Would a tumor show up on an x ray: X-rays of the Spine, Neck or Back
X-rays of the Spine, Neck or Back
What are X-rays of the spine, neck or back?
X-rays use invisible electromagnetic energy beams to make images of internal tissues, bones, and organs on film. Standard X-rays are performed for many reasons. These include diagnosing tumors or bone injuries.
X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a “negative” type picture is made (the more solid a structure is, the whiter it appears on the film). Instead of film, X-rays are now typically made by using computers and digital media.
When the body undergoes X-rays, different parts of the body allow varying amounts of the X-ray beams to pass through. Images are made in degrees of light and dark. It depends on the amount of X-rays that penetrate the tissues. The soft tissues in the body (like blood, skin, fat, and muscle) allow most of the X-ray to pass through and appear dark gray on the film. A bone or a tumor, which is denser than soft tissue, allows few of the X-rays to pass through and appears white on the X-ray. At a break in a bone, the X-ray beam passes through the broken area. It appears as a dark line in the white bone.
X-rays of the spine may be performed to evaluate any area of the spine (cervical, thoracic, lumbar, sacral, or coccygeal). Other related procedures that may be used to diagnose spine, back, or neck problems include myelography (myelogram), computed tomography (CT scan), magnetic resonance imaging (MRI), or bone scans. Please see these procedures for additional information.
Anatomy of the spine
The spinal column is made up of 33 vertebrae that are separated by spongy disks and classified into distinct areas:
The cervical area consists of 7 vertebrae in the neck.
The thoracic area consists of 12 vertebrae in the chest.
The lumbar area consists of 5 vertebrae in the lower back.
The sacrum has 5 small, fused vertebrae.
The 4 coccygeal vertebrae fuse to form 1 bone, called the coccyx or tailbone.
The spinal cord, a major part of the central nervous system, is located in the vertebral canal and reaches from the base of the skull to the upper part of the lower back. The spinal cord is surrounded by the bones of the spine and a sac containing cerebrospinal fluid. The spinal cord carries sense and movement signals to and from the brain and controls many reflexes.
Reasons for the procedure
X-rays of the spine, neck, or back may be performed to diagnose the cause of back or neck pain, fractures or broken bones, arthritis, spondylolisthesis (the dislocation or slipping of 1 vertebrae over the 1 below it), degeneration of the disks, tumors, abnormalities in the curvature of the spine like kyphosis or scoliosis, or congenital abnormalities.
There may be other reasons for your health care provider to recommend an X-ray of the spine, neck, or back.
Risks of the procedure
You may want to ask your health care provider about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, like previous scans and other types of X-rays, so that you can inform your health care provider. Risks associated with radiation exposure may be related to the cumulative number of X-ray exams and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your health care provider. Radiation exposure during pregnancy may lead to birth defects. If it is necessary for you to have a spinal X-ray, special precautions will be made to minimize the radiation exposure to the fetus.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your health care provider prior to the procedure.
Before the procedure
Your health care provider will explain the procedure to you and offer you the opportunity to ask questions that you might have about the procedure.
Generally, no prior preparation, like fasting or sedation, is required.
Notify the radiologic technologist if you are pregnant or suspect you may be pregnant.
Notify the radiologic technologist if you have had a recent barium X-ray procedure, as this may interfere with obtaining an optimal X-ray exposure of the lower back area.
Based on your medical condition, your health care provider may request other specific preparation.
During the procedure
An X-ray may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your health care provider’s practices.
Generally, an X-ray procedure of the spine, neck, or back follows this process:
You will be asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that may interfere with the procedure.
If you are asked to remove any clothing, you will be given a gown to wear.
You will be positioned on an X-ray table that carefully places the part of the spine that is to be X-rayed between the X-ray machine and a cassette containing the X-ray film or digital media. Your health care provider may also request X-ray views to be taken from a standing position.
Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the X-rays.
The radiologic technologist will ask you to hold still in a certain position for a few moments while the X-ray exposure is made.
If the X-ray is being performed to determine an injury, special care will be taken to prevent further injury. For example, a neck brace may be applied if a cervical spine fracture is suspected.
Some spinal X-ray studies may require several different positions. Unless the technologist instructs you otherwise, it is extremely important to remain completely still while the exposure is made. Any movement may distort the image and even require another study to be done to obtain a clear image of the body part in question. You may be asked to breathe in and out during a thoracic spine X-ray.
The X-ray beam will be focused on the area to be photographed.
The radiologic technologist will step behind a protective window while the image is taken.
While the X-ray procedure itself causes no pain, the manipulation of the body part being examined may cause some discomfort or pain. This is particularly true in the case of a recent injury or invasive procedure like surgery. The radiologic technologist will use all possible comfort measures and complete the procedure as quickly as possible to reduce any discomfort or pain.
After the procedure
Generally, there is no special type of care following an X-ray of the spine, back, or neck. However, your health care provider may give you additional or alternate instructions after the procedure, depending on your particular situation.
X-rays and Other Radiographic Tests for Cancer
X-rays and other radiographic tests (also known as radiographs, roentgenograms, and contrast studies) help doctors look for cancer in different parts of the body including bones, and organs like the stomach and kidneys. X-rays are typically fast, painless, and there’s no special preparation needed. Contrast studies may require more preparation ahead of time and may cause some discomfort and side effects, depending on what kind you are having. (For names of contrast studies, see Table 1.)
What do x-rays show?
Radiographs, most often called x-rays, produce shadow-like images of bones and certain organs and tissues. X-rays are very good at finding bone problems. They can show some organs and soft tissues, but MRI and CT scans often give better pictures of them. Still, x-rays are fast, easy to get, and cost less than other scans, so they might be used to get information quickly.
Mammograms (breast x-rays) are a form of radiographic tests. To learn more about them, see Mammogram Basics.
Special types of x-ray tests called contrast studies use iodine-based dyes or contrast materials, like barium, along with the x-rays to make the organs show up on the x-ray and get better pictures. For instance, a lower gastrointestinal (GI) series, often called a barium enema exam, takes x-ray pictures after the bowel is filled with barium sulfate. Another contrast study, an intravenous pyelogram (IVP), uses a special dye to look at the structure and function of the urinary system (ureters, bladder, and kidneys). See Table 1 for more examples.
Due to advances in technology, many contrast studies are being replaced by other scans, such as CT or MRI scans. For instance, in the past, angiography was often used to help learn the stage or extent of cancer, but now CT and MRI scans are most often used to do this. Still, angiography is sometimes used to show the blood vessels next to a cancer so surgery can be planned to limit blood loss. And angiograms may be used to diagnose non-cancerous blood vessel diseases.
How do x-rays work?
A special tube inside the x-ray machine sends out a controlled beam of radiation. Tissues in the body absorb or block the radiation to varying degrees. Dense tissues such as bones block most radiation, but soft tissues, like fat or muscle, block less. After passing through the body, the beam hits a piece of film or a special detector. Tissues that block high amounts of radiation, such as bone, show up as white areas on a black background. Soft tissues block less radiation and show up in shades of gray. Organs that are mostly air (such as the lungs) normally look black. Tumors are usually denser than the tissue around them, so they often show up as lighter shades of gray.
Contrast studies provide some information that standard x-rays cannot. During a contrast study, you get a contrast material that outlines, highlights, or fills in parts of the body so that they show up more clearly on an x-ray. The contrast material may be given by mouth, as an enema, as an injection (put in a vein), or through a catheter (thin tube) put into various tissues of the body. It will look bright white on the x-ray and outline the body part. For most of these tests, the images can be captured either on x-ray film or by a computer.
Table 1: Commonly Used Contrast Studies
Dye is given by
Angiography, angiogram, arteriography, arteriogram
Arteries throughout the body, including those in the brain, lungs, and kidneys
Catheter (thin tube) in an artery
Intravenous pyelogram (IVP)
Urinary tract (kidney, ureters, bladder)
Injection into vein (IV)
Lower GI (gastrointestinal) series, barium enema (BE), double-contrast barium enema (DCBE), air-contrast barium enema (ACBE)
Upper GI series, barium swallow, esophagography, small bowel follow through
Esophagus, stomach, small intestine
Veins throughout the body, most often in the leg
Catheter in a vein
How do I get ready for x-ray(s)?
Other than removing metal objects that might interfere with the picture, no special preparation is needed before having a standard x-ray.
Preparation for a contrast study depends on the test. You may be asked not to eat anything or to prepare in other ways before the test (see the next section). The radiology center will give you instructions. Check with them first. Your health care provider also might give you instructions.
Always be sure to tell your health care provider whether you have allergies to iodine or have had problems with contrast materials in the past.
What is it like having x-rays(s)?
Usually x-rays are taken by an x-ray technologist. You will undress to expose the part of the body to be x-rayed. You’ll need to remove jewelry or other objects that might interfere with the image. You may be given a gown or drape to wear. You’ll be asked to sit, stand, or lie down, depending the body part to be x-rayed. Your body is put against a flat box or table that holds the x-ray film. The technologist then moves the machine to aim the beam of radiation at the right area.
You may have special shields put over parts of your body near the area being x-rayed so that they’re not exposed to the radiation. Usually the technologist leaves the room to operate the machine by remote control. But they can hear and see you at all times. Your exposure to the x-ray is very brief – usually less than a second. You may hear buzzing or clicking sounds while the machine is working.
For a chest x-ray, often 2 views are taken. First, you stand with your chest against the x-ray film and the image is taken from the back. Your arms are at your side. Then a side view is often taken with your arms either above your head or in front of you. The technologist will tell you when to take a deep breath and hold still. For a chest x-ray in people who can’t stand, the film is put under them and the picture is taken from the front.
During an abdominal (belly) x-ray, you lie down on a table. You may be asked to change position or sit up if more than one view is needed. You’ll need to hold your breath and lie still while the picture is taken quickly.
After the x-ray, the technologist will come back to the room to move the machine out of the way, remove any protective shields, collect the film, and help you back to the changing room where you can get dressed.
Angiography: You’ll be asked to not eat before this test. In most cases, you’ll be given medicine to relax you before the test starts. You will lie still on a table as the skin over the injection site is cleaned and numbed. A tiny cut will be made so the catheter (thin plastic tube) can be put into a blood vessel (usually the artery at the top of the thigh) and slid in until it reaches the area to be studied. The contrast dye is then put in, and a series of x-ray pictures is taken to see how the dye flows through the blood vessels. After that, the catheter is taken out.
Firm pressure might be needed on the catheter site for a while to make sure it doesn’t bleed. You’ll also need to lie flat and keep your leg still for up to several hours. This helps prevent bleeding at the catheter site, too.
Other types of angiography: Advances in technology have led to other forms of angiography that take less time and mean fewer risks than x-ray angiography. CT angiography takes pictures of blood vessels using a CT scanner instead of a standard x-ray machine. The contrast dye can be put into a small vein in the arm instead of having to put a catheter into a major blood vessel. Magnetic resonance angiography (MRA) is an MRI study of the blood vessels. It may be done with or without contrast dye, and is also quicker than a standard x-ray angiogram.
Intravenous pyelogram (IVP): You’ll probably be asked not to eat or drink anything for about 12 hours before this test, and you must take laxatives to clean out your bowel. For the test itself, you lie on a table for a series of x-rays. Contrast dye is then out into a vein in your arm. Your kidneys remove the dye from the bloodstream, and it goes into the urinary tract. Another series of x-rays is taken over the next 30 minutes or so to get pictures of the dye as it moves through the kidneys and out of your body. Pressure may be applied to the belly to help make the image clearer. Once the dye has reached the bladder, you’ll be asked to pass urine while another x-ray is taken.
Lower GI series (barium enema): Your diet may be restricted for a few days before this test. Laxatives and/or enemas are used to clean out the bowel (large intestine). For the test, you lie down and are strapped to a table. A series of x-rays is taken. Then liquid barium is put into your bowel through a small, soft tube placed in your rectum. The liquid feels cool. More images are then taken while the table tilts you into different positions. This helps the barium move through your bowels so they can be seen on the x-rays. You have to lie still and hold your breath as each image is taken.
After the test, you can go to the toilet to pass the barium solution out of your bowels. (It may take a few days until it’s all out. Your stool may be drier, harder, and light-colored during this time.)
To get clearer pictures, a “double-contrast” exam is often done. This exam uses a smaller amount of thicker barium liquid. After the barium is in, air is put into your bowel. This can cause a sense of fullness and discomfort, along with an urge to empty your bowels.
Upper GI series: You will probably be asked to not eat or drink for 8 to 12 hours before this test. You will lie down and be strapped to a tilting table while a series of x-rays are taken as the barium coats your esophagus and stomach. You’ll need to swallow the barium mixture a few times during the test. (In some cases, substances other than barium are used.) You might also be asked to swallow baking soda crystals to create gas in your stomach.
Sometimes more pictures are taken a few hours later to show the small intestine (it takes time for the barium to move from the stomach to the small intestine). This is called a small bowel follow through.
After the test you may be given a laxative to speed up getting the barium out of your body. It still may take a few days until it’s all out. Your stool may be drier, harder, and light-colored during this time.
Venography: As you lie still on a table, the skin over the vein to be used is cleaned and numbed. This will be a small vein below the vein that might be blocked (like the foot for a vein in the leg, or the hand for a vein in the arm). A catheter (thin plastic tube) is then put into the small vein. It may be threaded in so that it passes into a larger vein closer to the one to be studied, or a tourniquet may be used so the dye flows into the deeper veins. The contrast dye is put in to make the veins show up on the x-ray, and a series of x-ray pictures is taken.
Extra fluids may be given through the catheter to help wash the dye out of your body. After that, the catheter is taken out. Firm pressure may be needed on the site for a while to make sure it doesn’t bleed.
How long do x-rays take?
- Standard x-ray: about 5 to 10 minutes
- Angiogram: 1 to 3 hours
- Intravenous pyelogram: about 1 hour
- Lower GI series: 30 to 45 minutes
- Upper GI series: 30 minutes to 6 hours, depending on the part of the digestive system being tested
- Venogram: 30 to 90 minutes
What are the possible complications and side effects of x-rays?
Standard x-rays: Problems are rare and very unlikely.
Angiography: You may have a warm or burning feeling as the dye is given. The contrast material may cause nausea, vomiting, flushing, itching, or a bitter or salty taste. In rare cases, people can have a severe allergic reaction to the contrast material that affects their breathing and blood pressure. The contrast material can also cause kidney problems. This is rare, but it’s more common in someone whose kidneys already don’t work well.
There’s a small risk of a blood clot forming on the end of the catheter, which could block a blood vessel. There’s also a small risk of damage to the blood vessel from the catheter, which could lead to internal bleeding. A hematoma (a large collection of blood under the skin) may develop where the catheter was put in if pressure is not kept on the site long enough. Infection is possible at the catheter site. (Possible complications of CT or MR angiography are like those described in the sections on CT and MRI).
Your body may ache from lying still on the flat table for a few hours.
Intravenous pyelogram (IVP): The contrast dye sometimes causes some people to have flushing, mild itching, or a bitter or salty taste. In rare cases, people have a severe reaction to the contrast material and need emergency treatment.
Lower GI series (barium enema): The test can be uncomfortable. Some patients have abdominal (belly) cramping. Many patients find the test makes them tired. The barium contrast material will make your stools a light color for a few days after the test and may cause constipation. Very rarely, the barium can cause an obstruction, or blockage, in the bowels.
Upper GI series (barium swallow): The barium mixture has the thickness of a milkshake and tastes chalky. Baking soda crystals can cause bloating, gas, and belching. After the test, your stools will be a light color for a few days, and you may be constipated. There’s a slight chance that the barium might cause an obstruction or blockage in the intestine.
Venography: You may have a warm or burning feeling as the dye is given. Your arm or leg (where the catheter is put in) may feel numb during the test. Some people have a bitter or salty taste in their mouth. In rare cases, people can have a severe allergic reaction to the contrast material that affects their breathing and blood pressure. The contrast material can also cause kidney problems. This is rare, and it’s more common in someone whose kidneys already don’t work well.
There’s a small risk of a blood clot forming, which could block a blood vessel. There’s also a small risk of damage to the blood vessel from the catheter, which could lead to internal bleeding. There may be pain and bruising and infection is possible where the catheter is put in.
What else should I know about x-rays?
- Tell your doctor if you could be pregnant or are breastfeeding before having any of these tests.
- X-ray tests expose the body to radiation, but modern x-ray equipment uses much smaller amounts of radiation than in the past. (See “Understanding Radiation Risk from Imaging Tests” for more on this.)
- A newer technology, called digital radiology, produces pictures on computer screens rather than on film. The size and contrast of the pictures can be digitally adjusted to make them easier to read, and they can be sent to computers in other medical offices or hospitals.
- If you are to have a test that uses a contrast dye, tell your doctor if you are allergic to contrast materials, iodine, or to seafood. This may put you at a higher risk for having a reaction.
X-rays | Tests and scans
An x-ray is a test that uses small doses of radiation to take pictures of the inside of your body. They are a good way to look at bones and can show changes caused by cancer or other medical conditions. X-rays can also show changes in other organs, such as the lungs.
You usually have x-rays in the imaging department of the hospital, taken by a radiographer. But in an emergency they are sometimes done on the ward.
There are different types of tests using x-rays, including:
- chest x-rays to show fluid, signs of infection, an enlarged heart or tumours in the chest
- x-rays of the bones to show breaks (fractures), degenerative changes, infection or tumours
- x-rays of the breasts (mammograms)
- dental x-rays to look at the teeth and jaw
- real time x-ray screening (fluoroscopy) to help doctors put in stents or wires, or to look at blood vessels (angiography), or to show the outline of body structures (barium x-rays)
- CT scans are a series of x-rays of an area of the body to build up a 3 dimensional (3D) picture
Before your x-ray
There is no special preparation for an x-ray. You can eat and drink normally beforehand. Take your medicines as normal.
When you arrive, the radiographer might ask you to change into a hospital gown and take off any jewellery.
During your x-ray
You usually have a chest x-ray standing up against the x-ray machine. If you can’t stand you can have it sitting or lying on the x-ray couch. For x-rays of other areas of the body the best position is usually lying down on the x-ray couch.
The radiographer lines the machine up to make sure it’s in the right place. You must keep very still to prevent blurring of the picture.
The radiographer then goes behind a screen. They can still see and hear you. They might ask you to hold your breath for a few seconds while they take the x-ray.
X-rays are painless and quick. You won’t feel anything.
You might have more than one x-ray taken from different angles. The whole process may take a few minutes.
After your x-ray
After the x-ray you can get dressed and go home or back to work.
An x-ray is a safe test for most people but like all medical tests it has some possible risks. Your doctor and radiographer make sure the benefits of having the test outweigh these risks.
The amount of radiation you receive from an x-ray is small and doesn’t make you feel unwell.
The risk of the radiation causing any problems in the future is very small. The benefits of finding out what is wrong outweigh any risk there may be from radiation.
Talk to your doctor if you are worried about the possible effects of x-ray.
Fertility and pregnancy
The ovaries and testicles are particularly sensitive to radiation and you may have lead blocks to shield them if they are in the x-ray field.
It is very important to tell your doctor if you think you may be pregnant, as the x-rays could affect your developing baby. If you can’t delay the x-ray, the radiographer may be able to shield the baby with a lead apron or block.
Getting your results
You should get your results within 1 or 2 weeks at a follow up appointment.
Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.
You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.
Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.
We have more information on tests, treatment and support if you have been diagnosed with cancer.
Sarcomas, Soft Tissue: Diagnosis | Cancer.Net
ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.
Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments may work best.
For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Although biopsies have a small chance of not giving a definite answer, they are very important to allow your doctor to make a clear diagnosis and develop a clear team-based treatment plan.
This section describes options for diagnosing sarcoma. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
The type of cancer suspected
Your signs and symptoms
Your age and general health
The results of earlier medical tests
There are no standard screening tests for sarcoma. A doctor should examine any unusual or new lumps or bumps that are growing to make sure it is not cancer. If a sarcoma is suspected, it is very important to talk with a doctor who has experience with this type of cancer.
A diagnosis of sarcoma is made by a combination of clinical examination by a doctor and imaging tests. It is confirmed by the results of a biopsy. In addition to a physical examination, some of the tests described below may be used to diagnose sarcoma.
Both benign and cancerous tumors can show up on imaging tests, such as an x-ray. A radiologist, a medical doctor who performs and interprets imaging tests to diagnose disease, will use the way the tumor looks on the test to help determine whether it may be benign or cancerous. However, a biopsy is almost always needed.
X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. X-rays are particularly useful for bone sarcomas but less valuable for STS.
Ultrasound. An ultrasound uses sound waves to create a picture and may be used to look at lumps under the skin or other organs in the body.
Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size or see if the cancer has spread somewhere else. Sometimes, a special dye called contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein and/or be a pill or liquid the patient must drink.
Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein. MRI is often used to determine whether a sarcoma can be removed with surgery.
Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body. This technique can be used to look at both the tumor’s structure and how much energy is used by the tumor and normal tissues. This information can be helpful in planning treatment and evaluating how well treatment is working, but it is usually not performed in all cases of known or suspected STS.
Biopsy and tissue tests
Imaging tests may suggest the diagnosis of sarcoma, but a biopsy will be needed to confirm the diagnosis and to find out the type of sarcoma. Because a biopsy that is not properly done can make a surgery more difficult, whenever a sarcoma is suspected, it is very important for a patient to see a sarcoma specialist before any surgery or biopsy is done.
A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a reliable diagnosis. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.
Because STS is rare, an expert pathologist should review the tissue sample to properly diagnose a sarcoma. Sometimes properly diagnosing a sarcoma requires special tests on the tumor tissue, and it is best if a specialist who sees this type of cancer regularly does this.
There are different types of biopsies.
For a needle biopsy, a doctor removes a small sample of tissue from the tumor with a needle-like instrument—usually a core needle biopsy. This may be performed with the help of ultrasound, CT scan, or MRI to precisely guide the needle into the tumor.
In an incisional biopsy, a surgeon cuts into the tumor and removes a sample of tissue.
In an excisional biopsy, the surgeon removes the entire tumor. Excisional biopsies are generally not recommended for sarcomas because the risk of local recurrence is very high and second surgeries are often needed to completely remove the tumor. A recurrence is when cancer comes back after treatment.
The type of biopsy and how it is done are important in diagnosing and treating sarcomas. Patients should be seen in a sarcoma specialty center before the biopsy is performed, so that the treating surgeon can identify the location for the biopsy. It is important to have an expert pathologist review the sample of tissue removed to appropriately diagnose a sarcoma.
Tissue testing of the tumor
Your doctor or the pathologist looking at the sarcoma may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. Results of these tests will help decide what the treatment should be, because each sarcoma can be as different from one another as breast cancer is different from colon cancer.
After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging and grading.
The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.
Head and Neck Cancer: Diagnosis
ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.
Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.
For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.
There are many tests used for diagnosing head and neck cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. In addition, the following tests may be used to diagnose head and neck cancer:
Physical examination/blood and urine tests. During a physical examination, the doctor feels for any lumps on the neck, lips, gums, and cheeks. The doctor will also inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and a mirror for a clearer view. Blood tests and urine tests may be done to help diagnose cancer.
Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated as the tube is gently inserted through the nose into the throat and down the esophagus to examine inside the head and neck. Sedation is giving a person medication to become more relaxed, calm, or sleepy. The examination has different names depending on the area of the body that is examined, such as laryngoscopy to view the larynx, pharyngoscopy to view the pharynx, or nasopharyngoscopy to view the nasopharynx. When these procedures are combined, they are sometimes referred to as a panendoscopy.
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. A pathologist then analyzes the sample(s) removed during the biopsy. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A common type of biopsy is called a fine needle aspiration. During this procedure, cells are collected using a thin needle inserted directly into the tumor or lymph node. The cells are examined under a microscope for cancer cells, which is called a cytologic examination.
The biopsy may include testing to see whether the person has HPV. As described in Risk Factors and Prevention, HPV has been linked to a higher risk of some head and neck cancers. In some cases, whether a person has HPV can also be a factor in determining which treatments are likely to be most effective.
Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options.
X-ray/barium swallow. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. A barium swallow may be required to identify abnormalities along the swallowing passage. During a barium swallow, a person swallows a liquid containing barium, and a series of x-rays are taken. Barium coats the lining of the esophagus, stomach, and intestines, so tumors or other abnormalities are easier to see on the x-ray. A special type of barium swallow called a modified barium swallow may be needed to evaluate specific swallowing difficulties. If there are signs of cancer, the doctor may recommend a computed tomography (CT) scan (see below).
Panoramic radiograph. A panoramic radiograph is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer or evaluate the teeth before radiation therapy or chemotherapy. This is often called a panorex.
Ultrasound. An ultrasound uses sound waves to create a picture of internal organs.
Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.
Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.
Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The amount of radiation in the tracer is too low to be harmful. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears lighter to the camera, and areas of injury, such as those caused by cancer, stand out on the image. This test may be done to see if cancer has spread to the bones.
Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.
After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.
The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.
Brain Tumor Diagnosis | UCSF Health
To find the cause of your symptoms, your doctor will ask about your personal and family medical history and perform a complete physical examination. In addition to checking general signs of health, your doctor will perform a neurologic exam. This includes checks for alertness, muscle strength, coordination, reflexes and response to pain. Your doctor also examines the eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.
Depending on the results of the physical and neurologic examinations, your doctor may request one or both of the following:
- Computerized Tomography (CT) Scan Computerized tomography (CT) or computerized axial tomography (CAT) scan is a series of detailed pictures of the brain, created by a computer linked to an X-ray machine. In some cases, a special dye is injected into a vein before the scan. The dye helps to show differences in the tissues of the brain.
- Magnetic Resonance Imaging (MRI) Magnetic resonance imaging (MRI) provides pictures of the brain, using a powerful magnet linked to a computer. MRI is especially useful in diagnosing brain tumors because it can “see” through the bones of the skull to the tissue underneath. A special dye may be used to enhance the likelihood of detecting a brain tumor.
The doctor may also request other tests such as:
- Angiogram or Arteriogram These tests are a series of X-rays taken after a special dye is injected into an artery, usually in the area where the abdomen joins the top of the leg. The dye, which flows through the blood vessels of the brain, can be seen on X-rays. These X-rays can show the tumor and connecting blood vessels.
- Brain Scan A brain scan reveals areas of abnormal growth in the brain and records them on special film. A small amount of a radioactive material is injected into a vein. This dye is absorbed by the tumor and the growth shows up on the film. The radiation leaves the body within six hours and is not dangerous.
- Functional Imaging This test utilizes MRI or magnetic source imaging to identify functional pathways in the brain (motor, visual, language) and alerts the surgeon to potential injury to these pathways during surgery before damage could occur.
- Myelogram A myelogram, sometimes called a lumbosacral spine X-ray, is an X-ray or computerized tomography (CT) scan of the spine. A special dye is injected into the cerebrospinal fluid in the spine and the patient is tilted to allow the dye to mix with the fluid. This test may be done when the doctor suspects a tumor in the spinal cord.
- MR Spectroscopy This is a modified MRI scan that shows metabolic activity within a brain tumor. This has largely replaced positron emission tomography (PET) scanning due to its superior resolution and accuracy.
Whole-Body Scans to Screen for Cancer
They don’t help find cancer—and may do more harm than good
Whole-body scans are imaging tests. They take pictures of your entire body. Medical centers usually market them directly to consumers. The medical centers say that the scans help find cancer and other diseases early.
But these scans aren’t very good at finding cancer in people without symptoms. And the scans have risks and costs. Here’s what you need to know.
Whole-body scans are a poor screening tool.
No medical societies recommend whole-body scans. That’s because there is no evidence that the scans are a good screening tool.
- Whole-body scans find cancer tumors in less than two percent of patients without symptoms. Some of these tumors would never cause a problem if left alone. They would disappear. Or they would grow too slowly to cause problems.
- Whole-body scans can miss signs of cancer. The tests that are recommended—like mammograms—would probably find these signs.
- A whole-body scan can give you a false sense of security. You may ignore real symptoms if they appear.
Whole-body scans use a lot of radiation.
The scans use two kinds of technology:
- CT (computed tomography) scan: Takes many X-ray pictures of the body.
- PET (positron emission tomography) scan: Radioactive material is injected into the body and collects in areas with cancer.
These scans use large amounts of radiation. This can increase your risk of cancer. If you have more tests, your risk increases.
Also, there are no federal radiation limits for CT scans (unlike other tests, such as mammograms). Therefore, it’s hard to be sure how much radiation you’re getting.
Get scans when and where you really need them.
Sometimes CT scans and other imaging tests are really necessary. For example, you may need a scan of the head after an injury. In these cases, your doctor thinks the benefits are greater than the risks.
When you have a scan on one body part, your risks are limited. There is protection for other parts—like the lead blanket that covers you during dental X-rays.
Whole-body scans can lead to unnecessary follow-up tests.
Often, whole-body scans show some things that do not look normal. Almost all of these are harmless. But in one study, about a third of patients were referred for more imaging tests.
For example, there may be a group of shadows on the picture. Many doctors will want to take another look. This can lead to more imaging tests and more radiation. It can lead to biopsies and surgery to find out if there is a problem. These tests can cause worry and extra costs.
Whole-body scans are costly.
Usually, insurance does not pay for whole-body scans. The scans may cost from $500 to $1,000. If you have follow-up tests, your costs can be much higher.
Are whole-body scans ever recommended?
Your doctor may order the test if you already have cancer, to see if it has spread.
The test may also be helpful in an emergency. Doctors may use the test to help examine a major injury.
This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
© 2015 Consumer Reports. Developed in cooperation with the American College of Preventive Medicine for Choosing Wisely, a project of the ABIM Foundation.
90,000 A new method for diagnosing breast cancer has been developed in Germany | Analysis of events in political life and society in Germany | DW
Breast cancer is one of the most common cancers in women living in industrialized countries. Breast cancer accounts for 30 percent of all cancers. If a malignant tumor can be detected at an early stage, then the chances of recovery in patients increase up to 95 percent.
Cancer diagnosis today requires the analysis of a sample of altered tissue – a procedure called a biopsy.Although biopsy in most cases does not require major surgery, it nevertheless carries some risks, is unpleasant, and sometimes does not produce the desired result.
Liquid biopsy enables early diagnosis of breast cancer
Scientists have long sought more effective ways to identify different types of tumors in the early stages of development, when they are relatively easy to treat. 5 years ago, a group of American researchers from Baltimore developed a new diagnostic method called liquid biopsy.This is essentially a search for tumor DNA in a blood sample.
Experiments on several hundred cancer patients have confirmed that their concept of liquid biopsy actually works. But it was not always effective. For example, it was not suitable for the diagnosis of brain tumors and did not allow the detection of malignant tumors in the early stages of the disease.
However, researchers continued to refine this method. As a result, German scientists from Heidelberg have achieved the fact that liquid biopsy can now be used as an additional means of diagnosing breast cancer in the early stages.At the end of February 2019, they presented this method at a scientific congress in Dusseldorf.
German scientists predict that liquid biopsy diagnostics will be possible this year. At the same time, the new method should not at all replace the well-known and widely used mammography (X-ray of the mammary glands), ultrasound or MRI of the breast (magnetic resonance imaging), which is widely used for the diagnosis of breast cancer, but only an additional way to recognize the disease in the early stages.
A liquid biopsy does not guarantee the result in all cases
A blood test based on a liquid biopsy is recommended by doctors for women under 50 years of age who have a genetic predisposition to cancer. In this group of women, breast cancer can be detected in almost 90 percent of cases.
X-ray of the breast during mammography
However, the older the woman, the greater the risk of an inaccurate diagnosis. In the age group from 50 years, accurate diagnosis occurs in 60 percent of cases.But when a blood test using a liquid biopsy is done, malignant tumors can be found that are not visible on x-rays on mammograms.
Back in November 2018, a group of scientists from the UK, Denmark, Poland, the Netherlands and Spain published the results of a study according to which up to eight types of cancer can be recognized at an early stage using a liquid biopsy, although with low accuracy so far. Using the liquid biopsy method, they were able to diagnose only one in three cases of breast cancer.Compared to mammography, when a diagnosis can be made in 78 percent of cases, this is a rather low result. Therefore, liquid biopsy is recommended as an additional method for diagnosing breast cancer.
Liquid biopsy is not a substitute for traditional diagnostic methods
However, scientists do not doubt the success of this method. Last year, they diagnosed more than 900 women with liquid biopsies, 500 of whom had breast cancer. In addition, liquid biopsy is used to better understand the process of metastatic formation and to prevent recurrence in cancer patients.
Liquid biopsy also has important advantages over traditional biopsy, which involves the collection and examination of a very small piece of tumor tissue.
It may not show signs of resistance development. In the blood, however, there are DNA fragments from different parts of the tumor, so their analysis will give more reliable and reliable results. A liquid biopsy can also help determine if the tumor is responding at all to the therapy prescribed by your doctor.
How Germans Get Rid of Ailments
Before deciding what to do with a particular illness, it’s a good idea to have a cup of herbal tea.It can be bought in Germany not only in a pharmacy, but also in any store. Herbal teas have a beneficial effect. In addition, they perfectly raise the general tone and help to relax.
How Germans Get Rid of Ailments
A well-known cough remedy – licorice root, licorice or licorice root (Latin Glycyrrhiza glabra), is the basis of the “viscous” delicacy, beloved by the Germans. Regardless of the shape and degree of sweetness, licorice candy can do other wonders as well.A paste of crushed licorice lozenges and petroleum jelly helps to relieve calluses and horny skin on the feet.
How the Germans get rid of ailments
Today, few people know about the benefits of mustard plasters in Germany. Also rarely do Germans soar their feet with mustard powder. Mustard is better known here as a remedy for … heartburn! It sounds paradoxical, but a teaspoon of hot mustard, “taken” after a meal, soothes the stomach. The mustard oil contained in mustard improves the function of the gallbladder and liver, preventing the occurrence of heartburn.
How Germans Get Rid of Ailments
In the Middle Ages, ginger (lat. Zingiber officinale), imported from distant countries, was added to the well-known remedies for “all diseases” in Germany – garlic and horseradish root. Rich in vitamins and essential amino acids, the miracle root improves digestion and blood circulation. And ginger tea with lemon and honey is a universal antipyretic and anti-inflammatory agent.
How the Germans get rid of ailments
The fact that a moderately “accepted” drink not only warms, but also relieves of various ailments has been known for a long time.Adherents of traditional medicine in Germany use vodka as a remedy for … excessive sweating of the legs and arms. To get rid of such a nuisance, it is recommended to wipe your hands and feet with gauze soaked in vodka twice a day.
How Germans Get Rid of Ailments
Lard in German
A slice of smoked bacon or “speck”, as the Germans call it, can save you from a toothache! Anyway, calm her down for a while until you get to the dentist.Do not rush to eat the whole piece at once – leave it behind your cheek, where the tooth hurts, and in 15-20 minutes it will feel better for you. The meat salt “draws” fluid from the swollen gums and acts as a mild pain reliever.
How Germans Get Rid of Ailments
Due to its high content of oleic (monounsaturated) acid, olive oil is considered to be simply miraculous. It has healing properties. For example: to eliminate eczema, thoroughly rub oil into reddened skin.An excellent prophylactic agent against skin inflammations is a bath with the addition of 100 ml of oil and 500 ml of milk.
How Germans Get Rid of Ailments
Legends can be made about the benefits of white cabbage. In Germany, it is considered a migraine remedy. The juice of both fresh and sauerkraut is especially useful, according to traditional healers. A compress applied to the forehead of finely chopped cabbage leaves wrapped in a cotton towel also helps.
How Germans Get Rid of Ailments
Instead of mustard plasters, cottage cheese is often used in Germany. Curd compress helps to get rid of annoying cough. To do this, the heated (not hot!) Curd mass is spread on a towel and placed alternately on the chest and back, covering the patient with a woolen blanket.
How Germans Get Rid of Ailments
As you know, they knock out a wedge with a wedge, and hiccups with pepper! This physiological reaction of the body cannot be called dangerous, it usually goes away by itself.But sometimes the hiccups can be excruciatingly prolonged. In this case, it is recommended to sniff the ground black pepper. The alkaloid piperine contained in it will cause a “defensive reaction”, and the hiccuping sneeze will get rid of the hiccups.
How the Germans get rid of ailments
Artificial baking powder or just soda – the Germans urgently resort to this “handy” remedy for inflammation of the bladder. A pinch of baking soda or baking powder, dissolved in a glass of water, neutralizes the acidic environment, so favorable for the growth of bacteria, and turns it into an alkaline one.
How Germans Get Rid of Ailments
With a breakdown, flu and other ailments, the list of “healing” dishes in Germany is headed by chicken broth cooked over low heat. Spices are added to the broth: cloves, peppercorns, bay leaves, parsley roots, onions, and, if desired, a small piece of ginger. The favorite German chicken broth soup – with thin, homemade noodles.
Author: Inga Wanner
90,000 CT for cancer – DocDoc.ru
90 150 CT for cancer
Computed tomography (CT) is especially informative in oncology. Layer-by-layer scanning allows you to detect tumors at an early stage and initiate treatment in a timely manner. In modern tomographs, the “step” of scanning is so small that neoplasms with a diameter of only a few millimeters are detected. CT scan for cancer is performed not only for diagnosis, but also to assess the effectiveness of treatment, search for metastases. Sometimes, CT-guided biopsies of the neoplasms are performed.
What is CT and what are its advantages?
Computed tomography is a method of layer-by-layer scanning of the area of interest using X-rays. It is based on the fact that tissues of the body of different density weaken the rays to varying degrees. After passing through the tissues, the radiation is recorded by sensors and transmitted to a computer, where the signals are converted into an image.
CT scans produce clearer images than conventional X-rays, especially if the study is performed with contrast.Layer-by-layer scanning allows you to identify and evaluate the size, structure of any tissue changes. For example, CT with contrast can distinguish a cancerous tumor from a benign neoplasm without biopsy.
The main advantages of CT:
- non-invasive and absolutely painless examination;
- high precision;
- the ability to get a three-dimensional image;
- the image is stored in the computer memory;
- uses low doses of X-rays, so the method is considered safe.
Spiral CT for cancer
Gradually, spiral tomographs are replacing conventional tomographs, with the help of which even more accurate images are obtained in less time. The more spirals in the scanner, the higher the accuracy of the study. Most often, in clinics, tomographs with 4 or 16 spirals are installed – this is quite enough for assessing the diagnosis of brain or lung tumors. For CT angiography, a 64-coil device is more suitable.
How is CT performed?
CT preparation depends on the area of interest and the use of contrast.For example, CT of the abdomen is done only on an empty stomach. Before the study with contrast, an abundant drink is prescribed so that the substance is quickly excreted from the body. If CT is done under general anesthesia, do not eat or drink for 4 hours.
The examination itself takes from 5 to 30 minutes, depending on the anatomical region and the type of tomograph. During this time, the patient must lie still for the pictures to be clear.
If you are worried about a health problem, make an appointment for a diagnosis.The success of treatment depends on the correct diagnosis.
This article is posted for educational purposes only, does not replace a doctor’s appointment and cannot be used for self-diagnosis.
24 August 2015
Diagnostic accuracy of various imaging techniques after computed tomography (CT) performed to assess the operability of pancreatic and periampullary cancers
How well do different imaging techniques determine if pancreatic cancer or periampullary cancer is resectable (can be surgically removed) in patients suspected of being operable by computed tomography (CT)?
A CT scan consists of a series of X-rays that are combined by a computer to form detailed images of an area of the body.
The pancreas is an organ located in the abdominal cavity near the transition of the stomach into the small intestine. The gland secretes digestive juices, which are necessary for the digestion of all nutrients. Digestive juices secreted by the pancreas enter the upper part of the small intestine through the pancreatic duct. The bile duct is the tube that carries bile out of the liver and gallbladder. The pancreatic and bile ducts have a common part immediately at the junction into the small intestine.This area is called the periampullary area. Surgical removal is only a potentially effective treatment for tumors originating from the pancreatic and periampullary regions. A significant proportion of patients needlessly undergo major open abdominal surgery (laparotomy) because the prevalence of cancer on CT has been underestimated. If cancer has spread throughout the abdominal cavity, as is found with major open surgery, the main treatment is chemotherapy, which does not cure the cancer but may improve survival.Thus, extensive open abdominal surgery, with all its risks, can be avoided if the area where the cancer has spread throughout the abdominal cavity is known prior to the operation. Determining the area where the cancer has spread is called “staging” the cancer. The CT scan is usually the diagnostic minimum for staging. However, CT can underestimate the spread of the tumor. In addition to CT, other methods can be used to assess the operability of the cancer (the possibility of surgical removal).These include the following studies.
1. Magnetic resonance imaging (MRI): the use of a powerful magnet to obtain images of various body tissues.
2. Positron Emission Tomography (PET): A small amount of radioactive glucose (sugar) is used to examine various tissues. PET scans work on the principle that cancer cells often consume more glucose than normal cells.
3. Endoscopic ultrasound (Endo-ultrasound): the use of an endoscope, a camera inserted into the body cavity for the purpose of their visualization.An ultrasound (high frequency sound vibration) probe at the end of the endoscope is used to examine various tissues.
In addition, a combined study – PET-CT – can be performed instead of CT.
Various studies have reported different accuracy of these methods in assessing cancer operability. In preparing this review, we identified all such studies and used appropriate mathematical methods to assess the mean diagnostic accuracy of these tests in staging pancreatic and periampular cancers that were found to be resectable after CT.
We included two studies with 34 patients in this review. Both studies assessed the diagnostic accuracy of endo-ultrasound. The evidence is current to 5 November 2015.
Quality of evidence
Of the two studies, one was conducted in the way that a similar study should be conducted. The methodological quality of the other study was low.
The two included studies found that among people with pancreatic cancer in whom CT showed complete surgical removal, 61% (61 out of 100) had the cancer too widespread to be removed by laparotomy.Due to the small sample size, there is significant uncertainty about the benefits of endo-ultrasound in people with pancreatic cancer that has been found to be resectable on CT. There is no evidence to suggest that it should be done routinely in people with pancreatic cancer that is known to be resectable on CT.
The main risk factors affecting the occurrence of kidney cancer include:
– High blood pressure
– Presence of kidney cancer in relatives
– Long-term use of anti-inflammatory drugs
Symptoms of the disease
In the early stages, kidney cancer may not manifest itself in any way and is often found as an accidental finding during a planned ultrasound of the abdominal cavity.If the tumor continues to grow and grow in size, the following symptoms may appear:
– Blood in urine
– Solid mass in the abdomen
– Constant pain in the side
– Loss of appetite
– Weight Loss
Diagnosis of the disease
- Inspection. In advanced stages, a kidney tumor can be palpated through the abdominal wall, because it is large.Also, there will be a more pronounced pain syndrome when tapping on the lower back from the side affected by the tumor.
- Ultrasound procedure. Ultrasound can detect both small and large kidney tumors. Ultrasound is the primary but not definitive method for making a diagnosis.
- Analysis of urine. The presence of protein in the urine, erythrocytes can also serve as a sign of the presence of a kidney tumor
- Computed tomography (CT).A study based on a series of X-rays that allows you to make accurate images of specific organs, including a kidney with a tumor. Most often, it is performed using a contrast agent that is injected intravenously, which allows you to see tissues and organs more clearly.
Rice. 1 CT scan of the tumor of the left kidney
Magnetic resonance imaging (MRI). A study based on magnetic and radio waves that uses computer technology to create a series of detailed images of organs and tissues.
After a preliminary diagnosis is made – a kidney tumor, an additional examination of the body is performed to stage the disease. The main goal is to exclude the spread of secondary foci (metastases) throughout the body. CT is also used for this purpose.
In the first stage, the tumor is less than 7 cm in size and is located only in the kidney
In the second stage, the tumor is more than 7 cm in size and is located only in the kidney
At the third stage, tumor cells spread to the lymph nodes closest to the kidney and / or the tumor grows into the vessels of the kidney (vein / artery) or perirenal fatty tissue
In the fourth stage, the tumor spreads to other organs such as bones, lungs, brain
Rice.2 Diagram of kidney tumor stages
There are three main directions in the treatment of kidney tumors:
– Systemic therapy
– Radiation therapy
Surgical treatment of kidney tumors
Surgery is the treatment of choice for the first three stages of kidney tumors. In some cases, removal of the kidney is necessary even at stage IV.
In the modern world, it is difficult to imagine surgical treatment without the use of minimally invasive technologies (laparoscopy).
Minimally invasive surgery makes the hospital stay shorter, but just as effective. High-tech endoscopic operations are performed through an operative access up to 1 cm, which significantly reduces trauma to organs and tissues, minimizes the risks of intra- and postoperative complications.Patients after laparoscopic operations can walk around the ward on the day of the operation, and even have dinner in the evening.
The method of choice in the treatment of small tumors up to 7 cm (stage I) is laparoscopic resection of the kidney tumor. This operation removes only the kidney tumor and leaves most of the healthy kidney tissue intact.
Laparoscopic resection of a kidney tumor is a rather complex surgical procedure, and sometimes surgeons prefer to remove the entire kidney with the tumor in order to reduce operational risks.
At our center, the urological oncology team has extensive experience in removing “complex” kidney tumors while preserving the kidney.
In the figure, you can see a CT scan of a patient with a tumor of the right kidney before surgery. The tumor has dimensions in the largest dimension of 54 mm, located in the immediate vicinity of the renal pelvis.
Drawing. CT of the tumor of the right kidney before surgery
The patient managed to save the right kidney by removing only the kidney tumor.Already on the 3rd day, the patient was discharged in satisfactory condition.
Drawing. Preserved right kidney after tumor removal
The clinic of St. Petersburg State University is a university clinic, in this regard, we are conducting a clinical study with the aim of better preserving renal function in patients with kidney tumors after laparoscopic resections.
The main complication during the resection of a kidney tumor is intraoperative bleeding.The “standard” situation is blood loss in the amount of 100-300 ml, which does not have any negative consequences for patients. There are situations when blood loss reaches larger volumes (up to 1000 ml). In this case, a blood transfusion may be required. An extreme situation may be the need to remove the entire kidney in order to stop bleeding. Fortunately, this rarely happens.
After surgery, urine may begin to flow from the resection area. To prevent urine from flowing into the abdominal cavity after the operation, a drainage tube is installed in the resection area, which is led out to the abdominal wall.Usually, the discharge through the drainage ceases to flow for 2-3 days, after which the drainage tube is removed. In rare cases, the drainage can be kept for up to a month.
For larger tumors (more than 7 cm, stage II and III), a radical laparoscopic nephradrenalectomy is performed. The essence of this operation is the complete removal of the kidney with the tumor, as well as the perirenal lymph nodes and the adrenal gland adjacent to the kidney in order to achieve the best results of recurrence-free survival.
During laparoscopic nephrectomy, bleeding may also occur, which is usually clinically insignificant and does not require any additional intervention.
Systemic therapy of kidney tumors
Over the past 10 years, systemic treatment of kidney tumors has developed greatly. Targeted drugs, as well as immunotherapy, have become ubiquitous, leading to an increase in the overall survival of patients with metastatic kidney cancer.
Radiation therapy in the treatment of kidney tumors is used most often for palliative purposes, for example, in the presence of foci in the bones to relieve pain.
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