The services and procedures provided by the Hematology and Medical Oncology section of Pinehurst Medical Clinic range from commonly used blood tests to highly sophisticated interventions for blood diseases and cancer.
The primary procedure for diagnosing blood disorders is laboratory testing to examine the contents of the blood. For cancer, many different kinds of laboratory tests may be used, including blood testing and urinalysis, tests to evaluate liver and kidney function, and genetic tests. Imaging tests and tissue biopsies are also used to aid in the diagnosis and staging of cancer, to assess how well treatment is working, and to determine if cancer has recurred after treatment has ended.
During a cancer patient’s first visit to Medical Oncology, a complete medical history will be taken, including information about the health history of family members. The physician will review referral notes from prior physicians and will perform a complete physical examination. Tests may be ordered at the initial visit, either to assist in diagnosis or to establish baseline values so that the effects of treatment can be evaluated.
Here are examples of some of the services and procedures we offer:
- Complete blood count (CBC)
A blood test that includes a count of the number of red blood cells, number of white blood cells, total amount of hemoglobin in the blood, the size of the red blood cells, and the fraction of the blood that is composed of red blood cells (hematocrit). The CBC is used to aid in diagnosing anemia and certain cancers of the blood, as well as to monitor blood loss, infection, and effects of cancer treatment.
- Platelet count
Platelets are elements in the blood that aid in blood clotting. A platelet count is used to diagnose and/or to monitor a variety of diseases, including anemia, leukemia, and bleeding and clotting disorders.
- Prothrombin time
A measure of how long it takes the blood to clot. It is used to evaluate bleeding and clotting disorders and to monitor anticoagulation (anti-clotting) therapies, such as Coumadin (warfarin).
Diagnostic tests that use high-energy beams to produce images of internal tissues, bones, and organs.
- Computed tomography (CT or CAT) scan
An imaging test that uses X-rays and a computer to produce cross-sectional images (slices) of the body. Some CT scan procedures involve drinking a special contrast material or receiving an injection of a contrast material to help generate clearer images. CT scanning can be used to detect cancer in the brain, lung, lymph nodes, liver, and other organs and is helpful in diagnosing and staging cancer.
An imaging test that uses high-frequency sound waves to generate images of tissues and organs, to identify tumors, and to assess blood flow through blood vessels. Ultrasound is a painless and noninvasive test.
A test performed to obtain a sample of tissue for the diagnosis or staging of cancer. In a needle biopsy, a syringe is used to withdraw fluid or soft tissue. In an open biopsy, an incision is made in the skin and a tissue sample is taken from the exposed organ.
- Bone marrow biopsy
Removal of marrow from a large bone (often the hip bone) using a needle under local anesthesia. Bone marrow is soft tissue found inside large bones that produces platelets and red and white blood cells. Bone marrow biopsy is performed to help diagnose certain types of anemia, cancer, and other systemic diseases and to monitor the response to some types of cancer therapy.
- Bone marrow aspiration
Removal of a small sample of liquid marrow from the breastbone, pelvic bone, or another bone to help diagnose certain types of anemia, cancer, and other systemic diseases. Bone marrow aspiration requires only local anesthetic. It is sometimes performed along with a bone marrow biopsy.
- Lumbar puncture (spinal tap)
A procedure performed to measure the pressure in the spinal canal and brain and to obtain cerebrospinal fluid (CSF, the fluid that bathes the brain and spinal cord) for testing. To perform a spinal tap, a local anesthetic is injected into the skin of the lower back, and then a special needle is placed in the lower back to remove a small sample of CSF. The fluid can be tested in the lab to determine if there is an infection or other problem.
Therapies to Treat Blood Disorders and Cancer
To treat blood disorders, hematologists may prescribe blood products and/or the removal of blood components as needed. They also prescribe immunosuppressive, growth factor, and biological therapies for the treatment of blood disorders. Stem cell transplants and bone marrow transplants are also part of the specialty of hematology.
Medical oncologists specialize in the treatment of cancer using chemotherapy, immunotherapy, hormone therapy, and other non-surgical therapies. Medical oncologists often work with surgeons and radiation oncologists in the treatment of cancer.
Here are brief explanations of some of the most common medical therapies used for blood disorders and cancer:
The treatment of cancer using anti-cancer drugs (drugs that destroy cancer cells). Anti-cancer drugs target rapidly dividing cells, stopping them from growing or multiplying. The side effects of chemotherapy result from harm to healthy cells, especially cells that divide rapidly, such as blood cells forming in the bone marrow, cells in the digestive tract, and hair follicles. Chemotherapy is usually given in cycles separated by rest/recovery periods. In addition to its use to treat cancer, chemotherapy may also be given to prevent a recurrence of cancer.
Biological response modifier therapy
A type of cancer treatment that helps the immune system fight cancer. Biological response modifier therapy may help fight cancer by stopping or slowing the growth of cancer cells, making it easier for the immune system to destroy cancer cells and/or prevent cancer from spreading to other parts of the body.
- Cancer vaccine
A form of biological response modifier therapy. Unlike vaccines to prevent infectious diseases, most cancer vaccines are given after cancer has occurred in order to help the body fight cancer and prevent cancer from returning. Many of these are not yet commercially available.
- Monoclonal antibody therapy
A form of biological response modifier therapy. Monoclonal antibodies are created in a laboratory to work like the natural antibodies produced by the body’s immune system to fight disease.
Use of hormones (substances produced by the endocrine glands to regulate organ functions) in order to block the actions of other hormones that cause cancer.
Stem cell transplantation
Removal of immature cells from circulating blood or the bone marrow, followed by replacement of these cells after chemotherapy treatment.
Neupogen or Neulasta
A biological therapy that increases white blood cell counts and helps prevent infection in people who are getting chemotherapy.
Procrit or Aranesp
A biological therapy that helps make red blood cells in people who have anemia.
A device inserted in the upper chest wall (the space between the collarbone and the breast) to make chemotherapy easier and more comfortable. Placement of the device is a simple procedure that requires only local anesthesia. The port-a-cath eliminates the discomfort of multiple needle sticks and can be used to deliver chemotherapy, antibiotics, and other fluids and to draw blood for laboratory testing.
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for informational purposes only.
It is not a substitute for professional medical advice.