Consultation when a tumor is suspected

When to seek a consultation

• A new lump or one that is growing.
• Blood in stool or urine, blood in coughed-up sputum, or vaginal bleeding after menopause.
• Unexplained weight loss or persistent fatigue.
• A persistent cough, change in bowel habit or difficulty swallowing.
• Suspicious findings on tests or a recommendation from your doctor.

These signs can have other causes, often benign. Absence of pain does not exclude a problem that needs investigation, because many tumors do not hurt in early stages. Assessment should not be postponed just because you feel well. Particular signs may also call for consultation with other specialists, for example blood in stool with the gastro-hepatologist or blood in urine with the nephro-urologist; the clinic helps with the right referral.

What the doctor reviews

The doctor asks when the change began, how it has evolved and what symptoms accompany it. He or she reviews past illnesses, medicines, smoking, exposures and family history (especially cancers in the family at a young age), then performs a clinical examination. Blood tests, ultrasound, endoscopy or other imaging may be recommended, depending on the organ and the suspicion. CT, magnetic resonance imaging and specialized tests are arranged at the relevant service when needed; the clinic interprets the results.

Are blood tests enough

No. Blood tests help, but a normal result does not exclude every tumor and an abnormal result does not confirm cancer: abnormal laboratory results are not a sure sign of cancer. Tumor markers (substances made by tumor cells or by the body in response to a tumor) are not a universal screen for all tumors; they are used more for monitoring and, in certain cases, for guiding the diagnosis, always together with other findings.

In many cases a biopsy is needed, that is, taking a tissue sample for examination by the pathologist, which is often the only way to be certain whether cancer is present. The need, method and site of the procedure are decided by the specialist; not every finding requires an immediate biopsy (see biopsy).

What to bring to the visit

Bring reports and imaging materials, earlier tests, the biopsy result if one was done and the list of medicines. Note changes in symptoms and the questions you want answered. At the end of the consultation you should have a clear plan for the next step, its timeframe and how results will be obtained. If symptoms change, seek reassessment; when follow-up is needed, checks are planned every 6 months to a year, or sooner when the doctor considers it reasonable.

Care at Tirana Polyclinic: we offer oncology consultation, specialist interpretation of tests and imaging performed at other clinics, and guidance on further investigation. The assessment is coordinated with other specialties as needed.