
(Autonomous),Sivaksi

2. Chest X- Ray- Mediastinum
Skeletal X- rays- primary cancer of
bone-large dense- osteosarcoma-
Sunray-like
Secondary cancer of bone- metastatic –
less dense –damaged –not infallible &
not detect malignant lesions in bone
Chest X-Ray & Skeletal X-rays

3.  (Radio- opaque materials- dyes
Injected into arteries, veins and even
lumph vessels- immediate view of
television
Radiologist –determine – normal
position or abnormal position
Angiography

4. Some cancers – distinctive blood suppling-
showing - technique- cluster of small
blood vessels called a- Tumor blush
Modern angiography-allowed arteries-
every part of the body outlined by
radiographic technique-detect – treat-
deep seated tumors
Lymphangiography- by injecting – radio-
opaque “dyes”- into lymph vessels – allow
x-rays to lymph nodes- determine –are
enlarged or partially replaced by abnormal
tissues that may be cancer

5. Isotope – radioactive source- iodine (radioactiv
material)- injected into peripheral vein & is
distributed in the bloodstream
The radioactive dose is used very small amount
– to combined agents- depending organ or tissu
is to be examined.
Ex . Iodine
 thyroid gland – uptake, size, shape, position
&consistency of tissue in thyroid gland -
Technetium
Isotope scans (Nucelar
Scintigraphy

6.  Bone with cellular activity or growth- will not only
position, shape and size of bone-abnormal cellular
activity –may due to cancer.
 Similar scans –used to size, shape and abnormal
activity in liver & spleen.
 Radioisotope scan tests now available –organs, tissues,
brain, lungs, & lymph nodes.
 Isotope-gallium- help-delinate b/w normal and
abnormal patterns
 Scanning –carried out – patient lying –on a special
table- apart –needle prick- to inject –the material-into
vein- quite painless.

7.  Computerized Axial Tomography
 In early 1970’s British workers – developed
 Small doses of X-rays- used- construct – cross section of –trunk, head,
neck and limbs.
 They developed three dimensional image concept.
 The position of size, shape of all organs- blood vessesls, bones, muscles-
abdomen- position, size and density of the abnormal tumor-
considerable accuracy.
 CT Scans- requires – specialized equipment – skilled person.
 Investigating –head, abdomen, chest & limbs.
CT SCAN or CAT Scan

8.  Depending on their penetrating x-rays and gamma rays- small dose –
used
 Frequently – pregnancy women- some times – fetus- caused to –
irritation & sensitivity.
 Developed to give a cross sectional picture of body tissues & organs.
 In earlier- to study- pregnant uterus – active ovaries.
 To detect – ovarian cancer, uterus, blood tissues & breast cancer
 Harmless, painless and causes no discomfort.
Ultrasound scans

9.  MRI scans – that tissues on cross sectional image -similar appearance of –
CT scans- quite different principles of physics
 The image based on the computer analysis- absorption, penetration of high
frequency radio waves by water molecules in a magnetic field.
 Some body tissues, bones, muscles, brain, spinal cord.
 This scans – image – horizontally.
 This method preferred – imaging – skeletal structures- intra- cranial and
spinal card investigation
 Size, shape & other characteristics of tumor & spread to surrounding
tissues
 It is not painful technique & anesthetic no required – conduct powerful
image
 Patient no wear jewellry or metal objects.

MRI (Magnetic Resonance
Imaging )

10.  Non- invasive studies – to produce –black/white shadows or grey
 Detect surface of the position, size, shape and consistency of tumors
or lumps- deep surface position to tissues & arteries, nerves, muscles,
bone and important organs
 Based on the laws of physics –using penetration x-rays& radio waves
 PET- produces – three dimensional pictures- magnetic field.
 PET – opposed – anatomical imaging
 PET – very safe –but expensive- equipment costs million dollars.
 PET scanning- unique tool- cancer investigation-supported
financially by health authorities.
PET (Positron Emisson
Tomography)

11.  Rigid Scopes
 Dentist – examine – back of the teeth- stereotypical image –head
mirror to reflect- light waves through mouth, throat, larynx or
back of the nose.
 Non- operative examination- inside body cavities was limited to
larynx, trachea, air passages (bronchi), osephagus, stomach,
rectum, lower large bowel, bladder and vagina.
 This simple technique
 Cost effective
 Doctors- hospitals, surgeries are available.
Endoscopic examinations:
Rigid & Flexible scopes

12.  Replaced by colonscopy- more flexible
 Still used to sigmoidoscopy
 Examination of rectum & lower bowel
Sigmoidoscopy

13.  The body cavities – peritoneal cavitiy- pleural cavitity- examanined by
passing an instrument – called as laparoscope.
 General anaesthesia – CO2 – used to fill- peritoneal cavity
 Manipulation of the instrument-b/w loops, bowel, other tissues
 Some times – examined biopsies of – suspicious lesion are seen.
 Now available to carry out this indtument
 Ex. Abdominal cancer, uterus cancer, cervical cancer- operations
carried out this way.
Laparoscopy (Peritoneoscopy)

14.  Similar examination of the pelvis
 This instrument is a passed in to the pelvic cavity through a
small incision made in the top of the back wall of the vagina
Culdoscopy

15. Blood test show either direct or indirect evidence of
cancer
Blood and serum tests
Haemoglobin & Red Cell Count (RCC)
 Anaemia- manifests – decreased haemoglobin &
red blood cell counts- mights – tumor – quite
advanced before this becomes apparent.
Indirect evidence if cancer

16. Total white cell count – cancer-
significantly- no.& types of white
cells- first direct indication of
leukemia.
White Cell Count (WCC)

17. ESR- index of body sedimentation &
increases with elevation of certain
proteins- ill health
ESR falls –after cancer treatment –
effective- cannot be regarded as a
guarantee of complete cure
Erythrocyte Sedimentation
Rate (ESR)

18. Change biochemical components of blood
Prostate gland- cause – elevation- enzyme
Serum acid phosphatase
Breast cancer & large bowel cancer-
elevation – of serum – calcium
Papillary adenocarcinoma- loss of
potassium- fall in serum potassium
Liver failure – detect – serum biochemistry-
check – patient – not suffering from-
Cirrhosis
Serum Biochemistry

19. Direct Evidence of Cancer

20.  Biopsy- piece of tissue is taken from a suspected cancer & examined
microscopically
 Pathologists determined not only the cancer-but also type of cancer-
even –degree of malignancy
 Some cancers- biopsy- good indication of the –appropriate treatment &
likelyhood of a cure being possible
 Ideally-clincical team- decide-before treatment- surgical treatment-
started
 Sometimes surgeon –does not cancer cells- spread on it- “clear margin”-
tissue free of cancer
Biopsy

21.  Limps in breast cancer- special needle- inserted into
lump- aspirate or tissue for biopsy examination
 Special needle called as TURCUT- pinch out
mechanism- a small core of tissue to be punched
out
 Done logcal anesthesia –required –expert team –
take specimen- diagnosis rapidly- liitle disturbance
to- patient
 Pinch out – used for no. of – different types of
tumors- variety of tissues such as prostate gland,
liver, thyroid gland or deep seated tumors- in limbs
or chest
Needle Aspiration or punch out
“Biopsy

22.  Aspiration biopsy – applies for examine for cells in
cysts or other fluids
 Determined malignant cells are found, a positive
diagnosis of cancer
 Whether cancer – present- biopsy may be necessary
 It is still possible – cancer cells – cyst or adjacent
lymph – but not sample of fluid taken
Aspiration Cytology

23. Similar – aspiration technique-
specimen of bone marrow
Presence and type of any – leukaemia
Bone marrow biopsies can also be
valuable – confirming – presence –
metastatic cancer - bones
Bone Marrow Biopsy

24.  Preparation and staining – biopsy- microscopic
examination- several days
 Prepared embedding paraffin wax – wax block-
staining the several cells
 Diagnosis immediately
 Experienced pathologist- frozen section- biopsy
specimen- finely sliced – stained – microscopic
examination
 Pathologists take – few minutes
 Highly accurate results – many cancers- skilled
pathologists
 Such as immunohistochemistry tests, antibodies
against tumor markers are needed.
Standard Paraffin section and Frozen Section Biopsy