NCCN Guidelines for Patients® | Caring for Adolescents and Young Adults - page 17

NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Version 2013
Part 2: Dealing with the diagnosis
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Blood tests and imaging studies can tell a doctor only so much about a
potential cancer. The only way to be absolutely sure about what is going on
is to look at the cells themselves. And that means taking a biopsy—removing
some suspicious tissue so that it can be examined by a pathologist and tested
for cancer cells. A pathologist is a doctor who’s an expert in testing cells to find
Biopsies often include removal of tissue from nearby lymph nodes (groups of
special disease-fighting cells) to determine whether the cancer has moved
beyond the original tumor. Once the biopsy has been completed, a pathologist
will look at the tissue sample—or samples—under a microscope to determine:
Whether the tumor is benign or malignant,
What kind of cancer it is, and
If—or how far—the cancer has spread.
The pathologist may also perform additional tests to see if the cancer cells
contain specific genes (instructions in cells for making and controlling cells) or
proteins that can help in understanding how the cancer is likely to behave and
which treatments will be most effective.
Biopsies are usually performed by a surgeon, a doctor specially trained in
performing surgical procedures. Biopsy techniques include bone marrow
aspiration (removal of liquid bone marrow for testing), endoscopic biopsy,
incisional biopsy (surgical removal of a sample of tumor tissue for testing),
excisional biopsy (surgical removal of the entire tumor for testing), laparoscopic
biopsy, laparotomy (a long surgical cut in the abdomen), lumbar puncture,
needle biopsy, and thoracotomy.
Before undergoing a biopsy, you may be asked to stop eating or drinking for a
period of time, stop taking some medicines, or stop smoking. Depending on the
Endoscopic biopsy:
of a thin, lighted tube to
remove tissue samples to
test for disease
Laparoscopic biopsy:
thin, lighted tube inserted
through a small cut in the
belly to remove tissue to
test for disease
Lumbar puncture:
Use of
a thin needle inserted into
the lower part of the spine
MRI scan:
A test that uses
radio waves and powerful
magnets to see the shape
and function of body parts
Needle biopsy:
of a needle into a tumor to
remove tissue for testing
PET scan:
A test that uses
radioactive material to see
the function of organs and
tissues inside the body
done through a large cut in
the chest to remove tissue
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