What tests and scans might you need?

Why more tests are needed after a diagnosis

You may have already had tests or scans to diagnose cancer, but extra tests are often needed after diagnosis to give doctors more information about the disease.

Depending on the type of cancer, further tests and scans may be used to find out:

• where the cancer started – doctors may need to work out the source of the cancer; different cancers are treated in different ways
• the stage of the cancer – this shows the size of the cancer, if it has spread and how far
• the grade of the cancer – this shows how quickly the cancer may grow
• your general health – other health issues, such as heart problems, may affect how cancer is treated
• other information about the cancer – doctors may look for features in the cancer to help work out the best treatment.

Once your doctors know more about the cancer, they’ll talk to you about which treatments may help you the most. You may have more tests and scans during and after treatment.

You probably won’t need every test or scan mentioned in here, but you’ll need some. If you’re unsure about a test or scan, ask your doctor to explain it. You can also ask your doctor if some or all tests can be bulk-billed or done in the public system to help with costs.

My diagnosis was made after the biopsy. I felt relieved to finally have a label for my illness.

Dee

Common tests and scans

Blood and urine tests

It’s likely that you’ll have blood tests to check your general health and sometimes to find out more about the cancer.

You may also be offered a blood or saliva test to check for certain gene changes. The results can help your doctor work out which treatments may work for you. For some types of cancer, your urine (wee or pee) may be tested to check for cancer cells or blood.

Imaging scans

You may have several imaging scans to create pictures of the insides of the body.

Biopsies

A biopsy is when a doctor removes a sample of cells or tissue from an area of the body. The sample is examined under a microscope to look for signs of cancer and what type of cell is affected.

If the cancer can be easily felt or seen, a doctor may use a needle or make a small cut in the skin to take a sample.

Other ways to have a biopsy include:

• with imaging guidance – a specialist may use a scan to guide a needle into the cancer to get a sample
• during a scoping test
• during surgery – a surgeon makes a cut in the skin to remove a sample.

For a biopsy, you’ll have a local anaesthetic to numb the area. If you’re having surgery, you may have a general anaesthetic to put you to sleep.

Scoping tests

For some cancers, doctors use a thin, flexible tube with a camera on the end (called a scope) to look inside your body and examine your organs. Different types of scoping tests are used to check different parts of the body. These include:

• bronchoscopy – inserted through the mouth to see airways and lungs
• colonoscopy – inserted through the anus to see the large bowel
• cystoscopy – inserted through the urethra to see the bladder
• hysteroscopy – inserted into the vagina and passed through the cervix to check the uterus (womb)
• laparoscopy – inserted through a small cut in the abdomen (belly) to check organs such as the stomach, pancreas or liver.

Your doctor will explain how to prepare for the scoping test and how long it will take. A small tissue sample may be removed during the procedure (biopsy). The sample will then be sent to a laboratory to confirm that it’s cancer as well as the type and stage.

Prognosis

The first question that comes to mind after a cancer diagnosis is often “what’s going to happen to me?”. Your doctor may talk to you about the expected outcome of the cancer. This is called the prognosis.

No one can predict exactly how the cancer will affect you, but your doctor can explain what usually happens for people with the type of cancer you have.

To work out your prognosis, the doctor will consider:

• your test results
• the type of cancer
• the stage and grade of the cancer
• how likely it is that the cancer will respond to a specific treatment
• your age, fitness level and medical history.

In general, the earlier cancer is diagnosed, the better the chances that treatment will be successful. In some cases, advanced cancer can also respond well to treatment. Advanced cancer is cancer that has spread from one organ to other organs. It may also be called stage 4 or metastatic cancer.

Although the doctor will do their best to predict the outcome after cancer treatment, a prognosis is never certain. It can also change over time.

Some people don’t want to know their prognosis, and this is completely natural. You can decide how much you want to know. Talk to your doctor about how you’re feeling. If you have any questions or worries about your prognosis, talk to your cancer care team. You can also call Cancer Connect on 13 11 20 to speak to our qualified professionals.