Tests & investigations of cancer

How is cancer diagnosed?

Most people experience symptoms and begin by seeing their GP. If your GP thinks that you have symptoms that may be caused by cancer, s/he will examine you and refer you on to a specialist at the hospital for tests and treatment, if necessary.

At the hospital, the doctor will take your medical history and do a physical examination. You may have x-rays and blood tests taken and possibly scans. You may need to have a sample taken of the lump or abnormal area – this is known as a biopsy. The biopsy sample is then analysed in a laboratory and the cells examined so that the doctors can see exactly what type of cancer it is and whether it is likely to grow slowly or more quickly.

Scans can measure the size of the cancer and whether it has spread to other tissues or nearby lymph glands (nodes). This process is called “staging” the cancer. Once the type and stage of the cancer is known, the doctors can decide how best to treat it.

Types of tests

Specific information on relevant tests and investigation is available in the cancer type area of the website.

The Q&As section also gives further information on this topic; please select a link below to find out more about the following types of tests:

 
  • Barium meal
  • Barium swallow
  • Biopsy
  • Blood tests
  • Bone marrow
  • Bronchoscopy
  • Colonoscopy
  • CT scan
  • Endoscopy
  • Faecal occult blood
  • Mammography
  • Mediastinoscopy
  • MRI scan
  • PET scan
  • Radiostope scan
  • Tumour markers
  • Ultrasound
  • X-ray

    Like all warts, cervical warts are caused by a virus, the human papilloma virus (HPV). There are over 100 types of HPV, some types cause common skin warts, and others genital warts. There are about 30 types which can infect the cervix. If the cervix is infected with the virus this may cause visible warts but in many women infection can be only detected microscopically by a smear test.

    Genital HPV is usually spread though direct sexual contact, including oral sex, but non-sexual infection, although rare, is also possible. The virus can also lie dormant in the body for many years. It would be wise not to assume anything about how you contracted the wart until you have had a full discussion with your husband about this. When transmission has occurred from an infected person, warts can take anything from a few weeks up to several months to appear. Generally the types of HPV that infect the skin of the hands and body don’t infect the genital area, so it would be very unusual to contract cervical warts in this way.
     
    About half of the different types of HPV that can infect the cervix are associated with cervical cancer. The presence of the HPV infection in the cervix does increase the risk that mild abnormalities in the cervical tissue will progress to severe abnormalities and very occasionally to cervical cancer. However the overwhelming majority of HPV infections of the cervix never lead to cancer. Most HPV infections seem to go away by themselves, or with simple treatment from a specialist, without causing any cervical abnormalities. Cervical cancer can almost always be prevented by regular follow-up with cervical smears to detect and treat pre-cancerous changes before they go on to become invasive cervical cancer.

    The most important thing to do now is to discuss the treatment and follow-up of the cervical wart with your specialist.

    I have a cervical wart. My husband and I have been married 15 years. Does this mean he has been having an affair? Can this be passed on by oral sex? Will I get cancer? What do I do?
    Category: ABOUT CANCER

    The short answer to your question is no, there is no link between sickle cell anaemia and cancer of any type.

    Although sickle cell anaemia and cancer can both be serious illnesses, there is no link between the two conditions.  Sickle cell anaemia never turns into cancer, and people with sickle cell disease are not at any greater risk than other people of developing cancer.

    Hydroxyurea is a drug sometimes used to treat sickle cell disease.  There are concerns that many years of treatment with hydroxurea can increase the risk of getting a ‘blood’ cancer but the risk is yet to be proven and appears to be small.

    Sickle cell disease is due a faulty gene, which is inherited, so it runs in families.  It occurs mainly in people of African-Caribbean descent, and in some parts of central Africa is very common indeed.  It is also, much less commonly, found in people from parts of India, Saudi Arabia, Greece, Italy and North Africa.

    If you inherit the sickle cell gene from just one parent then the condition is quite mild and usually causes no problems (this is called sickle cell trait), but if you inherit the gene from both your parents then this is sickle cell disease, which is much more serious.  However, over the last 25 years the treatment of the condition has improved a great deal and the outlook is very much better now than it used to be. 

    For further information and support about sickle cell anaemia you may find it helpful to contact The Sickle cell society.

    Is there any link between sickle cell anaemia and cancer?
    Category: ABOUT CANCER

    It may help to answer your question by starting with an explanation about lymphomas in general.

    Lymphomas are cancers of the lymphoid tissue which is part of our body’s immune system.

    Our immune system protects us from infection. It is a complex system made up of the bone marrow, the thymus gland (which lies behind the breast bone), the spleen and the lymph nodes (or lymph glands).

    One of the most important cells in our immune system is a type of white blood cell called a lymphocyte. There are two types of lymphocytes: ‘B-cells’ and ‘T-cells’. All lymphocytes are produced in the bone marrow and start life as young, immature cells called stem cells. Some lymphocytes continue their development in the bone marrow or lymph nodes and these are called B-cells but others move to the thymus gland and they are called T-cells.

    Many years ago it was thought that lymphomas could be divided into just two conditions: Hodgkin’s disease (named after Thomas Hodgkin, the London doctor who first described it over 100 years ago) and non-Hodgkin’s lymphoma (NHL). With the passage of time it has become clear that NHL is not a single illness but includes a number of cancers, which behave very differently.

    The description and classification of the various types of NHL has developed over the years as more has been learnt both about the immune system and the cancers themselves. The most recent classification still recognises the difference between Hodgkin’s disease and NHL but then goes on to divide NHL into some fifteen different tumour types.

    The cause for the great majority of these different types of NHL remains a mystery but in three types of the disease, all of which are very rare in the UK, a link with viruses has been established. These are Burkitt’s lymphoma, Burkitt-like lymphoma and post-transplant lymphom

    In 1956 a British surgeon called Dennis Burkitt was working in equatorial AfricH described an unusual type of lymphoma which was very common in children in that region. This became known as Burkitt’s lymphomLater research showed that B-lymphocytes in these children became infected with a virus, the Epstein-Barr virus, or E-B virus. Epstein-Barr virus infections are common and usually cause no problems but in central Africa many of the children had chronic malaria infections which reduced their resistance to the virus. In some cases this allowed the virus to change the infected B-lymphocytes into cancerous cells leading to the development of the lymphom

    In recent years it has been recognised that in the western world there is one type of NHL where the tumour cells have very similar appearances under the microscope to those of Burkitt’s lymphoma. This rare condition has been called Burkitt’s-like lymphoma. Further research has shown that a high proportion of patients with Burkitt-like lymphoma (but not all) are HIV positive and many have AIDS. It seems that in this condition once again an Epstein-Barr virus infection occurs and because the HIV has reduced the patient’s immunity the Epstein-Barr virus is able to survive and ‘transform’ the normal B-lymphocytes to cancerous cells.

    The same situation has been seen in some patients who have had organ transplants. Often after organ transplantation drugs are given for some time, often years, to suppress the patient’s immunity in order to reduce the risk of rejection of the grafted organ. Some of these patients appear to develop E-B virus infections and once again, as their resistance is reduced, this may lead to the development of a B-cell lymphom

    All three of these virally-related types of NHL behave in a very aggressive way and need immediate treatment.

    In the African children with Burkitt’s lymphoma chemotherapy gives a high cure rate but the Burkitt-like lymphoma and post-transplant lymphomas tend to be more resistant to treatment. Although a variety of different drug combinations have been used cure is not possible in the majority of people. This means that a number of clinical trials are in progress to try and improve the results of treatment.

    In conclusion, the likelihood of your husband’s NHL being one of those types with a known viral cause is very, very remote. Almost certainly he has one of the forms of lymphoma for which no definite cause is known.

    My husband has recently been diagnosed as having a lymphoma. We read about someone who has a Burkitt’s like lymphoma and the article said it was due to a virus. Is my husbands lymphoma also due to a virus?
    Category: ABOUT CANCER

    Wart virus (also known as human papillomavirus or HPV) is known to be associated with abnormalities in the cervix known as CIN which if untreated can sometimes develop into cancer of the cervix. It is much less commonly associated with similar changes in the cells of the vagina known as VAIN (vaginal intraepithelial neoplasia) but this only very rarely leads to vaginal cancer. So once the cervix has been surgically removed (as it will have been if you have had cervical cancer), then there is no risk of getting a new cervical cancer and the chances of getting vaginal cancer are very slim indeed. There is always a very small risk of a recurrence of the original cervical cancer, but there is absolutely no evidence that having the wart virus in the vagina will increase this risk.

    Although wart virus is known to be one of the factors in the development of most cervical cancers, it is also found in many other women who will never develop cervical cancer. So having the wart virus certainly does not mean a woman will develop cervical cancer. In fact only a very small number of women who ever have a wart virus will develop cancer or even pre-cancerous areas on the cervix.

    There are over 80 different types of the wart virus, and some of these types are more likely to be associated with cancer development than others. For example some types are commonly found in women with cervical cancers, whereas other types just cause common skin warts. There are also other factors that may contribute to the risk of cancer; these include number of sexual partners, age, heavy smoking, number of children and other genital infections.

    At this stage there is no known method for getting rid of the virus. It is likely to just go way on its own accord with the help of your natural body’s defences. It is certainly important, however, that you continue to have regular smears and examinations as follow up after your cancer.

    I had a hysterectomy for cervical cancer two years ago. My doctor has taken a smear from my vagina and says I have a wart virus. Does it mean I will develop another cancer? Is there anything I can do to get rid of this?
    Category: ABOUT CANCER

    Cancer of the vulva is a rare cancer. It usually affects women between the ages of 55 and 75, but can occur in younger or older women.

    The cause of most vulval cancers remains unknown but there are a number of conditions that can affect the vulva which will sometimes lead to cancer after many years. These are: n VIN (vulval intraepithelial neoplasia) which can occur in the skin of the vulva and is linked to infection by some types of wart virus, known as human papilloma virus (HPV). There are three levels of abnormality: VIN1, VIN2 and VIN3. VIN3 is the most abnormal and, in some women, can develop into cancer of the vulva if left untreated. n vulval lichen sclerosus and vulval lichen planus. These are two non-cancerous conditions which cause inflammation of the skin of the vulva and occasionally can lead to the development of a cancer after a number of years.

    Also there is evidence that cigarette smoking may increase the risk of developing both VIN and vulval cancer. This may be because smoking depresses the immune system.

    My mother has been told she might have a cancer of her vulva. What might have caused this?
    Category: ABOUT CANCER

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Tests & investigations of cancer

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