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Diagnostics
There are many diagnostic tests and techniques used throughout treatment. Some are only currently available privately.
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Below, we discuss the most common diagnostics: what they are, what they are used for and whether or not they are available on the NHS.
What is a CT Scan?
A CT (Computed Tomography) scan is the usual standard for both diagnostics and monitoring during your treatment. It produces excellent imaging of our organs and bones.
CT relies on radiation to achieve the imaging – a series of X-rays, creating cross-sectional images of the body.
A CT scan typically lasts less than 15 minutes, although preparing you and getting you into exactly the right position
takes a bit more time.
You might also have a CT scan with contrast - this is a longer appointment of 1 - 1.5 hours. The contrast is an iodine-based substance either taken orally or injected through an IV or sometimes, your port or PICC. (usually dependent on Nurse experience in administering via Port/PICC).
Your usual monitoring scans will be CT scans as these are the best way of determining shrinkage, growth or NED alongside bloodwork. NED means 'No Evidence of Disease'.
What is a PET Scan?
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A PET (Positron Emission Tomography) scan uses a radioactive tracer (a luminous dye) injected into the body an hour or so prior to the scan. The scan is used to create very highly detailed images of how organs and tissues are working.
The scan itself lasts between 30 and 60 minutes, but can be much longer depending on how long the tracer takes.
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You might have a PET scan after diagnosis to identify how effectively parts of your body are working in spite of cancer (determining a need for surgery, radiotherapy, etc) or you might have one to identify whether very small spots seen on a previous CT are likely to be cancerous. PET scans are also used prior to surgery to help plan best approaches.
What is an MRI Scan?
MRI (Magnetic Resonance Imaging) is usually a more specialist diagnostics technique, used to look at specific types of metastases that may be in soft tissues within the body.
An MRI usually takes between 30-60 minutes depending on how much of your body is being scanned.
What is a Blood or Liquid Biopsy / ctDNA Test?
This test is currently only available privately or as part of a trial. The test has many names – scientifically known as a ctDNA or circulating tumour DNA test, it is also referred to as a blood biopsy or a liquid biopsy. The test can be blood-only, or it can combine diagnostics from your blood and a stored sample of the tumour itself.
It is a non-invasive diagnostic test that detects fragments of DNA shed by tumours into the bloodstream.
It gives insights into the genetic profile of a cancer, enabling early detection, monitoring of treatment response and identification of mutations associated with resistance to therapy. By analysing ctDNA, Oncologists can obtain a snapshot of the tumor's genetic landscape, aiding in personalised treatment strategies.
ctDNA tests also provide insights into how a tumour might react to different drug regimens and therefore guide subsequent lines of treatment.