IndiaCancer - Specific Investigations

	Specific Investigations

	Here are some basic explanations for procedures you may be subjected to, while your doctor is trying to detect a possible cancer in you, or trying to map out the extent of the disease. Endoscopy This is a procedure which involves the use of self illuminated, hollow, flexible (fiberoptic) or rigid (metallic) tubular structures which are introduced into the body, in order to visualize various organs internally. These 'scopes also have a variable number of ports for taking biopsies, and performing other procedures. Endoscopy is a very useful, relatively new invention, which has solved the problem of getting tissue problems from suspicious sites in internal organs, w scenario which erstwhile required the patient to be subjected to open surgery. The Types:
		Nasoscopy - used for the internal part of the nose and the nasopharynx, which is the topmost part of the throat.
		Direct laryngoscopy - the 'scope is introduced through the patient's mouth while he is sedated or anaesthetized and the larynx or voice box is visualized.
		Bronchoscopy - the 'scope is introduced through the patient's nose and into the the airway, after locally anaesthetizing the same, and the airway and it's branches are visualized.
		Mediastinoscopy - the mediastinum is the central part of the chest, which includes the heart and the great vessels going to the heart. The 'scope is introduced through a small cut made at the root of the neck and the mediastinum is visualized.
		Esophagoscopy - the 'scope is introduced through the patient's mouth the 'scope is introduced through the patient's mouth and the esophagus or the food pipe is visualized.
		Gastrodudenoscopy - the 'scope is introduced through the patient's mouth and passed into the stomach and then through a small valve like opening at it's base, which is known as the pylorus, and the duodenum, which is the first part of the small intestine, is visualized.
		ERCP (endoscopic retrograde cholangiopancreatography) - the 'scope is introduced through the patient's mouth and passed into the stomach and then through the pylorus and the duodenum, and into a small opening on the left wall of the second part of the duodenum, into the common bile duct and the duct of the pancreas. A dye may then be injected to visualize the entire biliary tree and the pancreas.
		Proctoscopy - a short, metallic tube is introduced into the patient's anal canal and the rectum is visualized.
		Sigmoidoscopy - a short, fiberoptic tube is introduced into the patient's anal canal and the rectum and then the sigmoid colon, which is the subterminal part of the large intestine, is visualized.
		Colonoscopy - the 'scope is introduced through the patient's anal canal and is used to visualize his entire large intestine or colon.
	Laparoscopy A procedure in which a keyhole like opening is made in the patient's abdomen to look for internal problems, rather than a formal large surgery which takes a longer time to recover from. Air or gas is then introduced into the abdomen and a self illuminated instrument called a laparoscope is introduced to visualize the internal organs. Separate hole(s) may be made to insert manipulative or dissecting instruments. This procedure is also known as minimal access surgery. Lymphangiography Considered an obsolete procedure now, it was previously used to map out the entire lymphatic system after injecting a dye into a web space between two toes. Angiography and digital subtraction angiography (dsa) These are investigations in which a contrast medium or dye is injected into an artery, which is a blood vessel carrying blood from the heart, and then the blood vessels are visualized on X-ray plates. DSA is more sophisticated and digitally (with the help of a computer) subtracts the background from the vessels, thus making the picture clearer. CT Scan (computer assisted tomography, also known as a CT scan) A special X-ray technique, in which multiple X-rays are taken in very thin slices, which are then integrated by a computer to give a comprehensive picture of an organ, a mass or even of the entire body. Ultrasonography An imaging method in which high-frequency sound waves are used to outline a part of the body. The sound wave echoes are picked up and displayed on a television screen. Also called ultrasound. MRI Scan (Magnetic resonance imaging) An imaging process used for diagnosis of a cancer or to measure the size of the cancer and the extent of its spread. It uses a special, powerful magnet to create images of the body which are then integrated, interpreted and changed to a recognizable, high resolution image by a computer. X-RAYS A photograph or examination made by using low power radiation, which can penetrate solid objects and see through them. The image is captured on a special film. It is used for diagnostic purposes, that is, to detect problems inside the body. X-rays are also known as radiographs. Barium swallow, meal, follow through and enema Barium sulfate, a chalky substance, is given orally and pictures are taken radiographically to visualize the upper gastrointestinal tract. When the barium is seen in the esophagus, it is called a barium swallow. When seen in the stomach, it is called a barium meal and when it passes into the small intestine it is called a barium meal follow through. Barium enema is also called a double contrast barium enema. A method used to help diagnose colorectal cancer is used to partially fill and open up the colon. When the colon is about half-full of barium, air is inserted to cause the colon to expand. This allows good x-ray films to be taken. The contrast is given as an enema.

	Radionuclide scans: During these tests, radioisotopes are injected into the blood. They travel through the body and collect in areas where the disease is active, showing up as highlighted areas on the pictures.
		Gallium Scan - It is a diagnostic test using a small amount of radioactive material to localize a hidden source of infection, a localized abcess or a localized neoplastic spread. The radioactive material is injected into a forearm vein, and a series of pictures are taken at regular intervals six hourly upto six days.
		Liver Scan - It is a diagnostic test to visualize the Liver and Spleen. Pictures are taken 15 to 30 minutes after injection of radioactive material.
		Bone Scan - It is a diagnostic test to visualize all the bones in the body. It is helpful in detecting even small amounts of metastasis. Three hours after injecting the radioactive material, a set of pictures is taken of the whole body over a period of 40 mins.

Mammography

An x-ray of the breast; the method of finding breast cancer that can't be felt. Mammograms are done with a special type of x-ray machine used only for this purpose. A mammogram can show a developing breast tumor before it is large enough to be felt by a woman or even by a highly skilled health care professional.

Screening mammography is used to help find breast cancer early in women without any symptoms.

Diagnostic mammography helps the doctor learn more about breast masses or the cause of other breast symptoms.

Mammography