Diagnostic and Treatment Technologies

Many technological advances are revolutionizing how cancer is diagnosed and treated today. UM/Sylvester’s team of oncologists, surgeons, and radiologists are leaders in the use of a variety of cutting-edge diagnostic and treatment options that help detect and treat cancers at their earliest stage.

Diagnostic Options

Advanced X-Ray Technology
Advanced X-ray technology includes the many types of devices and combinations of technology to detect specific types of cancer.  Examples include barium enema, a series of X-rays of the colon and rectum; intravenous pyelogram (IVP), an imaging technique that uses a special dye to detect abnormalities in the kidneys, ureters, and bladder; and myleogram, a procedure that uses injected dye into the spinal canal to make the structure visible on X-rays.

Biopsy Procedures
Biopsy involves removing tissue samples for examination under the microscope to more accurately diagnose the disease. UM/Sylvester offers many types of  biopsies including image-guided biopsy, fine needle biopsy aspiration, core needle biopsy, surgical biopsy, and sentinel lymph node biopsy, a procedure that uses a dye to locate the lymph node closest to the tumor (sentinel node) to determine if the cancer has spread.

Combined CT-PET
Combined CT-PET integrates PET (positron emission tomography) and CT (computed tomography) to pinpoint even the smallest of tumors.

Diagnostic Radioisotope Services
These services involve injecting radioisotopes (atoms that are unstable and prone to breaking up) into the body. These radioisotopes collect in areas where the cancer is active, to identify where the cancer is located.

Magnetic Resonance Imaging (MRI)
MRI is a noninvasive diagnostic test that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Mammography
An x-ray exam of the breasts used to evaluate a patient with abnormal clinical findings—such as a breast lump. Radiologists may recommend such a test after an abnormal finding on a screening mammography.

Needle Aspiration
The removal of tissue samples for examination under a microscope to check for cancer cells. A variation of this approach is bone marrow aspiration, which also is available.

Positron Emission Tomography (PET Scan)
This type of imaging uses a dye injected into the bloodstream to scan the entire body for areas of concern.

Spinal Tap/Lumbar Puncture
This procedure measures pressure in the spinal canal and brain using a special needle placed into the lower back, into the spinal canal. A small amount of cerebral spinal fluid (the fluid that bathes the brain and spinal cord) is generally removed and sent for testing to determine if there is an infection or other issues.

Ultrasound (also called Sonography)
This diagnostic imaging technique uses high-frequency sound waves and a computer to create images of the internal organs. Variations in the technology include ultrasonography or transvaginal ultrasound, transabdominal ultrasound, which produces a picture of the pancreas and other internal organs, and transrectal ultrasound (TRUS), an imaging technique that produces a picture (or sonogram) of the prostate gland.

Other Diagnostic Procedures
Bronchoscopy is an examination using a flexible tube to look into breathing passages of the lung, while mediastinoscopy involves removing a tissue sample from the lymph nodes along the windpipe and bronchial areas for evaluation. 

Sputum cytology involves microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs. Cytoscopy is an examination of the inside of the bladder and urethra to check for abnormal areas.  Urinary cytology involves an examination of urine under a microscope to find any cancerous cells.

Dedicated head and neck PET scans are used in conjunction with small amounts of radiolabeled compounds to help surgeons visualize brain (head) anatomy and function.

Surgical Options
In some cases, surgery may be a patient’s best option for eliminating or treating cancer. At UM/Sylvester, we offer a variety of surgical options depending on the type of cancer. These range from invasive procedures such as masectomy to laparoscopic ones such as video-assisted thoracic surgery.

Blood or Bone Marrow Transplantation
This is a procedure where a patient’s diseased blood or marrow is replaced using the patient’s own healthy blood or marrow (autologous) or blood or marrow from another person (allogenic). UM/Sylvester has the only allogenic transplant program in South Florida and is one of the largest blood and marrow transplant programs in the state. To date, UM/Sylvester’s team has performed more than 500 stem cell transplants.

Cryosurgery
Cryosurgery is the use of extreme cold to freeze and destroy cancer cells.

Ductoscopy
This procedure allows doctors to look directly into the milk ducts where most breast cancers develop. It also may help surgeons decide how much tissue to remove and could improve early detection of breast cancer in women at high risk for the disease.

Laser Surgery
Laser surgery uses a powerful beam of light which can be directed to specific parts of the body without making a large incision, to destroy abnormal cells.

Mastectomy
Mastectomy has many variations. With radical mastectomy, surgeons remove the entire breast that contains cancer, the chest wall muscles under the breast, and all of the lymph nodes under the arm. Skin-sparing mastectomy is a procedure where the entire breast is removed, including the nipple and areola, conserving the skin of the breast and allowing for immediate breast reconstructive surgery using the patient’s own breast skin tissue. Subcutaneous mastectomy, a type of skin-sparing mastectomy where the nipple and areola are left intact and no lymph nodes are removed.

Mohs Surgery
Mohs surgery is a highly effective treatment for removal of certain types of skin cancer.

Stereotactic Radiosurgery
Stereotactic radiosurgery, also known as gamma knife, is an experimental procedure using a special machine to focus high doses of radiation at the tumor site, while sparing the surrounding normal tissue.

Other Surgical Procedures
Laparoscopic lymph node sampling involves the removal of lymph nodes through a viewing tube, while pelvic lymph-node dissection involves the removal of some lymph nodes from the pelvis.  Salpingo-oophorectomy involves the removal of the fallopian tubes and ovaries to treat patients affected by certain types of gynecologic cancers.

Laryngoscopy is a close examination of the larynx performed indirectly (through the throat) or directly, with a lighted instrument inserted through the nose or mouth. Video-assisted thoracic surgery involves using a tiny video camera placed inside the chest cavity to help surgeons see tumors through small incisions. 

Radiation Therapy
UM/Sylvester physician-scientists and radiologists offer patients a number of innovative radiation therapy options including the use of a new applicator for the delivery of low-dose-rate internal radiotherapy for cancers of the cervix, vagina, and endometrium (uterus).  Choosing the type of radiation therapy depends on the type of cancer and its location.  The most common forms of radiation therapy include:

External Radiation Therapy
External radiation therapy is usually administered with a linear accelerator (linac); newer forms of this treatment including IMRT and 3D-CRT allow doctors to match the shape of the radiation beam with the tumor.

• Intensity modulated radiation therapy (IMRT) - This form of radiation therapy conforms to the tumor shape, but also allows the beams to be adjusted to lessen damage to body tissue; it may cause even fewer side effects than traditional radiation therapy.

• Three-Dimensional Conformal Radiation - Three-dimensional conformal radiation therapy (3D-CRT) involves fitting the patient with a mold or cast to keep the body immobile so the 3D-CRT can deliver shaped beams from varying angles directly to the cancer.

High-Dose-Rate (HDR) Brachytherapy
HDR brachytherapy is a form of internal radiation therapy that uses a powerful radioactive source placed in an applicator directly into, or as close as possible to, the cancer.

Chemotherapy & Other Therapies
Chemotherapy is the use of a single drug or a combination of drugs (usually administered in the vein) to kill cancerous cells by stopping them from dividing and reproducing. UM/Sylvester offers numerous clinical trials for a variety of cancers that examine different chemotherapy combinations and their effects on attacking cancer cells. For more information about clinical trials, including an explanation of the different types of trials, click here.

Arterial Embolization
Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel associated with kidney cancer. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.

Biological Therapy
This type of therapy uses the body's own immune system to fight cancer. Biologic therapies can act in several ways in cancer treatment, including interfering with cancer cell growth, acting indirectly to help healthy immune cells control cancer, and helping to repair normal cells damaged by other forms of cancer treatment. Several kinds of biologic therapy techniques are now in use, and can be combined with chemotherapy or radiation therapy to treat cancer.

Hormonal Therapy
Hormonal therapy (e.g., Tamoxifen, Toremifene, Fulvestrant, or Aromatase inhibitors) is a form of adjuvant systemic therapy used to block the negative effects of certain hormones.

Photodynamic Therapy
This is a type of laser treatment that involves injecting chemicals into the bloodstream. The chemicals collect and remain longer in the cancer cells than in the healthy cells. At the right time, the light of a laser can be focused directly on the tumor. As the cells absorb the light, a chemical reaction destroys the cancer cells.