Investigations and tests for cancer

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Your doctor may recommend a number of tests before, during and after cancer treatment. These can take the form of blood test, x-rays, CT, MRI scans or nuclear medicine scans such as bone or PET scans or even scopes and further examinations under anaesthetic including biopsies of suspicious areas. As  a general rule tests should only be performed if the result will change the management of the patient. Test are generally performed for the following reasons:-

 Before treatment

• Find out if patients have cancer
• To determine the type of cancer*
• Assess the extent of disease
• Assess damage to other organs
• Assess function of organs and fitness for treatment

The histology* This is what the cancer looks like down a microscope. the pathologist is able to tell the surgeons and oncologist a range of factors which predict prognosis and guide future treatments. In summary they include:

• A report of the type of cancer
• Whether it has been completely removed (the margins)
• The grade of cancer (how aggressive it is)
• Other prognosis factors such as growth rate and whether it has invaded into the vessels or spread to adjacent organs or to the local nodes (the stage)
• For breast  the ER status (whether it is sensitive to oestrogen and therefore to hormonal drugs)
• For breast the HER status (whether is sensitive to herceptin)
• For bowel whether the tumour carries the K-ras mutation which needs to be excluded before treatment with erbitux

During treatment

• Assess whether treatment is working
• To investigate new symptoms
• Assess function of organs and fitness to continue treatment
• To asses side effects of treatment such as loss of done density or cardiac function

After treatment

• To assess whether cancer remains in remission
• To investigate new symptoms