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Diagnosis is the process of finding the cause of a health problem. The process of diagnosis may seem long and frustrating, but it is important for the doctor to rule out other reasons for a health problem before making a cancer diagnosis. Diagnostic tests for adrenal gland cancer are usually done when:
Many of the same tests used to initially diagnose cancer are used to determine the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. Tests may include the following.
|Diagnostic tests||Staging and other tests|
The medical history is a record of present symptoms, risk factors and all the medical events and problems a person has had in the past. The medical history of a person’s family may also help the doctor to diagnose adrenal gland cancer.
In taking a medical history, the doctor will ask questions about:
A physical examination allows the doctor to look for any signs of adrenal gland cancer. During a physical examination, the doctor may:
Collection of urine over a 24-hour period may be used to measure the amounts of adrenal gland hormones and the products of their breakdown (metabolites) in the body. The urine test will report the 24-hour urinary free cortisol or catecholamine levels.
Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are functioning and can also be used to detect abnormalities. They are used to diagnose adrenal gland cancer.
A dexamethasone suppression test may be done to measure the cortisol level in the blood. The person takes an oral (by mouth) dose of dexamethasone, which slows the production of cortisol. The blood cortisol level is measured 12 hours later.
A CT scan uses special x-ray equipment to make 3-dimensional and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures. It is used to:
MRI uses powerful magnetic forces and radio-frequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-dimensional pictures. It is used to:
A MIBG scan is a nuclear medicine imaging test that uses small amounts of the radiopharmaceutical metaiodobenzylguanidine (MIBG) to help locate and diagnose certain types of cancer.
MIBG scans are used to find tumours that develop in the medulla of the adrenal gland (called pheochromocytomas). Tumours that develop in the adrenal cortex do not show up with this test. MIBG is used to:
Ultrasound uses high-frequency sound waves to make images of structures in the body. It is rarely used to diagnose adrenal gland cancer because CT scans are more commonly used. An ultrasound may find an adrenal gland tumour when it is being done for other medical reasons.
An x-ray uses small doses of radiation to make an image of the body’s structures on film. A chest x-ray may be done to detect the spread of cancer to the lungs.
A bone scan uses bone-seeking radioactive materials (radiopharmaceuticals) and a computer to create a picture of the bones. It is used to detect the spread of cancer to the bones.
During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample.
A biopsy is rarely done for adrenal gland tumours.
Generally, a biopsy is only done when the tumours are outside the adrenal glands. It is used to find out if there is spread from the adrenal tumour or from another cancer. The types of biopsies done are a fine needle aspiration (FNA) or core needle biopsy guided by CT scan or ultrasound.
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The Canadian Cancer Society’s peer support program is a telephone support service that matches cancer patients and their caregivers with specially trained volunteers.