Asbestos Cancer Diagnosis - Lung Cancer Diagnosis

Most common cancers (but not the haematological cancers) start as focal microscopic clones of transformed cells, and diagnosis only becomes likely once sufficient tumour bulk has accumulated to cause symptoms or signs. In order to try to make an earlier diagnosis and increase the curative possibilities, an increasing number of screening programmes are being investigated which target the asymptomatic or preinvasive stages of the cancer.

Increasingly, genetic screening is being used to target screening to those at most risk of developing cancer. To be successful in improving individual and population survival, this strategy is dependent upon finding tests that are sufficiently sensitive and specific, detection methods that identify cancer before it has spread, and curative treatment that is practical, consistent with maintenance of a normal lifestyle and quality of life, and is affordable.

Symptoms of cancer

The diagnosis of cancer may be suspected by both patient and doctor but advice about treatment can usually only be given on the basis of a tissue diagnosis. This may be obtained by surgical biopsy or on the basis of cytology (e.g. lung cancer diagnosed by sputum cytology or cervix cancer diagnosed on the basis of a cervical smear). Malignant lesions can be distinguished morphologically from benign by the pleomorphic nature of the cells, increased numbers of mitoses, nuclear abnormalities in size, chromatin pattern and nucleolar organization, and evidence of invasion into surrounding tissues.

The degree of differentiation (or conversely of anaplasia) of the tumour has prognostic significance: generally speaking, more differentiated tumours have a better prognosis than poorly differentiated ones. Immunocytochemistry, using monoclonal antibodies against tumour antigens, is very helpful in differentiating between lymphoid and epithelial tumours and between some subsets of these, for example T and B cell lymphomas, germ cell tumours, prostatic tumours, neuroendocrine tumours, melanomas, sarcomas. However, many adenocarcinomas and squamous carcinomas do not bear any distinctive immunohistochemical markers that are diagnostic of their primary site of origin.

Before a decision about treatment can be made, not only the type of tumour but also its extent and distribution need to be established. Various 'staging investigations' are therefore performed before a treatment decision is made. To be useful clinically the staging system must subdivide the patients into groups of different prognosis which can guide treatment selection.

Cancer Tip Conventional cancer treatments, such as chemotherapy and radiation therapy, cannot distinguish between cancer cells and healthy cells. Consequently, healthy cells are commonly damaged in the process of treating the cancer, which results in side effects.

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