If Hodgkin's disease is suspected, the doctor will ask about your Medical History and will do a thorough Physical Exam. Blood Tests and X-Rays of the Chest, Bones, Liver and Spleen will also be done.

Tissue from an enlarged Lymph Node will be removed. This is known as a Biopsy. It is the only sure way to tell if cancer is present. A Pathologist will look at the tissue under the Microscope for Reed-Sternberg cells, Abnormal Cells that are usually found with Hodgkin's disease.

When Hodgkin's disease is diagnosed, the doctor needs to know the stage, or extent, of the disease. Knowing the stage is very important for planning treatment. The stage indicates where the disease has spread and how much tissue is affected. In staging, the doctor checks:

• The number and location of affected Lymph Nodes
• Whether the affected Lymph Nodes are above, below or on both sides of the diaphragm (the thin muscle under the Lungs and Heart that separates the Chest from the abdomen)
• Whether the disease has spread to the Bone Marrow, to the Spleen or to places outside the Lymphatic System, such as the Liver

In staging, the doctor usually orders several tests, including biopsies of the Lymph Nodes, Liver and Bone Marrow. Many patients have lymphangiograms, X-Rays of the Lymphatic System using a special dye to outline the Lymph Nodes and vessels. Another test is computed Tomography (also called CT or CAT Scan), a series of X-Rays of cross-sections of the body.

Staging Hodgkin's:

Each stage for Hodgkin's disease is further divided by an "A" or "B," based on whether there are certain symptoms called B Symptoms. B Symptoms include the following:

• Loss of more than 10 percent of weight in the previous six months
• Fever without any known cause other than Hodgkin's disease
• Night Sweats that leave the body soaked

For example, if a patient had stage I disease without any B Symptoms, the patient would have Stage IA Disease; if the patient had stage I disease with B Symptoms, the patient would have Stage IB Disease.

Women who have regular Pelvic Exams increase the chance that, if Ovarian Cancer occurs, it will be found before the disease causes symptoms. However, Pelvic Exams often cannot find Ovarian Cancer at an early stage. Often, the doctor orders a Blood Test to measure a substance in the blood called CA-125. This substance, called a tumor marker, can be produced by Ovarian Cancer. However, CA-125 is not always present in women with Ovarian Cancer, and it may be present in women who have benign ovarian conditions. Thus, this Blood Test cannot be used alone to Diagnose Cancer.

A Diagnosis can be made only by Surgical Removal of the mass and/or ovary. Once the mass is removed, a Pathologist must examine a sample of the Tissue under the Microscope to determine the Diagnosis. To obtain the Tissue, the surgeon does an operation by making an incision. This is called Laparotomy. An alternative procedure is Laparoscopy, which is surgery performed through small tubes where a camera is used to view the pelvis and abdomen. If cancer is suspected, the surgeon removes the entire ovary. The surgeon should be prepared to perform complete surgical staging if the malignancy appears to be confined to the ovary. A large portion of these patients will have spread that is recognized only by obtaining Multiple Tissue samples and removing Lymph Nodes.

Before starting treatment, you may want a second Pathologist to review the Diagnosis and another specialist to review the treatment plan.

Some Insurance companies require a second opinion; others may cover second opinion if the patient requests it.

It may take a week or two to arrange for a second opinion.

This short delay will not reduce the chance that treatment will be successful.

A Gynecologic Oncologist is usually in the best position to offer a patient an expert opinion on the Diagnosis and management of Cervical Cancer.

At Hostpital, patients also have their case presented at the Gynecologic Oncology Multidisciplinary tumor board.

This is a meeting where Gynecologic Oncologists, radiation therapy physicians and gynecologic Pathologists meet to discuss the diagnostic and treatment options for a patient with or suspected to have a Gynecologic Malignancy.

The doctor may remove a small amount of Cervical Tissue to be evaluated by a Pathologist.

In one type of Biopsy the doctor uses an instrument to pinch off small pieces of Cervical Tissue.

To find the cause of symptoms, the doCTor will ask about your personal and family medical history. He will do a physical exam, and may order laboratory tests. In addition to the exams discussed above, the doCTor may also order the following tests:

• Lower GI series – X-Rays of the Colon and Rectum (the lower gastrointestinal traCT). The X-Rays are taken after the patient is given an enema with a white, chalky solution containing barium. (This test is sometimes called a Barium Enema.) The Barium Outlines the Colon and Rectum on the X-Rays, helping the doCTor find Tumors or other abnormal areas. To make small Tumors easier to see, the doCTor may expand the Colon by carefully pumping in air during the test. This is called an air contrast or double-contrast Barium Enema.
• Colonoscopy – An examination of the inside of the entire Colon using a Colonoscope, an instrument similar to a flexible Sigmoidoscope, but longer.

If a Polyp or other abnormal growth is found, the doCTor can remove part or all of it through a Sigmoidoscope or Colonoscope. A Pathologist examines the Tissue under a Microscope to check for cancer cells. This procedure is called a biopsy. Most Polyps are benign, but a biopsy is the only way to know for sure.

If the Pathologist finds cancer, the patient’s doCTor needs to learn the stage, or extent of the disease. Staging exams and tests help the doCTor find out whether the cancer has spread and, if so, what parts of the body are affeCTed. Treatment decisions depend on these findings.

Staging may include X-Rays, Ultrasonography or CT (or CAT) scans of the Lungs and Liver, because Colorectal Cancer tends to spread to these organs. The doCTor may order blood tests to measure how well the Liver is funCTioning. The doCTor also may do a blood test called a CEA assay. This test measures the Blood Level of Carcinoembryonic Antigen (CEA), a Substance that is sometimes found in higher-than-normal amounts in people who have Colorectal Cancer, especially when the disease has spread.