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19

NCCN Guidelines for Patients

®

Adolescents and Young Adults with Cancer, Version 1.2017

Biopsies often include removal of tissue from nearby

lymph nodes. The lymph nodes are groups of small

round structures in the lymphatic system that help

fight disease. By removing lymph nodes, your doctor

can see if cancer has gone beyond the primary tumor.

Once the biopsy is complete, a pathologist will look at

the tissue sample—or samples—under a microscope

to determine:

††

Whether the tumor is benign or malignant.

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What kind of cancer it is.

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If—or how far—the cancer has spread.

The pathologist may also perform other tests to see if

the cancer cells have specific genes (instructions for

cells) or proteins. This can help in understanding how

the cancer will act in the body and what treatment

should be given.

Biopsies are usually done by a surgeon, a doctor

specially trained in performing surgical procedures.

Imaging scans can be used during a biopsy to guide

the doctor when removing the tissue.

Biopsy techniques include:

††

Endoscopic biopsy –

a lighted scope is

inserted into an opening in the body to remove

tissue or cells through a tube.

††

Needle biopsy –

uses a needle to remove

fluid or tissue in the body.

††

Incisional biopsy –

surgical removal of a

sample of tumor tissue for testing.

††

Excisional biopsy –

surgical removal of the

entire tumor for testing.

Biopsies are the final step in a cancer diagnosis. Ask

your doctor or nurse to explain what biopsy you will

have and what you can do to get ready.

The pathology report

The pathology report is written by a doctor for

a doctor, which can make it hard for patients to

understand. The report will cover everything from your

name, age, and other details on who you are (check

this carefully). It will have details on how the biopsy

sample looks, how the cancer seems to be growing,

and what it’s likely to do.

Staging

Once all of your tests are done, the doctor will tell you

the stage of your disease. Staging tells the extent

of cancer in the body. Your doctor will stage your

disease to decide on a prognosis (the likely course

the cancer will take) and to choose the best treatment

for you.

The stage of the cancer may be expressed in several

different ways.

††

Carcinoma in situ is limited to the layer of cells

where it began.

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Localized cancer is limited to the organ where

it began.

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Regional cancer has spread to nearby lymph

nodes or organs.

††

Distant cancer has spread to distant parts of

the body.

††

Unknown means there's not enough

information to determine the cancer’s stage.

Tumors may also be described as stage 0 through IV:

††

Stage 0 is a very early form of cancer that has

not yet invaded other areas.

††

Stage I–III indicates disease that is increasing

as the stages go up. This can include larger

tumor size and greater spread of cancer to

nearby organs or lymph nodes.

††

Stage IV indicates that the cancer has spread

to distant parts of the body.

2

Dealing with the diagnosis

How is cancer diagnosed?