Diagnosing and treating cancer is a complex process requiring the experience and skills of multiple medical and health professionals, often referred to as the oncology team (also known as a cancer care team or multidisciplinary care team). This blog reviews cancer risk factors, the five main types of cancer, and the screening tests used to diagnose cancer. But, in order for claims professionals to understand the diagnosis, they need to understand the significance of the pathology report. So, we’ll also look at the types of cancer staging and grading systems – and the importance of biomarker testing.
The Role of the Pathologist
The oncology team generally includes an oncologist, an oncology nurse, an oncology nurse practitioner, a patient navigator, an oncology social worker, a pharmacist, a genetic counselor, a registered dietician, a mental health professional, a spiritual support person and a pathologist. Pathologists are physicians who specialize in the diagnosis of diseases. They receive biopsy tissue samples and complete a macroscopic examination of a specimen by describing how the specimen looks to the naked eye based on color, size, extent and characteristics of the cancer. A histopathological (microscopic) examination of the tissue is performed to determine whether a tumor is present, if it is cancerous or noncancerous, the type of cancer (i.e., carcinoma, sarcoma, etc.), and the behavior of the tumor (i.e., well differentiated vs. poorly differentiated).
Biomarker testing allows the pathologist to provide a definitive diagnosis. After cancer is diagnosed, the pathologist determines the grade and stage of the cancer which helps with treatment planning and assessing the prognosis.
Definitive diagnoses has improved cancer prevention and education.
Understanding Cancer Risks
Knowing the causes of cancer provides basic insight for understanding prevention, early detection and cancer management; if a risk factor is known, it is easier to avoid.
- Risk factors that can be modified are often called lifestyle factors, and include smoking, excessive alcohol, poor diet, exposure to ultraviolet radiation (sun) and some viral infections, such as human papilloma virus (HPV).
- Risk factors that can’t be controlled include family history, age and genetic predisposition.
- Exposure to chemicals or hazardous substances can increase the risk of cancer. Some of the more well-known carcinogens are asbestos, nickel, cadmium, radon, vinyl chloride and benzene.
The risk of developing cancer depends on how much, how long, how often and when the exposure occurred.
Signs and symptoms are ways the body lets you know that you have an injury, illness or disease. The signs and symptoms of cancer depend on where the cancer is located, how much it has grown, how much it has spread (metastasized) and how it affects nearby organs or tissues. Common signs and symptoms are fever, bleeding, fatigue, pain, swelling or lumps and weight loss.
Routine screening tests such as a mammogram, PAP smear or colonoscopy may detect breast, cervical or colorectal cancers (respectively) at an early stage before symptoms appear.
Lab tests or blood tests can play an important role in diagnosing leukemia or Hodgkin’s lymphoma. While blood tests alone can’t be used to diagnose most cancers, certain chemicals and proteins in the blood can help with diagnosis. Urine testing, urinalysis, can help detect the presence of certain cancers including bladder, kidney, prostate and cervical cancer.1
In general, diagnosing cancer usually starts with a physical exam. Additional testing is recommended if cancer is suspected. Diagnostic imaging such as computerized tomography (CT‑Scan), magnetic resonance imaging (MRI), bone scan, ultrasound (US) or positron emission tomography (PET) scans help to detect the location and size of a suspicious tumor.
A biopsy is the most effective way to diagnose cancer. A sample of the tumor is excised during surgery, by biopsy or by drawing a blood; the blood or tissue samples are then sent to the pathology department for testing.
Cancers are classified according to the kind of fluid or tissue from which they originate, or according to the location in the body where they first developed.