If cancer is suspected, you will need additional tests to work out the type of cancer you have and whether it has spread. Your doctors will also need to learn more about your general health.
Waiting for the results can be stressful, but your care team needs to have as much information as possible so they can work out the best treatment plan for you.
Here are some of the most common tests that are used to diagnose cancer. If you are unsure about why you need a particular test, or if you have any questions about how it will be carried out, don’t hesitate to ask your doctor or nurse.
A biopsy involves removing a small part of a lump or tumour, either with a specially designed needle (needle biopsy) or during a small operation (open biopsy). The sample is then examined and tested in a laboratory to determine what type of tumour it is. Most suspected tumours will be biopsied.
Bone marrow tests
In a bone marrow test, a needle is inserted into the bone to collect some of the bone marrow. You may have a sedative to make you drowsy, or a general anaesthetic to make you sleep. If you are not having a general anaesthetic, the area will be numbed first using local anaesthetic. The bone marrow sample is checked in a lab to see if there are any abnormal changes that suggest cancer. This test might also be repeated to monitor your condition once you have a diagnosis.
Blood tests are usually done before, during and after treatment. Some of the reasons for blood tests include:
- Detecting cancer
- Checking for infection
- Monitoring how well treatment is working
- Monitoring the side effects of treatment
- Making sure your body’s systems (such as your liver or kidneys) are still working properly
- Matching your blood with a donor’s if you need a transfusion
- Monitoring your blood count (the number of red and white blood cells and platelets in your blood).
A reduction in the total number of blood cells is a common side effect of treatment, and can increase your risk of infection.
A lumbar puncture is used to test the fluid around your spinal cord (called the cerebrospinal fluid) to see if it contains cancer cells. A needle is inserted between the bones in your lower spine, and a few drops of the fluid are drawn out for testing in the lab. You will have a local or general anaesthetic before the test. As some people have a headache afterwards, once you have had the test you will be asked to lie flat for a while to try and prevent a headache coming on.
A lumbar puncture is used when leukaemia, lymphoma and some solid tumours are suspected or confirmed. It tests whether the cancer has spread to this fluid from elsewhere in the body.
X-rays can help to diagnose a suspected tumour in your chest or bones. X-rays are also used at other times, for example to check for a chest infection if you have a temperature. Sometimes tumour tissue can look very different to healthy tissue on an X-ray, but this isn’t always the case. If the tumour tissue is not obvious on an X-ray, the specialists may need to use different scans to get a more detailed picture.
This scan uses X-rays to produce images of the inside of your body. You will need to lie very still during the scan, but it only takes a few minutes. Sometimes an injection is also given with the scan to help different areas of your body show up more clearly.
An MRI scan involves lying in a narrow tunnel within the machine as the scan takes place. The scanner uses magnetic waves to create a detailed image of the inside of your body. The machine can be loud, so you will usually wear headphones to help reduce the noise.
The scanner may be fitted with a music or DVD player so ask in advance if you can bring something to keep you occupied. The scan will usually last between 20 and 60 minutes, depending on the parts of your body that need scanning, and you will need to lie very still. Sometimes you will be given an injection during the scan to show up parts of your body more clearly.
An ultrasound scan uses sound waves to look at different organs inside your body, especially your heart, liver or kidneys. It can show the presence of unhealthy tissue. The person doing your scan will put some gel on your skin, which may feel a little cold. They will then move a hand-held ultrasound wand around, pressing it over the part of your body that is being scanned.
This is a scan used to diagnose neuroblastoma. A radioactive substance is injected into the vein, which is then taken up by the tumour cells. You will need to take medicines to protect your thyroid gland in the days before the scan.
Updated December 2014, next planned review 2017.