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Cancer Diagnosis and Staging

Treatment Care

Surgical Oncology
Chemotherapy
Immunotherapy & Targeted Therapy
Radiation Therapy
Diagnosis
Multispeciality Support
Structured Patient Support

    Cancer Diagnosis and staging at Horizon Cancer Care

     Diagnosis and staging  determines whether treatment is curative, organ-preserving, systemic, or purely supportive. At Horizon Cancer Care, diagnosis is a disciplined, multi-layered clinical process.

    Staging Defines

    Whether the disease is localized or metastatic
    Whether surgery will be curative or futile
    Whether systemic therapy is required first
    Eligibility for advanced protocols like immunotherapy
    Prognosis and survival expectations

    Our Diagnostic Framework

    We follow a structured, evidence-based staging pathway aligned with global oncology standards.

    Our Clinical Examination is our Foundation

    Our comprehensive physical examination includes:

    Tumor palpation and fixation assessment
    Lymph node mapping (cervical, supraclavicular, axillary, inguinal)
    Abdominal examination for organ enlargement
    Rectal or pelvic examination when indicated
    Performance status evaluation

    Real example:

    A patient previously advised curative surgery for stomach cancer presented to us. On careful clinical examination, a large rectal nodule and pelvic fixation were detected. This upstaged the disease to metastatic spread. Surgery would not have benefited him. Instead, systemic therapy was initiated, avoiding a major unnecessary operation.
    Similarly, missed lymph node assessment frequently leads to under-staging.

    Pathology and Tissue Diagnosis

    No cancer treatment begins without histological confirmation.
    We perform:

    Biopsy (core, incisional, excisional)
    Endoscopic biopsy
    Image-guided biopsy
    Cytology (FNAC)
    Immunohistochemistry (IHC)
    Molecular markers when indicated
    Laboratory Evaluation

    Baseline and staging labs include:

    Complete blood counts
    Liver and renal function tests
    Tumor markers (CEA, CA-125, CA 19-9, PSA, AFP, etc.)
    Coagulation profile
    Nutritional markers
    Imaging Studies

    Imaging defines anatomical spread and guides treatment sequencing.

    We use:

    Ultrasound (USG) – Initial evaluation, guided biopsies
    Contrast-Enhanced CT (CECT) – Thorax, abdomen, pelvis
    MRI – Brain, pelvis, rectum, soft tissue, liver characterization
    PET-CT – Whole-body metabolic staging
    Bone Scan – Skeletal metastasis detection
    Endoscopic ultrasound (EUS) in select GI tumors

    PET-CT is especially valuable in:

    • PET‑CT scans are highly valued in cancer care because they –
      enable early detection
    • precise staging, detecting occult metastasis
    • Response assessment after therapy
    Types of PET:
    FDG‑PET- Lung,breast,GI, lymphoma, head & neck etc
    PSMA‑PET for prostate cancers
    DOTA‑PET (Dotatate) for neuroendocrine tumors
    Limitations:
    Not all cancers are FDG‑avid
    False positives can occur in infections or inflammatory
    TNM Staging System

    We follow the internationally accepted TNM system:

    T (Tumor) – Size and local invasion
    N (Nodes) – Regional lymph node involvement
    M (Metastasis) – Distant spread

    Accurate TNM staging determines whether treatment is:

    Curative surgery
    Neoadjuvant therapy followed by surgery
    Definitive chemoradiation
    Systemic therapy alone
    Immunotherapy or targeted therapy protocols

    Multidisciplinary Review

    Every confirmed cancer case is evaluated in a structured decision pathway:

    • Clinical assessment
    • Imaging review
    • Pathology confirmation
    • Stage allocation
    • Treatment intent defined

    This prevents fragmented care and inappropriate interventions.

    Reviewed By

    Medically Reviewed by : Dr. Srinivas Prasad, MCh (Surgical Oncology)
    20+ years of experience in oncologic surgery and multidisciplinary cancer care.
    Registration No: 2111
    Last reviewed: February 2026