UNIT III. PREVENTION, DETECTION, DIAGNOSIS AND CLASSIFICATION

Primary prevention

1. smoking cessation

2. healthy diet

3. regular exercise

4. vaccination (HPV, Hepa B)

5. avoid carcinogens

Secondary Prevention

1. Screening: Pap smear. mammography and colonoscopy

2. Early detection in program

Tertiary prevention

1. preventing recurrence

2. rehabilitation

3. survivorship care

Physical Examination

first step in cancer detection. It helps identify suspicious findings that require further diagnostic testing.

Types of Physical examination?

1. General Assessment

2. Systemic-Specific Examination

3. Red Flags (“Cancer warning signs”)

General Assessment

• weight loss

• fatigue

• fever

• lymphaedenopathy

• skin changes

Types that can be in System-Specific Examination

1. Breast cancer

2. Lung cancer

3. Thyroid cancer

4. GI cancer

Breast cancer

• palpation of breast muscles

• nipple changes

• skin dimpling

Lung cancer

• breath sounds

• wheezing

• clubbing of fingers

Thyroid cancer

• thyroid nodules

• cervical lymph nodes

GI cancers

• abdominal masses

• organomegaly

• ascites

Red Flags (“cancer warning signs”)

• non-healing ulcers

• persistent lumps

• unexplained bleeding

• difficulty swallowing

• change in bowel habits

Laboratory tests

help detect organ dysfunction, blood abnormalities and biochemical changes associated with cancer

What are the Types of Laboratory tests?

1. Complete Blood Count (CBC)

2. Blood Chemistry

3. Coagulation Profile

4. Urinalysis

5. Stool tests

Complete Blood Count (CBC)

• Anemia: gastric cancer, colon cancer

• Leukocytosis or blasts: Leukemia

• Thrombocytopenia: Bone marrow involvement

Blood chemistry

• Liver function tests: liver metastasis

• Renal function tests: Kidney involvement

• Calcium levels: Multiple myeloma (hypercalcemia)

Coagulation profile

• Abnormal clotting: liver cancer, leukemia

Urinalysis

• Hematuria: bladder cancer

• Proteinuria: myeloma

Stool Tests

• Occult blood: colorectal cancer

Imaging Studies

Imaging visualizes tumors, determines size, invasion and metastasis. It is essential for TNM staging.

Types of Imaging Studies

1. CT Scan (Computed Tomography)

2. MRI (Magnetic Resonance Imaging)

3. PET Scan (Positron Emission Tomography)

CT Scan (Computed Tomography)

Uses x-rays to create detailed cross-sectional images

USES of CT Scan?

• detects tumors in lungs, liver, pancreas, kidneys

• identifies lymph node enlargement

• guides biopsy

• evaluates metastasis

ADVANTAGES of CT Scan

• fast

• widely available

• excellent for chest and abdomen

LIMITATIONS of CT Scan

• radiation exposure

• less detailed for soft tissues compared to MRI

MRI (Magnetic Resonance Imaging)

Uses magnetic fields to produce high-resolution images.

USES of MRI

• brain tumors

• spinal cord tumors

• soft tissue sarcomas

• breast cancer (high risk patients)

ADVANTAGES of MRI

• superior, soft tissue detailed

• no radiation

LIMITATIONS of MRI

• expensive

• not ideal with patients with metal implants

PET Scan (Positron Emission Tomography)

shows metabolic activity of tissue using radioactive glucose

USES of PET

• detects metastasis

• evaluate treatment response

• identifies active cancer cells

ADVANTAGES of PET

• highly sensitive

• detects cancer before structural occur

LIMITATIONS of PET

• very expensive

• limited availability

TUMOR MARKERS

Tumor markers are substances produced by cancer cells or by the body in response to cancer. They are measured in blood, urine, or tissues.

Tumor markers do NOT diagnose cancer but they help in:

• Monitoring trearment

• Derecting reccurence

• cuppoming diagnosin

• Arsering prognosis