Comprehensive Cancer Tests and Diagnosis

Complete Range of Cancer Tests

At PACE Hospitals, we provide advanced cancer diagnostic services to enable early detection and precise evaluation, supporting timely and effective treatment decisions.

Clinical Laboratory Tests 

General Blood Tests

Complete Blood Count (CBC)

CBC checks the levels of different blood cells, red blood cells, white blood cells, and platelets. Cancer itself usually doesn’t show up directly in this test, but it can cause noticeable changes. In certain cancers like leukemia can increase or decrease white blood cells abnormally. Low red blood cells (anemia) might happen due to hidden bleeding or bone marrow problems caused by cancer. Platelet levels can also go up or down. So, while a CBC cannot confirm cancer on its own, it often gives doctors the first clue that something unusual is happening in the body, prompting further tests.

Blood Chemistry Tests 

This measures different substances in the blood, such as enzymes, salts (electrolytes), and waste products. These values tell doctors how well the organs are working. Cancer can affect these organs either directly (if it starts there) or indirectly (if it spreads). Abnormal liver enzymes might suggest liver involvement, and high calcium levels can sometimes be linked to certain cancers. 

Lactate Dehydrogenase (LDH) 

Lactate Dehydrogenase (LDH) is an enzyme found in many body tissues. When cells are damaged or break down quickly, LDH levels in the blood can rise. Some cancers grow rapidly and cause more cell turnover, which can increase LDH levels. A high LDH level doesn’t prove cancer, but it can indicate that there is increased cell activity or damage in the body, which doctors may investigate further.

Tumor Marker Tests

Prostate-Specific Antigen (PSA)

The PSA test measures the level of a protein made by the prostate gland in a man’s blood. Normally, PSA is present in small amounts, but higher levels can occur when something affects the prostate. This could be prostate cancer, but it can also happen with non-cancerous conditions like prostate enlargement or infection. So, a high PSA level doesn’t automatically mean cancer; it simply alerts the doctor that the prostate needs further evaluation, such as imaging or a biopsy. 

CA-125

CA-125 is a protein that can be measured in the blood and is often higher in women with ovarian cancer. However, it’s important to know that CA-125 can also rise in many non-cancer conditions, such as menstruation, endometriosis, or infections. Because of this, it is not used alone to diagnose cancer. Instead, doctors use it along with scans and clinical findings. 

Carcinoembryonic Antigen(CEA)

CEA is a protein that can be elevated in certain cancers, especially colorectal (colon) cancer, but also in some other cancers like lung or breast cancer. Like other tumor markers, it is not specific enough to confirm cancer on its own because levels can rise in non-cancer conditions such as smoking or inflammation. Doctors mainly use CEA to track how well treatment is working or to monitor for recurrence after cancer treatment.

Alpha-fetoprotein (AFP)

Alpha-fetoprotein is a protein that is normally produced in high amounts during pregnancy, but in adults, levels are usually very low. When AFP levels rise in adults, it can sometimes be a sign of certain cancers, most likely liver cancer or germ cell tumors (such as those affecting the testes or ovaries). It acts as a warning signal that leads to further tests like scans or a biopsy. It is also very useful for monitoring treatment response; if AFP levels go down, it often means treatment is working.

CA 19-9

CA 19-9 is a substance released into the blood by some cancer cells, especially those from the pancreas. Higher levels can be seen in pancreatic cancer, but they may also increase in non-cancer conditions like gallstones, liver disease, or inflammation of the pancreas. So, like other tumor markers, CA 19-9 cannot confirm cancer by itself. Doctors usually use it along with a CT scan to get a clearer picture. It is particularly helpful for tracking how the cancer is responding to treatment or checking if it has come back after therapy.

Advanced Blood-Based Tests

Liquid Biopsy

A liquid biopsy is a newer type of blood test that looks for tiny pieces of cancer-related DNA (called circulating tumor DNA or ctDNA) that may be released into the bloodstream by cancer cells. Instead of taking a tissue sample from a tumor, this test uses just a blood sample, making it less invasive and easier for patients. It can help doctors detect certain genetic changes in cancer, guide targeted treatments, and monitor how well treatment is working. 

Circulating Tumor Cell (CTC) Tests 

These tests look for actual cancer cells that have broken away from a tumor and entered into the bloodstream. These cells can travel to other parts of the body and may lead to the spread (metastasis) of cancer. By counting or analyzing these cells, doctors can get an idea of how active or advanced a cancer might be. CTC tests are mainly used to monitor disease progression and treatment response, rather than to make a first diagnosis. 

Hematologic & Specialised Tests

Immunophenotyping 

It is a test that studies the types of cells in the blood or bone marrow by looking at specific markers present on their surface. This is done using a technique called flow cytometry, where cells are passed through a machine and analyzed one by one. In cancers like leukemia or lymphoma, abnormal cells often have unique patterns of these markers. By identifying these patterns, doctors can tell exactly what type of cancer it is, which is very important for choosing the right treatment. 

Cytogenetic Analysis (Karyotyping)

Cytogenetic analysis looks at the chromosomes inside the cells to check for changes or abnormalities. In some cancers, especially blood cancers, parts of chromosomes may be missing, duplicated, or swapped (called translocations). These changes can help doctors confirm the diagnosis and understand how aggressive the cancer might be. For example, certain chromosome changes are strongly linked to specific types of leukemia.

Urine test

Urinalysis

A urinalysis is a simple test where the urine is checked for components like blood, proteins, sugars, and abnormal cells. By studying these components, urinalysis can provide information about health and help diagnose bladder, kidney, and urothelial cancers. While this could be due to infections or stones, it may also raise suspicion for cancer. So, this test acts as an early screening tool, helping doctors decide if further tests like imaging or a biopsy are needed.

Imaging Tests 

Basic imaging tests

X-rays

An X-ray is one of the simplest imaging tests. It uses a small amount of radiation to create pictures of the inside of the body. Doctors often use it as a first step to look for abnormalities, such as a mass in the lungs or changes in bones that might suggest cancer. However, X-rays don’t show fine details, so if something unusual is detected, doctors usually recommend more detailed scans like CT or MRI. 

Ultrasound

Ultrasound uses sound waves to create images of organs inside the body. It is commonly used to examine areas like the abdomen, pelvis, breast, and thyroid. This test helps doctors see whether a lump is solid (which could be suspicious) or filled with fluid. It is safe, painless, and often used as an initial investigation, especially in women for ovarian or uterine concerns. If anything unusual is found, further tests may be advised.

Computed Tomography (CT scan)

A CT scan uses X-rays combined with computer processing to create detailed cross-sectional images of the body. It can show the size, shape, and exact location of a tumor much more clearly than a regular X-ray. CT scans are highly used to detect cancer, check if it has spread, and guide biopsies. 

Magnetic Resonance Imaging (MRI)

An MRI scan uses strong magnets and radio waves to create very detailed images of soft tissues like the brain, spinal cord, muscles, and organs. It is especially useful for detecting cancers in areas where fine detail is important, such as the brain or liver. MRI helps doctors understand the exact extent of a tumor and its relationship to nearby structures, which is important for planning treatment like surgery or radiation.

Nuclear & Functional Imaging

Positron Emission Tomography (PET Scan)

A PET scan evaluates for active cells are inside the body rather than just showing their shape. Before the scan, a small amount of a safe radioactive tracers injected into the body. Cancer cells usually grow and use energy faster than normal cells, so they absorb more of this solution and light up on the scan. This helps doctors find cancer, see how active it is, and check if it has spread to other parts of the body. It is especially useful when other scans are unclear or when doctors want to assess how aggressive a tumor might be.

PET/CT Scan

A PET/CT scan combines two tests into one—PET (which shows how cells are functioning) and CT (which shows detailed structure). This means doctors can see both where the tumor is and how active it is at the same time. It is one of the most powerful tools for cancer care because it helps in detecting cancer, determining its exact location, staging (how far it has spread), and monitoring treatment response. 

Bone Scan

A bone scan is a type of nuclear imaging test used to check if cancer has spread to the bones. A small amount of radioactive material is injected into the bloodstream, which travels to the bones. Areas where the bone is changing or repairing itself (which can happen with cancer spread) will show up as bright spots on the scan. While these spots can also be caused by other conditions like arthritis or injury, the test helps doctors identify possible bone involvement and decide if further evaluation is needed.

Nuclear Scans

Nuclear scans are a group of imaging tests that look at how the organs and tissues are functioning. During the test, a very small amount of a safe radioactive tracer is injected into the body or swallowed. This tracer travels to specific organs, and a special camera detects it to create images. Cancer cells often behave differently from normal cells, so they may absorb more or less of the tracer, showing up as unusual hot spots or cold spots. These scans help doctors detect abnormal activity, find cancer spread, and monitor how well treatment is working.

Gallium Scan

A gallium scan is a specific type of nuclear scan that uses a radioactive substance that is called gallium. This tracer tends to collect in areas of infection, inflammation, or certain cancers, which can be lymphomas. After the tracer is given, images are taken to see where it has gathered in the body. If there are areas where gallium accumulates more than expected, it may suggest cancer or another abnormal condition. While it’s helpful, it is often used along with other tests like CT or PET scans for a clearer diagnosis.

Thyroid Scan

A thyroid scan is used to examine the thyroid gland (a small gland in the neck) and see how it is functioning. A small amount of radioactive iodine or another tracer is used because the thyroid naturally absorbs iodine. The scan shows areas of the gland that are more active (hot nodules) or less active (cold nodules). Some cold nodules may need further testing because they can sometimes be linked to cancer. This test helps doctors identify suspicious areas and decide if a biopsy is needed.

Specialized Imaging

Multi Gated Acquisition scan (MUGA Scan)

A MUGA scan is a special imaging test used to check how well the heart is pumping blood. It is not used to detect cancer itself, but it is very important before and during certain cancer treatments like chemotherapy. Some cancer medicines can affect the heart, so doctors use this test to make sure the heart is strong enough for treatment and to monitor it over time. The scan uses a small amount of radioactive material to clearly show the movement of blood through the heart, helping doctors keep your treatment safe.

Lymphangiogram

A lymphangiogram is an imaging test that looks for the lymphatic system, which includes lymph vessels and lymph nodes. Since many cancers spread through lymph nodes, this test helps doctors see if cancer has travelled beyond its original site. A contrast dye is injected into the lymph vessels, and images are taken to highlight any blockages or abnormal areas. 

Mammography (Mammogram)

A mammogram is a specialized X-ray of the breast used to detect breast cancer early, often before symptoms appear. It can show small lumps or changes in breast tissue that might not be felt during a physical exam. Early detection through mammography greatly improves the chances of successful treatment. If something unusual is found, doctors may recommend further tests to confirm whether it is cancer.

Biopsy

Fine Needle Aspiration (FNA / FNAC)

Fine needle aspiration uses a very thin needle to remove a small sample of cells from a lump or suspicious area. It is generally a quick, less painful procedure and usually doesn’t require surgery. Doctors often use it for lumps in the thyroid, breast, or lymph nodes. The collected cells are examined under a microscope to check for cancer. While it’s simple and safe, sometimes the sample may not be enough, and further tests might be needed.

Endoscopic biopsy 

An endoscopic biopsy is performed using a thin, flexible tube with a camera that is inserted into the body (like the stomach, colon, or lungs). Doctors can see the inside of the organ and take small tissue samples from suspicious areas. This method is commonly used in procedures like colonoscopy or bronchoscopy. It allows doctors to diagnose cancer in internal organs without open surgery.

Bone Marrow Biopsy

This test focuses on the spongy tissue inside the larger bones, often the hip, where the blood cells are produced. A specialized needle is used to remove a small, solid piece of bone and marrow tissue. A pathologist examines this sample under a microscope to look for abnormal or cancerous cells, which helps diagnose blood-related cancers like leukemia, lymphoma, and multiple myeloma. It also reveals if cancers from other parts of the body, such as the breast or prostate, have spread to the marrow

Pleural Biopsy

Pleural Biopsy is a procedure that involves taking a small sample of the pleura, which is the thin membrane that lines the chest cavity and surrounds the lungs. Doctors use a needle or a fiberoptic scope (thoracoscopy) to reach this area, sometimes guided by ultrasound or CT scans for precision. By analyzing this tissue, pathologists can determine if an abnormality is a cancerous tumor, such as mesothelioma or lung cancer, or if cancer from elsewhere has spread to the lung's lining

Endometrial Biopsy

An endometrial biopsy takes a small sample from the lining of the uterus (endometrium). It is commonly done in women who have abnormal uterine bleeding or other symptoms that may suggest a problem. The tissue is examined under a microscope to check for conditions like endometrial (uterine) cancer or precancerous changes. 

Cytology Tests (Cell-Level Diagnosis)

Pap Smear (Pap Test) 

A pap smear is a simple screening test used to check for early changes in the cells of the cervix (the lower part of the uterus). During the test, a doctor collects a small sample of cells from the cervix. These cells are examined under a microscope to detect precancerous or cancerous changes. 

Sputum Cytology

Sputum cytology involves examining mucus that are collected from the lungs. This test evaluates for abnormal or cancer cells from the airways. It is also sometimes used when lung cancer is suspected, especially if a person has symptoms like a persistent cough or blood in sputum. However, this test may miss cancers that are deeper in the lungs. That’s why it is usually combined with imaging tests like chest X-rays or CT scans. 

Urine Cytology

Urine cytology evaluates urine under a microscope to check for abnormal or cancerous cells that may be shed from the lining of the urinary tract (especially the bladder). If cancer is present, some of these cells can break off and appear in the urine. This test is more specific than a simple urinalysis, but it still cannot confirm cancer on its own because not all cancers shed enough cells to be detected. Doctors often use it along with other tests like cystoscopy, to get a clearer diagnosis.

Body fluid cytology 

Body fluid cytology involves examining fluids collected from areas like around the lungs (pleural fluid) or in the abdomen (ascitic fluid). These fluids may build up due to cancer or other conditions. By analysing the cells in the fluid, doctors can check if cancer cells have spread to these spaces. This helps in diagnosing and understanding how advanced a disease might be.

Endoscopic & Interventional Procedures

Endoscopy-Based

Colonoscopy

A colonoscopy is a test that allows doctors to examine the inside of the large intestine (colon and rectum) through a flexible tube with a camera. It is used to screen for colorectal cancer. During the procedure, doctors can spot small growths called polyps, which can sometimes turn into cancer over time. These polyps can often be removed immediately, preventing cancer from developing. If anything suspicious is seen, a small tissue sample (biopsy) can be taken for further testing. 

Bronchoscopy

A bronchoscopy is used to look inside the airways and lungs. A thin, flexible tube with a camera is passed through the nose or mouth into the lungs. Doctors use this test when there are symptoms like a persistent cough, breathing problems, or suspicion of lung cancer. It allows direct visualisation of abnormal areas and take tissue samples if needed. This helps in diagnosing lung conditions, including cancer, more accurately.

Upper Endoscopy (EGD)

An upper endoscopy is a test that examines the upper digestive tract, including the esophagus, stomach, and the first part of the small intestine. A thin tube with a camera is gently passed through the mouth. Doctors use it to look for ulcers, inflammation, or suspicious growths that could be cancer. If needed, they can take small tissue samples for biopsy. This test helps in early detection and accurate diagnosis of cancers in the upper digestive system.

Cystoscopy

A cystoscopy is a procedure that allows direct visualisation of the bladder and urinary tract using a thin tube with a camera (called a cystoscope). It is usually done when someone has symptoms like blood in the urine, frequent urination, or unexplained urinary problems. This test helps doctors directly see any abnormal areas, growths, or tumors inside the bladder. If something suspicious is found, they can take a small tissue sample (biopsy) during the same procedure. This makes cystoscopy a very useful tool for detecting and confirming bladder cancer.

Laryngoscopy 

A laryngoscopy is used to examine the larynx (voice box) and vocal cords. A thin, flexible camera is passed through the nose or mouth to look at this area. Doctors may recommend this test if someone has symptoms like a persistent hoarse voice, difficulty swallowing, or throat pain. It allows them to spot abnormal growths or lesions that could be cancer. If needed, a biopsy can be taken during the procedure for confirmation.

Thoracic & Chest Procedures

Mediastinoscopy

A mediastinoscopy is a procedure used to examine the mediastinum, which is a central area of the chest between the lungs where important lymph nodes are located. These lymph nodes are often one of the first places lung cancer can spread. During the procedure, a small incision is made near the neck, and a thin tube with a camera is inserted to look inside and take samples from lymph nodes. This helps doctors check whether cancer has spread and decide the stage of the disease.

Thoracoscopy

A thoracoscopy is used to look inside the chest cavity, including the lungs and the lining around them (pleura). A small camera is inserted through a tiny incision in the chest. Doctors use this test to detect tumors, examine suspicious areas, and take biopsies. It is often used when imaging tests show something abnormal but more detail is needed. Because it allows direct visualization and sampling, it plays an important role in confirming and staging cancers, especially lung cancer or pleural diseases.

Endobronchial Ultrasound (EBUS)

EBUS is an advanced form of bronchoscopy that combines a camera with ultrasound. A thin tube is passed into the airways, and ultrasound helps doctors see structures outside the airways. Using this guidance, they can insert a small needle to take samples from these lymph nodes without surgery. EBUS is very useful for detecting cancer spread and obtaining biopsy samples in a less invasive way compared to traditional surgical procedures.

Abdominal & Pelvic Procedures

Laparoscopy 

A laparoscopy is a minimally invasive procedure that allows doctors to look inside the abdomen or pelvis. Instead of making a large cut, the doctor makes a few small incisions and inserts the camera to view organs like the liver, intestines, uterus, ovaries, and lymph nodes. This test is often used when scans show something unclear. It helps doctors directly see any abnormal growths, tumors, or spread of cancer. If needed, they can also take small tissue samples (biopsies) during the same procedure for confirmation.

Molecular & Genetic Testing 

Next-Generation Sequencing (NGS)

This is a powerful test that reads the genetic material of cancer cells. It can identify many different gene changes at once. These changes can explain why the cancer is growing and help doctors choose targeted treatments that work specifically for those mutations. Instead of a one-size-fits-all approach, NGS helps create a personalised treatment plan. It doesn’t usually detect cancer on its own, but once cancer is found, it provides valuable information about how to treat it effectively.

Polymerase Chain Reaction (PCR)

PCR is a technique used to amplify (make many copies of) small pieces of DNA so they can be easily studied. In cancer care, PCR helps detect specific genetic changes or mutations that may be linked to certain cancers. It is very sensitive to find even tiny amounts of abnormal DNA. Doctors often use PCR to confirm specific cancer types, monitor disease, or detect minimal residual disease.

Fluorescence In Situ Hybridization (FISH)

This is a test that uses special fluorescent dyes to visualise at specific genes or chromosomes inside cells. It can detect changes such as missing, extra, or rearranged genes that are often linked to certain cancers. For example, it is commonly used to check for gene changes in breast cancer or leukemia. 

Gene mutation testing 

Gene mutation testing looks for inherited changes (mutations) in your genes that may increase the risk of developing certain cancers. For example, mutations in the BRCA1 and BRCA2 genes are linked to a higher risk of breast and ovarian cancer. This test is usually done using a blood or saliva sample.

Biomarker testing 

Biomarker testing looks for specific proteins or genetic changes in cancer cells that can guide treatment. Examples include: -

• HER2 for breast cancer
• EGFR, ALK for lung cancer

These markers act like signals that tell doctors how the cancer behaves and which treatments are likely to work best. For instance, if a tumor has a certain biomarker, doctors can use targeted therapy that specifically attacks those cancer cells.

Additional / Functional & Supportive Tests

Pulmonary Function Tests (PFTs)

PFTs measure how well the lungs are working. During the test, patients generally breathe into a machine that checks how much air they can inhale and exhale and how efficiently their lungs deliver oxygen. This is especially important if lung cancer is suspected or if surgery is being planned. Doctors use PFT results to see whether the lungs are strong enough for treatments like surgery, chemotherapy, or radiation. So, while PFTs don’t detect cancer directly, they help ensure that the treatment plan is safe and suitable for a patient.

Bone marrow studies 

Bone marrow studies include tests like bone marrow aspiration and biopsy, which examine the soft tissue inside your bones where blood cells are made. These tests are very important for diagnosing blood cancers like leukemia and lymphoma. They help doctors see whether abnormal cancer cells are present, how they are affecting normal blood cell production, and how advanced the disease is.

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