Cancer Diagnosis - CHI Health, Omaha, Nebraska (NE)

Cancer Diagnosis

At CHI Health, cancer care starts with a thorough, accurate and timely diagnosis, so a treatment plan can be developed and started as soon as possible.

Because no single test can accurately diagnose cancer, physicians use information obtained from several sources to make a diagnosis.

After the physician has a clear understanding of the patient’s medical history and completes a physical examination, additional diagnostic tests are ordered. Laboratory tests are performed to identify tumor markers, which are substances produced by cancer, or by other cells of the body in response to cancer, or certain non-cancerous conditions. Additional diagnostic tests include imaging technologies, endoscopic examination, tumor biopsy, or genetic testing.

Diagnostic Technologies

CHI Health offers the most advanced diagnostic procedures and technologies for diagnosing cancer. Screening tests can find cancer at an early stage, before symptoms appear. Other tests are used to determine tumor size, location and whether it has spread to other parts of the body.

Breast Cancer

The Breast Health Center provides state-of-the-art digital mammography, including the newest 3D technology, for screening and diagnosing cancer. Screening mammograms are used to look for breast cancer or disease in women who have no symptoms or signs. Diagnostic mammograms are used to diagnose breast disease after a lump or other sign of disease is found.

Digital mammography captures images electronically for immediate viewing on a computer screen and provides the highest level of accuracy to screen for the smallest tumors. If anything suspicious is found, patients receive all follow-up testing – including a biopsy, if necessary – within a matter of days, not weeks.

Breast Tomosynthesis (3D mammography) is able to look through dense tissue, and use less compression to get imaging results. The camera moves over the breast, taking images from multiple angles. These images are combined to create a three dimensional rendering of the entire breast so that see areas of concern can be viewed from all angles.

Breast Ultrasound is frequently used to evaluate breast abnormalities that are found with screening or diagnostic mammograms. It uses high-frequency sound waves, above the level detected by human ears. The sound waves enter the breast and bounce back. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen.

Breast MRI is a tool that uses a powerful magnetic field instead of x-rays to obtain very detailed images that can be examined on a computer monitor and stored. Breast MRI is most often used to screen for breast cancer in women who have a high risk of the disease or those with a positive cancer biopsy. Breast MRI for cancer diagnosis requires use of the contrast agent which causes tumors to "light up".

A biopsy is done when other tests show that cancer may be present. It is the only way to know for sure if the diagnosis is breast cancer. During the test, cells are taken from the area of concern and studied in the lab.

Lung Cancer

Lung cancer is 80 percent curable, if it is found early. The Lung Health Center utilizes two state-of-the-art technologies to detect and diagnose lung cancer and non-cancer lung conditions. Endobronchial Ultrasound (EBUS) and SuperDimension Electromagnetic Navigation Bronchoscopy® (ENB) find cancers that occur even deep within the chest, and obtain a biopsy, without making a single incision. These advanced tools provide physicians with the most accurate diagnostic information available, making it to diagnose lung cancers rapidly and less invasively than ever before; and to precisely identify the stage of cancer.

Colon Cancer

Colorectal cancer most often develops from pre-cancerous polyps (abnormal growths) in the colon or rectum long before symptoms appear.

Colonoscopy is the most effective screening technique for finding colorectal cancer or pre-cancerous polyps, so they can be removed before they turn into cancer. A colonoscope is a narrow tube fitted with a camera that enables the physician to view the entire length of the colon. Polyps usually can be removed during a colonoscopy for testing.

Flexible Sigmoidoscopy is a similar diagnostic technology that can find both colorectal polyps and cancer. It also uses a narrow tube fitted with a camera and polyps also can be removed during the procedure.

A Colonoscopy is a more complete test because it is an examination of entire length of the colon, while flexible sigmoidoscopy examines the lower two feet of colon.

Prostate Cancer

Prostate cancer is the second most common cancer found in men and can be found in 80% of men who reach the age of 80. Most prostate cancers are slow-growing; however there are certain forms may spread from the prostate to other parts of the body. There is no perfect test to look for prostate cancer. Prostate Specific Antigen (PSA) and Rectal Exams are the most common ways to screen for cancer. If either of these screening tests suggests cancer, the physician performs a biopsy to see if cancer cells are present.

There are different methods used to obtain a biopsy. A prostate ultrasound involves a thin probe inserted into the rectum. High-frequency sound waves are bounced off the prostate. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen. The sonogram detects abnormal growths and is used to guide small needles into areas where abnormalities are detected. The needles remove tiny amounts of tissue for biopsy.

Some physicians perform the biopsy through the perineum (the area located between scrotum and rectum). The physician makes a small incision and using a small needle, removes a small amount of tissue

Cancer Imaging Technologies

Angiography is a contrast substance is injected into the arteries to enhance visibility, an X-ray is used to assess blood flow and determine the location and size of tumors. This information is used to plan therapy.

Computed tomography scan (CT or CAT) scans are helpful in diagnosing and treating cancer. CT scans show bones, organs and soft tissues more clearly than standard x-rays. They are useful in helping physicians find cancer, because the images can be enlarged to make it easier to see areas of concern. CT scans can show a tumor’s shape, size and location, and even the blood vessels that feed the tumor – without surgery.  A CT scanner also can be used to help the physician guide a small needle to remove a tissue sample. This is called a CT-guided biopsy. In cancer treatment, a CT scanner can be used to guide needles into tumors for radiofrequency ablation (using heat to destroy a tumor).

Positron Emission Tomography (PET) is another essential diagnostic tool. A contrast agent containing glucose, a form of sugar, is injected into to a vein and travels throughout the body. Cancer cells absorb high amounts of this sugar because they have a higher metabolic rate than normal cells. A special camera can then spot these cells. A PET scan is useful when the physician thinks the cancer might have spread but does not know where.
CT and PET scans help physicians detect cancer, evaluate the extent of disease and select the most appropriate treatments. By comparing scans done over time, doctors can determine if the therapy is working and detect any recurrent tumors.

An Magnetic Resonance Imaging (MRI) scan takes pictures using radio waves and strong magnets instead of x-rays. This test can be helpful in looking at the brain and spinal cord. MRIs can be more uncomfortable than CT scans because they take longer and you need to lie in a narrow tube while the test is done. CHI Health offers the option of “open” MRI, which is less confining.

An ultrasound wand or probe gives off high-frequency sound waves, (above the level detected by human ears), is placed on the skin or into a natural opening to take pictures of the inside of the body. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen. A gel is often put on the skin first. This test is described in the Breast Ultrasound section above, but ultrasound can also be used to look for cancer that has spread to other parts of the body.