What tests should I have after a cancer diagnosis

Tests After a Cancer Diagnosis: What You Should Know

After a cancer diagnosis, your care team will recommend several tests to understand your specific cancer and guide treatment decisions. Here's what you should expect:

Initial Diagnostic Tests

According to the NCCN Guidelines for Patients: Acute Lymphoblastic Leukemia, accurate testing is essential for diagnosis and treatment planning. Your care team will typically order:

Blood and Bone Marrow Tests

• Complete blood count (CBC) - measures different types of blood cells
• Bone marrow aspirate and biopsy - removes samples of bone marrow tissue to confirm diagnosis and identify the specific type of cancer cells
• Flow cytometry - a lab method that uses special dyes and light to identify and count specific cancer cells

Imaging Studies

These create pictures of your body to see if cancer has spread:

• CT scans (detailed X-ray images)
• MRI (magnetic resonance imaging)
• PET scans (shows where cancer cells are most active)
• Ultrasound or bone scans (depending on your cancer type)

Specialized Testing for Treatment Planning

Beyond basic diagnosis, modern cancer care often includes:

Biomarker and Genetic Testing

According to ASCO Guidelines and NCCN recommendations, your doctor should consider:

• Hormone receptor testing (ER/PR status) - shows if cancer responds to hormone therapy
• HER2 testing - identifies if targeted therapies might work
• Genetic mutations - DNA/RNA sequencing to find specific mutations that might respond to targeted drugs
• Tumor profiling - comprehensive genomic analysis that can reveal actionable mutations for about 20% of patients

Emerging Advanced Tests

As noted in Cancer Patient Lab webinars on precision medicine, patients should ask about:

• Liquid biopsies - blood tests that detect circulating tumor DNA (ctDNA) to monitor disease and identify mutations
• Comprehensive genomic profiling - detailed analysis of your tumor's genetic makeup
• Immune profiling - assesses your tumor microenvironment to predict immunotherapy response
• Microsatellite instability (MSI) testing - helps determine if immunotherapy might work

General Health Tests

Your care team will also assess your overall health:

• Medical history review - document all past illnesses, injuries, and current medications
• Physical examination
• Organ function tests - blood tests checking liver, kidney, and heart function (important before starting treatment)
• Nutritional assessment - dietitian evaluation

Important Steps You Should Take

According to NCCN Guidelines, here's what helps:

✓ Keep copies of all test results - Create files for insurance forms, [ID removed] and test results (both paper and digital)

✓ Organize your information - Keep a list of:

• Your exact cancer type
• All test results and dates
• Contact information for your care team
• All medications and supplements you take

✓ Bring someone to appointments - A support person can help you take notes and ask questions

✓ Ask questions about testing - Don't hesitate to ask your care team to explain results in simpler language

Questions to Ask Your Oncologist

Based on NCCN shared decision-making guidelines, ask:

1. "What additional tests should I get to identify new treatment options and personalize my care?"
2. "Can I get comprehensive genomic profiling of my tumor?"
3. "Is a liquid biopsy an option for me?"
4. "Why is each test needed, and how will it affect my treatment plan?"
5. "Can I get copies of all my test reports?"
6. "Are there any emerging tests that might help guide my treatment?"

Important Reminder

According to Cancer Patient Lab webinars on precision medicine, not all tests are standard of care. You may need to advocate for additional testing—especially if you're considering later-line treatments or have a rare cancer. Ask your oncologist about molecular profiling and whether advanced diagnostic testing could reveal actionable insights for your specific situation.

Your oncologist will determine which tests are most appropriate for YOUR specific cancer type, stage, and individual factors. The goal is to gather enough information to create a personalized treatment plan that works best for you.

---

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.