Solid tumors
If a lump or cancer has been reported in your test, imaging or biopsy result, here you can read how the diagnosis is confirmed, what staging means and where the treatment plan starts.
What does solid tumor cancer mean?
Cancer is a disease in which cells lose controlled growth, grow without limit and may travel to other parts of the body. There are more than 100 types of cancer, and they are usually named after the organ or the type of cell they started from.
Many cancers form a solid tumor, which is a mass in an organ or tissue. This differs from blood cancers such as leukemia, which usually do not form a mass. Solid cancers include, for example, carcinomas (the most common group, from lining cells), sarcomas (bone and soft tissue) and melanoma (pigment-making cells).
Not every lump is cancer. A benign tumor does not invade nearby tissue and does not spread. A malignant tumor can invade nearby tissue and sometimes comes back after it is removed. The spread of cancer cells to other parts of the body is called metastasis; the cancer keeps the name of the original organ (for example, breast cancer that has gone to the lung is metastatic breast cancer, not lung cancer).
Who is this page for?
- Someone whose test, ultrasound or CT scan reported something unusual and who wants to know what happens next
- Someone who has just received a biopsy result and heard a diagnosis of a solid cancer
- Someone referred for the medicine part of treatment (such as chemotherapy, targeted therapy, immunotherapy or hormone therapy)
- A companion of a patient who wants to understand the path
How is it diagnosed?
No single test diagnoses cancer. The doctor usually starts with the history and an examination, and then asks for tests, imaging or a biopsy.
- Biopsy. In most cases it is needed to confirm the diagnosis. The sample is taken with a needle, with an endoscope or during surgery, and sometimes anesthesia or sedation is needed.
- Pathology. The pathologist looks at the sample under a microscope and runs other tests on the cells. The result is written in the pathology report, one of your most important documents.
- Imaging. CT scan, MRI, bone scan, PET scan, ultrasound or X-ray, depending on the case.
- Blood and urine tests. Some substances go up or down in cancer, but these alone are not conclusive.
- Biomarker testing. Checking genes, proteins and other markers in the cancer cells. Some targeted therapies and immunotherapies work only for cancers with a particular marker. The sample can come from the removed tumor, from a biopsy or from the blood, and is examined in a special laboratory.
Staging shows how advanced the cancer is: the size of the tumor (T), involvement of lymph nodes (N) and spread to other places (M). The doctor uses the stage to choose the best treatment.
Where does treatment start?
The type of treatment depends on the type of cancer and how far it has advanced. The main methods are surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy and hormone therapy (for some breast and prostate cancers). Some patients need only one method, and most patients a combination of several.
Several specialties usually work together in the treatment team. Surgery and radiotherapy are the work of specialists in those fields and, when needed, are done by referral. The medicine part of treatment (chemotherapy, targeted therapy, immunotherapy and hormone therapy) is explained on the “Chemotherapy and medicine-based treatments” page. Which method is done for you, in what order and where, you settle with the doctor at the visit.
Follow-up and care
During and after treatment, the doctor judges progress with visits, examinations, blood tests and sometimes imaging. You cannot tell from side effects alone whether the treatment is working. If a side effect worries you, do not wait for the next appointment. Read the home-care tips in the site’s patient guide.
For the first visit, bring the pathology report, the imaging disc and your list of medicines, bring a companion who can take notes, and write your questions beforehand.
When to call
- A fever of 38 degrees or higher during treatment: call the treatment team at once.
- Bleeding that does not stop a few minutes after pressure, black or bloody stools, or vomiting blood.
- Severe or sudden shortness of breath, chest pain, sudden weakness on one side of the body or trouble speaking: emergency (115, Iran’s emergency number).
- Vomiting or diarrhea that stops you from drinking fluids.
Every patient’s treatment plan is different; ask your doctor about your own situation.
Frequently asked questions
If a mass was seen on a CT scan or ultrasound, does that mean I have cancer?
Not necessarily. A mass can also be benign. A benign tumor does not invade nearby tissue and does not spread. To be sure, in most cases a biopsy is needed and a pathologist looks at the sample under a microscope.
What does the stage of the disease mean?
The stage shows how large the cancer is and whether it has reached the lymph nodes or other places. Many centers use the TNM system, and for many cancers the result is written from zero to four. The doctor uses the stage, along with the type of cancer and your situation, to choose treatment.
What is a biomarker test?
It is a test on a sample of the tumor or blood that looks for genes, proteins or other markers in the cancer cells. Some treatments work only for cancers that have a particular marker, and this test helps choose treatment. Not every patient needs it.
Does this doctor carry out all the treatments?
A cancer care team usually includes several specialists, such as a surgeon, a medical therapy specialist and a radiotherapy specialist. Ask at the visit which part is done where. Getting a second opinion is also normal, especially if you are unsure about the proposed treatment.
I have only one abnormal result. Should I be afraid?
An abnormal test result is not always a sign of cancer, and sometimes a test stays normal even when cancer is present. No single test diagnoses cancer. The doctor interprets the result together with the examination and the other checks.