Bone cancer - Diagnostic methods
Our bone cancer experts use state-of-the-art diagnostic tools, including advanced imaging and laboratory tests, to evaluate bone cancer. Then together, we develop a comprehensive bone cancer treatment plan that works for you. Your individualized plan will include advanced medical treatments and technologies, combined with supportive care services to help reduce side effects and keep you strong in body, mind and spirit.
A thorough and accurate cancer diagnosis is the first step in developing a bone cancer treatment plan. Your integrated team of bone cancer experts will use advanced diagnostic tests and tools to evaluate the disease, and plan your individualized treatment
Physical exam and health historywe will perform a complete array of diagnostic tests, and thoroughly review your medical records and health history. The doctor will also likely conduct a physical exam. This information helps us formulate treatment recommendations best suited to you.
Reduced wait times for appointments and test results
We understand that waiting for test results can create a great deal of stress. To ease anxiety and help you begin your bone cancer treatment sooner.
We also want you to be as comfortable as possible during your imaging tests. Our team uses padding and comfort equipment, as well as a variety of positioning devices, to help you feel more relaxed during scans and procedures.
Biopsy for bone cancerTwo biopsy techniques used for bone cancer detection include:
What is a biopsy?During a biopsy, a doctor removes a sample of tissue or fluid from the body. A pathologist inspects the cells under a microscope to see if they are cancerous. If the cells are found to be cancerous, a biopsy may help determine whether the cancer began at the site of the biopsy or if it started somewhere else in the body and spread to the biopsy site.
Some biopsies are performed endoscopically, others under image guidance, such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) in the radiology suite. In some cases, biopsies are performed in the operating suite. This allows your doctor to collect tissue from deep inside the body.
Some sites that are commonly biopsied include the breast, skin, bone marrow, GI tract, lung, liver, bladder, colon and lymph nodes. Our doctors determine the method of biopsy based on several factors, such as the size, shape, location, and characteristics of the abnormality.
Biopsy is critical, because the tissues that are removed during biopsy allow physicians to make a definite diagnosis. A physical exam, patient history, and imaging studies might suggest that a patient has a certain subtype of sarcoma, but that diagnosis can only be made after a pathologist examines the tumor`s cells.
Tissue samples can be obtained through needle aspiration or through open surgical methods. Because many soft tissue sarcomas are easy for physicians to locate and feel, needle biopsy is often all that is necessary. Needle biopsies are frequently performed by radiologists under CT guidance.
Sometimes an incisional biopsy is necessary because it allows for the removal of more tissue. This type of biopsy involves making an incision in the skin and obtaining some pieces of the tumor for evaluation. Excisional biopsy (a biopsy that removes the entire tumor) should be avoided in most cases of suspected sarcomas, with rare exception. Instead, a well-planned resection surgery is preferred after the disease has been diagnosed and staged.
The Pathologist`s Role in Sarcoma Diagnosis
A pathologist is a physician who uses scientifically-based laboratory methods to diagnose and characterize diseases. It is the pathologist who is ultimately responsible for making a sarcoma diagnosis based on the examination of tumor tissue.
Because the pathologist’s analysis of tissue from a patient’s tumor is absolutely critical in sarcoma treatment, sarcoma pathologistsare specially trained in the diagnosis of these rare tumors. Correct identification of the specific sarcoma subtype is important because treatment protocols differ for various subtypes of sarcoma. Historically, sarcomas have been classified based on how they look under the microscope. Today it is also possible for pathologists to use molecular diagnostics to assist in diagnosis.
The pathologist’s report contains the diagnosis (the identification of the particular subtype of sarcoma), as well as information about the size, shape, and appearance of the tumor sample, and information about the completeness of resection for surgical specimens. This report might also come with a molecular pathology report , which indicates the presence or absence of specific genetic mutations.
X-ray for bone cancer
Cancer may make the bone appear different from surrounding healthy bone on an X-ray. The bone may look ragged, or it may appear to have a hole in it. A chest X-ray may also help determine if cancer cells have spread to the lungs.
An X-ray, a type of high-energy electromagnetic radiation, is often used for medical imaging. X-ray technology may be used to examine many parts of the body. This image-guided technology is an important procedure for cancer diagnosis, staging and treatment.
An X-ray uses electromagnetic radiation to create images. The image is recorded on a film, called a radiograph. The images produced appear light or dark, depending on the absorption rates of the various tissues. For example, dense materials, such as bone, show up white on a film, while fat and muscle may appear in varying shades of gray.
Originally, X-rays were used for imaging bones because they were easily distinguishable from soft tissues on films available at the time. Today, improvements such as better photographic films, more accurate focusing systems and more sensitive detection methods have led to better imaging technology and results. Using lower-exposure levels, fine detail and subtle differences may be distinguished in tissue density. Advances in technology have led to the development of computed tomography (CT), which combines multiple X-ray images into a 3D model.
Before undergoing certain types of X-rays, you may be given a contrast medium like barium or iodine to help identify a specific area of the body on the X-ray image. Contrast mediums may be swallowed or given as an injection or an enema. An X-ray exam is quick and painless. In low doses, X-rays may be used to create images of structures inside the body to detect and stage a tumor. Radiation exposure from an X-ray for imaging is low, and research suggests the benefits far outweigh the risks. In higher doses, X-rays may be used in radiation therapy to help destroy cancerous cells in the body.
Managing side effects
X-ray procedures have fewer side effects than those typically associated with traditional cancer treatments, including surgery, chemotherapy and radiation therapy. Patients may experience some side effects, including fatigue and pain
An MRI may be very effective for outlining a tumor in the bone, and may also help determine if cancer cells have spread to the brain or spinal cord. Magnetic resonance imaging (MRI) is an imaging tool designed to create detailed, cross-sectional pictures of the inside of the body. Using radiofrequency waves, powerful magnets and a computer, MRI systems may distinguish between normal and diseased tissue.
MRI plays an important role in cancer diagnosis, staging and treatment planning. With MRI, we may distinguish between normal and diseased tissue to precisely pinpoint cancerous cells within the body. It also may be useful for revealing metastases. MRI provides greater contrast within the soft tissues of the body than a CT scan. As a result, it is often used for imaging the brain, spine, muscle, connective tissue and the inside of bones.
For bone cancer, a radionuclide bone scan may be used to diagnose and stage the disease.
This bone cancer detection tool may reveal if the primary tumor has spread to other places in the bone, and how much damage it has caused. In a bone scan, a small dose of radioactive material is injected into a blood vessel, where it travels through the bloodstream. The material then gathers in the bones and is detected by a scanner through nuclear imaging. This test is very sensitive and often may find small metastases before they would appear on a re gular X-ray. However, other conditions such as arthritis or infection look similar on the scan, so a confirmatory biopsy is often needed.
A bone scan is an imaging test that may detect cancerous cells, evaluate fractures in bones and monitor other bone conditions, such as infections and arthritis. During a bone scan, a small dose of radioactive material is injected into a vein, where it travels through the bloodstream. The material collects in the bones and is detected by a scanner using nuclear imaging to reveal cell activity and function in the bones.
A bone scan may detect cancer that has metastasized to the bone from a different primary site, such as the breast, prostate or lungs. It may also be used to evaluate bone health before treatment.
CT scans are usually used to help make the initial bone cancer diagnosis and to see if the cancer has spread to other areas of the body. CT scans may also be used to guide the biopsy needle.
Computed tomography (CT) scan (also known as a computed axial tomography scan, or CAT scan) is one of the most commonly used tools for the screening, diagnosis and treatment of cancer.
During a CT scan, a patient rests on a table and slides into a large tunnel-shaped scanner. Some exams require a contrast dye to be injected into a vein before the procedure. This helps certain areas show up better on the images. The procedure is painless and typically takes a few minutes.
A CT scan may be used to pinpoint the location of a tumor, evaluate the extent of cancer in the body and assess whether the disease is responding to treatment. In some cases, CT technology is used to accurately guide cancer treatment during a procedure.