Cancers are diagnosed through imaging studies (X-ray, mammogram, sonographer, scanner, nuclear magnetic resonance, scintigraphy, etc.), on which the tumor is visible and its size is determined. After that, a histological examination must be done - a sample of the tumor is taken and looked under a microscope to see what cells it contains.
Everything is recorded in the epicrisis of the hospital, where the biopsy was performed. In addition to the type and stage of the tumor in letters and numbers, the epicrisis also contains the block numbers of material from your tumor. In the pathology of the hospital and against a signature on your part, you can request the blocks for reanalysis. If you decide, you can take them to another pathology for a new determination of the type and stage of the tumor.
IF THE TWO OPINIONS DO NOT MATCH, LOOKING FOR A THIRD OPINION. ANY TREATMENT WITHOUT A CLEAR DIAGNOSIS CAN LEAD TO UNPREDICTABLE DEVELOPMENT OF THE DISEASE.
Some types of cancer also have tumor markers, which help establish and confirm the diagnosis.
The RESULT of all tests is the DIAGNOSIS, which we will fight TOGETHER.
When you are aware of the type and stage of the disease, you should submit your documents to an oncology committee, which will decide how you will be treated. Such a committee meets in all specialized oncology hospitals (until recently called dispensaries, now complex oncology centers or specialized hospitals for active treatment of oncological diseases) in the country.
Where and how to make the correct diagnosis?
As we have already specified, the diagnosis is established, through a number of studies.
Imaging research, histological examinations and tumor markers.
When you need to do such research, it is important to know some details.
1) Regardless of how reliable the scanner or MRI is, the doctor is important, who will read the research. So get these tests done at major imaging centers. Many people pass there, doctors have extensive experience in reading. Here, too, the rule of second opinion applies in full force. Look for proven specialists and specialized hospitals for the treatment of oncological diseases.
2) The second opinion rule also applies to histological examination, wherever you did it, in any hospital in the country. When you are wondering which hospital to do your tests or biopsy, focus on specialized hospitals and clinics. Of course, specialists in oncology clinics know what and where to look and examine. Do not proceed with treatment, before the diagnosis is clear and accurate, confirmed by two independent histological examinations. If the two opinions do not match, seek a third opinion.
When examining tumor markers, we recommend that the examination be done in the same laboratory every time to be sure, that the data are comparable. Pay attention to which method the respective laboratory works with and what the reference values are. Discuss the results with your oncologist, without worrying beforehand. Keep in mind, that the marker can also be affected by inflammatory processes in the body. They can raise its values up to twice the upper reference limit. Only after that, oncologists look for a reason for the development of the tumor process.
When you have all the research, you know:
- It is clear whether there is interference in other tissues and organs.
- The diagnosis is specified and this is the most important thing at this first stage.
Now you should present your documents to an oncology committee, which will prescribe the appropriate treatment for you.
Modern devices for research and diagnostics in Bulgaria
The most – generally speaking imaging studies are: sonographer, X-ray, mammogram, scanner, nuclear magnetic resonance, PET/CT и SPECT/CT.
We also have three-dimensional mammography with tomosynthesis, which is becoming the gold standard in the world for the diagnosis of mammary gland diseases. Which of them to examine depends on what and where your complaints are, as well as what exactly will be looked at - tissue or bone.
All this will be decided by the specialist, where you went for a consultation. It matters whether the head is examined, the pancreas or the lung - the relevant specialist will guide you on what research to do, (whether it is contrasting, for example, or not.) Usually, the same specialist will also direct you to where the best devices are in your region. Apart from the best device, the specialist is also of great importance, who will read the results to you. Even if the research was done on the most modern device, if the specialist does not know what and where to look, you just have a picture /disc/ of excellent quality and no clarity about the disease.
Don't do research on your head. Some of the above devices irradiate the body with large doses. So find a doctor, someone you can trust and who will take the time to explain what research to do and where to do it, what's ahead. This is extremely important, to keep you calm during treatment.
Right to treatment, places for treatment, specialists
After the diagnosis, commission must prescribe you treatment, and sometimes he may recommend additional tests, before determining the treatment plan.
An oncology committee meets in every oncology center in the country.
What will be the treatment, It depends on many factors:
- tumor type and size;
- can the tumor be operated on;
- are there metastases;
- age of the patient, other diseases, etc.
WHERE YOU GET TREATMENT depends only on YOU!
There is an accepted standard for cancer treatment. If you need to discuss the treatment proposed by the committee at the nearest oncology center, you may appear with all epicrisis and researches before another committee, in another medical institution.
You can also make an appointment for a consultation with one of the leading specialists (chemical- or radiation therapists). So you can in 30 minutes to familiarize yourself with what lies ahead and ask questions, who interest you.
You can also ask if there are experimental drugs and programs and what conditions you must meet, to opt in.
When you appear before an oncology committee (t. the sun. oncocommittee) and he looked into your case, it may turn out, that medicine does not have a suitable therapy for you.
THIS CAN HAPPEN, IF: Your tumor is not affected by radiation either, nor from drug treatment (chemotherapy). Then you will only be required to make control examinations at the oncology dispensary during a certain period of time, to monitor you and influence side ailments.
Due to an advanced stage of the disease or other reasons (eg co-morbidities) standard therapy may be inappropriate, because it will worsen the quality of life.
Every patient can be treated in the oncology clinics of all major hospitals, as well as in interregional oncology dispensaries in the country. Choose a hospital or clinic with a doctor, who you trust. This is important for your treatment. If you have the slightest doubt about the doctor's qualifications, just turn to another.
For different types of cancer, specialists can be different.
Always look for a specialized clinic or hospital. When the tumor is on the skeleton or some muscle, refer to a medical oncologist at a specialist clinic (e.g. such is the Clinic for Onco-Orthopaedics and Bone Pathology in. Sofia), when it is a disease of the blood – to an oncohematologist, for liver or stomach look for gastroenterology clinics.
Proven specialists work there, which will help you with diagnosis and treatment.
Whatever decision you make about where and how to get treatment, you should know, that treatment is complex.
Given the complex nature of malignancy, The World Health Organization has adopted standards for modern therapy, including radiation therapy, chemotherapy and surgical treatment or a combination of the methods. Diet is also important for successful treatment, the movement and emotional attitude.