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 penile 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.
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.
In taking a medical history, the doctor will ask questions about:
A physical examination allows the doctor to look for any signs of penile cancer. During a physical examination, the doctor may:
A complete blood count (CBC) measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to:
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. The biopsies that could be used for penile cancer are:
The most common place for penile cancer to spread is the lymph nodes in the groin that are closest to the penis. A lymph node biopsy removes lymph nodes or cells from lymph nodes during a surgical procedure so they can be examined under a microscope to find out if they contain cancer.
The doctor will examine the lymph nodes to check if they look or feel swollen.
Fine needle aspiration (FNA) biopsy may be used to remove some fluid from an enlarged lymph node to check for cancer cells. FNA is sometimes used instead of removing lymph nodes to see if they contain cancer. If the biopsy shows that there are cancer cells present, surgery may be done to remove all the lymph nodes in the area.
The doctor may use ultrasound or a computed tomography (CT) scan to guide the needle into the lymph node if it is too deep to be felt.
The sentinel node is the first lymph node or cluster of lymph nodes that receives fluid from the area around a tumour. Cancer cells will most likely spread to these lymph nodes first. Sentinel lymph node biopsy (SLNB) is the removal of the sentinel lymph node so it can be examined to see if contains cancer cells. There may be more than one sentinel lymph node, depending on the drainage route of the lymph vessels around the tumour.
Surgery may be done to remove an enlarged lymph node and check for cancer cells. An inguinal lymphadenectomy (groin lymph node dissection) removes lymph nodes in the groin and checks them for cancer.
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 penile cancer.
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:
Sometimes a contrast mediumcontrast mediumA substance used in some diagnostic procedures to help parts of the body show up better on x-rays or other imaging tests. is used with a CT scan to help provide better detail. It is usually injected into a vein in the hand or arm.
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:
Sometimes a contrast medium, such as gadolinium, is used with MRI to help provide better detail. It is usually injected into a vein in the hand or arm.
Ultrasound uses high-frequency sound waves to make images of structures in the body. It is used to:
An x-ray uses small doses of radiation to make an image of the body’s structures on film. It is used to:
A bone scan uses bone-seeking radioactive materials (radiopharmaceuticals) and a computer to create a picture of the bones. It is used to see if penile cancer has spread (metastasized) to the bones.
A PET scan uses radioactive materials (radiopharmaceuticals) to detect changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3-dimensional colour images of the area being scanned. PET scan may be combined with a CT scan (PET-CT) to see if cancer has spread to nearby lymph nodes.
PET scans are not available in all treatment centres.
For more than 50 years, the Canadian Cancer Society’s transportation program has enabled patients to focus their energy on fighting cancer and not on worrying about how they will get to treatment.