Diagnosing Cancer

In cancer care, it’s important to get from your diagnosis to treatment to survivorship as quickly and accurately as possible. At Montefiore Einstein Comprehensive Cancer Center, we offer testing and staging services for all types of cancer. Whether you are receiving a screening, a diagnosis or a second opinion, our world-renowned team of experts is ready to provide you with everything needed to prepare for cancer treatment.

Getting a Second Opinion

You may already have a cancer diagnosis. In those cases, the experienced and compassionate Montefiore Einstein Comprehensive Cancer Center specialists can confirm your diagnosis and discuss the best customized treatment plan for the type and stage of your cancer.

MRI machine

Cancer Screening Tests

At Montefiore Einstein Comprehensive Cancer Center, we provide screening tests and staging for all cancer types. Cancer screening tests check for signs of cancer activity before symptoms appear and are critical for early detection and successful treatment. If your medical or family history puts you at a higher risk for cancer it’s important to get screened regularly. 
 

Cancer Diagnostic Tests

An accurate cancer diagnosis is crucial for developing the right personalized treatment plan. There are many diagnostic tests for each type of cancer. The most common tests include these:

During a physical exam, your doctor will look and feel for signs of cancer, including lumps, skin abnormalities or enlarged organs.

Your doctor may draw blood to test for cancer, sending your blood to a laboratory for analysis. In the lab, experienced technicians perform various tests to look for signs of cancer. Our team of highly specialized professionals may order blood tests to check for the following:

  • Cancer cells
  • Specific proteins
  • Chemicals made by cancer cells (tumor markers)
  • The number of specific blood cells (a complete blood count, or CBC)

A PSA (prostate-specific antigen) test is a blood test used to check for signs of prostate cancer.

Genetic tests look for changes in genes passed down to you from previous generations. Many genetic tests can predict your chances of getting certain types of cancer. The “BReast CAncer,” or BRCA gene test is one example of a genetic test. It checks for genes linked to breast cancer and other cancer types.

Doctors also use genetic tests to diagnose cancer or evaluate any changes in your genes that could affect your ability to recover. Learn more about cancer genetic testing.

Imaging tests take pictures of the inside of your body, using radiation, sound waves and radio waves to look for signs of cancer. Imaging tests are often combined with other cancer diagnostic tests. Our cancer imaging doctors use several different types of diagnostic imaging tests, including these:

  • Computed tomography (CT): traditional cross-sectional images of internal organs
  • Magnetic resonance imaging (MRI): two-dimensional images of internal organs
  • Positron emission tomography (PET): 3D color images of how your body’s cells are working
  • X-rays: black and white images of structures inside your body
  • Ultrasound: pictures of tissues and organs produced from soundwaves

At Montefiore Einstein Comprehensive Cancer Center, we also offer 4D PET/CT and are one of the only centers in the region to offer this incredibly advanced imaging technique. A 4D PET/CT scan allows for more accuracy when it comes to radiation treatment, and also decreases the chance of any unnecessary radiation exposure. Another benefit of the 4D PET/CT is that it allows us to see movement within the body’s structures by combining CT images with PET video.

We also offer the most advanced available mammography and breast imaging services to diagnose breast cancer. The Breast Cancer Program at the Montefiore Einstein Comprehensive Cancer Center is one of America’s best, according to U.S. News & World Report, using the most advanced diagnostics, treatments and technologies for all types and stages of benign and malignant breast disease.

A biopsy involves removing tissue or fluid for evaluation. Members of our team who analyze this tissue and fluid are called cancer pathologists.

There are many ways to collect tissue and fluid. One technique is called fine needle aspiration. In this procedure, doctors use a thin needle to collect tissue or fluid from suspicious lumps or masses. A biopsy used to collect fluid from your spine is called a lumbar puncture (spinal tap).

Sometimes you can have a biopsy in your doctor’s office. These are called outpatient biopsies. Outpatient biopsies may include:

Other biopsies involve more invasive procedures, minor surgery or anesthesia. These biopsies may require a short hospital stay. Examples include:

  • Colon biopsy: a test to check for colorectal cancer, a type of gastrointestinal cancer. Colon biopsies are performed during a procedure called a colonoscopy
  • Image-guided breast biopsy: a test for breast cancer that uses magnetic resonance imaging (MRI) or ultrasound to guide doctors to the correct tissue
  • Liver biopsy: a test for liver cancer, a type of gastrointestinal cancer
  • Lung biopsy: a test for lung cancer performed using a procedure called bronchoscopy

Cytology is the study of an individual or small group of cells. Our experienced cancer pathologists use cytology tests to detect many types of cancer.

For cytology tests, doctors collect samples through urine, saliva, fine-needle aspiration, lumbar puncture, or brushing or scraping cells from organs or tissues. The Pap test is a common cytology test used to look for signs of gynecologic cancer.

A man and a woman hold hands while concentrating on someone not pictured.

Getting Your Results

We understand how important it is to get cancer diagnostic test results quickly. Our radiologists often offer same-day imaging test results. Our pathologists use leading-edge technology to track each test and ensure it is analyzed quickly and accurately.

Your compassionate and knowledgeable care team will reach out to you directly to share results and discuss your next steps. You can also review your results within Montefiore MyChart, our online patient portal.

Cancer Staging

With many cancers, doctors use staging after diagnosis to indicate how advanced a cancer is. Cancer staging helps you understand the seriousness of your disease. Staging also helps your care team prepare the best personalized treatment plan and potentially find clinical trial options that might be helpful to you.

Some of the same tests used to diagnose cancer are used to determine its stage. These include imaging tests like X-rays and bloodwork.

How Cancer Is Staged

Most cancers are staged by medical professionals using a system called the tumor, node and metastasis (TNM) system to more exactly measure the stage of your cancer. Cancers that may be staged using other systems include brain and spinal cord cancers and blood cancers.

In the TNM staging system,

  • T describes the size of the main (primary) tumor, 
  • N refers to the number of nearby lymph nodes that have cancer and
  • M indicates if cancer has metastasized (spread to other body parts).

Numbers are added within the TNM system to give more details about your cancer.

You may be more familiar with a less technical staging method. This method, which describes cancer in stages ranging from 0 to 5, is a less-detailed version of TNM.

  • Stage 0: Cells could become cancerous. Stage 0 is not cancer but indicates that abnormal pre-cancerous cells are present.
  • Stages 1, 2 and 3: Cancer is detected. The higher the number, the larger the cancerous tumor and the more it has spread into nearby tissues.
  • Stage 4: Cancer has spread beyond the primary tumor.

Your doctor and nurse navigator will talk with you about your cancer stage and answer your questions. They will then use your cancer staging to develop your personalized comprehensive treatment plan.