Douglas Kemme, MD; Thomas Lininger, MD; Samuel Shelanski, MD; Michael Stone, MD; and Ann Stroh, DO

How are cancers detected?
There is no one cancer screening test. Proven screening procedures are specific for a given type of cancer. For instance, skin exam for melanoma, pap smear for cervical cancer, mammograms for early diagnosis for breast cancer and stool samples to look for blood or colonoscopies to detect colon cancer. Your primary care physician can detail for you the tests you need for screening for cancer and determine how often you need them performed. The American Cancer Society also has information regarding screening tests recommendations.

Once a cancer is detected a biopsy confirms the diagnosis there are any number of tests that can help determine the extent of the disease, which is called "staging" the cancer. Testing may include blood tests called "tumor markers", as well as traditional x-rays, and more sophisticated testing with CT (computerized tomography) scans, nuclear medicine scans (such as bone scans), MR scans (magnetic resonance) and most recently, PET scans (position emissions tomography) utilizing a radioactive glucose (sugar) molecule that is taken up more readily by more metabolically acute cancer tissue which a scanner can then pick up as a location of increased amount of radioactive sugar. Scopes can be used to look in the lungs (bronchoscopes), stomach or colon. Surgeons can use scopes in the operating room to look in the abdomen or chest cavity if needed.

What are some types of cancer treatments?

• Surgery: using an operation to remove the cancer and frequently the adjacent lymph nodes.
  
• Radiation Therapy: using a machine that produces a high energy beam (like x-rays) which is pointed by sophisticated computer programming to the area that includes the cancer we wish to treat. Radiation treatments are given in small daily doses up to a predetermined total amount necessary to kill the cancer cells and cause a minimum of injury to normal cells. There is also a form of radiation therapy called brachytherapy, which involves delivering the radiation by tiny radioactive sources called "seeds" implanted into the cancerous tissues. This is a common way to treat prostate cancers.
• Chemotherapy: the use of drugs derived from non-node and natural products that are taken by mouth or given IV (intravenously)given through a needle into a vein) that attacks the cancer cells wherever they are. Chemotherapy is therefore a systematic treatment (goes through the body). Chemotherapy can be curative in cancers such as lymphoma, leukemia, testicular cancer and others. Chemotherapy can also be used even if cure is not possible by containing and controlling the cancer, slowing its growth and therefore providing a better quality of life than if the cancer were allowed to grow and progress without intervention. There are fewer symptoms from the cancer, such as pain, if the cancer can be controlled by chemotherapy or radiation therapy.
• Immunotherapy: the use of medicines such as interferon or interleukin-2 to treat cancers such as melanoma and kidney cancers. Unfortunately, it has been much more difficult to manipulate the immune system to our advantage in treating cancer than certain popular notions would lead us to believe.
• Targeted therapy: using drugs and antibiotics to attack specific sites and receptors on a cancer cell. This is an area of rapid growth in treating cancers and is frequently combined with chemotherapy.

  Today, combinations of some or most of the above mentioned approaches are used to work with each other and more effectively treat a given cancer. There is much reason to be hopeful as we enter this new century with more effective and tolerable cancer treatments.