Having tests and scans

Why do I need to have this test?

Some chemotherapy drugs, such as cisplatin, and radiotherapy to the head can affect your hearing. You may have a hearing test before, during and after treatment. A hearing test is called an audiometry.

What happens?

The test may take up to an hour. It will be done by an audiologist. First, they check your ears for any blockages such as ear wax. After this, they give you headphones to wear and test your ears one at a time. They play sounds at different volumes and pitches. You will be asked to press a button on a device each time you hear a sound. The sounds gradually get quieter. Sometimes they also play words and ask you to repeat back what you hear.

Always tell your doctor or nurse if you notice any changes in your hearing.

What is a biopsy?

This is when your doctor takes a small piece of tissue from a part of your body to look at it closely. 

Why do I need to have this test?

A biopsy helps your doctors to make a diagnosis. They look at the tissue under a microscope and do tests on the cells. This tells them if a lump or abnormal area on your skin or inside your body is cancer or not. It also tells them what type of cancer it is.

What happens?

There are different types of biopsy. Your doctor or nurse will explain more about the type of biopsy you will have and what will happen. You may be able to have a family member or friend with you during the test, if you want to. 

Before the biopsy

You might have the biopsy taken under a general anaesthetic. This means you will be asleep and will not be aware of what is happening, or be able to feel anything. You will be asked not to eat or drink for six hours before having a general anaesthetic. A general anaesthetic is usually used if a larger area or tissue is being taken, or if the area is deeper in the body.

Or you might have the biopsy under a local anaesthetic. This means you will stay awake, but the doctor will give you an injection to numb the area so you can’t feel it. You might feel some pressure during the biopsy, but it should not be painful.

During the biopsy

What happens during the biopsy depends on the type you have. The most common types of biopsy are:

• needle biopsy – the doctor uses a thin needle to remove a very small piece of tissue
• surgical biopsy – the doctor makes a cut to remove a bigger area of tissue
• excisional biopsy – the doctor can remove the whole abnormal area.

For deeper biopsies, the doctors might use an ultrasound or CT scan during the biopsy to help guide them to the exact area.  

After the biopsy

If you had a general anaesthetic, you might feel a bit tired or sick for a few hours afterwards. Your nurse can give you drugs to help with any sickness. If you had a local anaesthetic, you won’t feel sick.

You may feel a bit sore around the area of the biopsy. Your doctor will tell you which painkillers to take. Any bruising you have will go away in a couple of weeks.

It may take 1 to 2 weeks to get the results. This can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.

What are blood tests?

Blood tests can check your general health, or look for certain changes in your blood. 

Why do I need to have blood tests?

Blood tests are done for different reasons:

• To measure the number of red blood cells, white blood cells and platelets in your blood. This is called a full blood count (FBC).
• To check how well your liver, kidneys and hormones are working.
• Some cancers make chemicals called tumour markers. Blood tests can check for these markers. This helps to diagnose some cancers and check how well treatment is working.
• To check for an infection in your blood.

If you are having chemotherapy, you will have blood tests before each treatment. This is to make sure your blood cells are at the right level for you to have your treatment.

What happens?

Blood samples are usually taken from a vein in your arm, unless you already have a line (PICC, Hickman®, or portacath).

You will be sitting down when you have a blood test. Seeing blood or needles can make some people feel dizzy or faint. Let the person taking your blood (phlebotomist) know if you feel like this.

The phlebotomist puts a tight band around your arm. They clean the skin and gently insert a small needle. It can feel like a scratch or a slight sting when it goes in, but it should not be painful. If you are worried about it hurting, you can ask to have an anaesthetic cream or a cold spray to numb the area. The blood is withdrawn into small tubes.

After the test

Afterwards, they will put a cotton pad or a plaster over the area. Your doctor or nurse will explain your results when they are ready.

What is a bone marrow test?

Bone marrow is the spongy part in the middle of your bones where blood cells are made. You might have a bone marrow test to check for cancer cells in the bone marrow. A doctor or nurse takes a sample of bone marrow from your hip bone. The sample is then sent to a laboratory and looked at under a microscope to check for cancer cells.

Why do I need to have this test?

A bone marrow test can help your doctors to make a diagnosis. It might be done if doctors think you may have a type of leukaemia or lymphoma. This is because cancer cells might be found in the bone marrow with some of these cancers. This test may also be done to diagnose some other types of cancer.

You might also have a bone marrow test to check how well treatment is working.

What happens?

Before the test

Your doctor or nurse will give you information about the test.

You usually have the test under a local anaesthetic. This means you will stay awake, but the doctor will give you an injection before the test to numb the area so you can’t feel it. You may also have a tablet or injection to make you feel sleepy and relaxed. Sometimes this is given as gas instead of tablets. You breathe in the gas through a mask or mouthpiece, which you hold yourself. You can have a family member or a friend with you during the test, if you want to.

Or you might have it under a general anaesthetic. This means you will be asleep and will not be aware of what is happening, or be able to feel anything. You will be told not to eat or drink for six hours before having a general anaesthetic.

During the test

Bone marrow is found in big bones like the hip bones and the pelvis. During this test, a doctor or nurse takes a sample of bone marrow from the back of your pelvic bone, just above the hip bone. You have the test while you are lying on your side on a narrow bed.

The doctor or nurse puts a needle through the skin into the bone. Then they use the needle to take out a small sample of the fluid from inside your bone marrow. This is called a bone marrow aspirate. You might find it uncomfortable for a few seconds while the sample is taken.

You may also have a small piece of bone marrow taken. This is called a trephine biopsy. The doctor or nurse puts a thicker needle through the skin into the bone marrow. You might feel some pressure while this is happening. When they take the needle out, it contains a small piece of bone marrow. They put a plaster over the area, which you can take off the next day.

After the test

You will probably feel sore afterwards. Your doctor or nurse will tell you which painkillers to take. Tell your doctor or nurse if the area where the needle was put in becomes red or swollen, or if it bleeds.

You will usually get the results within a few days. If you had a trephine biopsy, it can take longer. Waiting for results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.

What is a CT scan?

A CT scan uses pictures (x-rays) to build up a 3D picture of the inside of your body. CT stands for computerised tomography.

Why do I need to have this scan?       

Doctors might use a CT scan to show:

• if a lump or abnormal area is cancer or not
• the size of a cancer and if it has spread
• how well cancer treatment is working.

What happens?

Before the scan

The hospital gives you information about the scan so you know what to expect. Sometimes they may ask you not to eat or drink for a few hours before the scan. This helps to make sure they get a clear picture.

If there is any chance you could be pregnant, it is important that you tell your doctor, nurse or the person doing the scan (radiographer).

On the day of the scan, the radiographer will explain what will happen. You can ask them any questions you have. They will ask you to remove all jewellery and metal before the scan. They might also ask you to change into a gown.

You may need to drink a dye called contrast. This is sometimes given as an injection. The dye makes parts of your body show up more clearly on the scan. This can sometimes make you feel hot all over for a few minutes.

During the scan

The CT scanner looks a bit like a giant doughnut, with a narrow bed that goes through the middle.

The scan is not painful, but lying still on the bed during the scan can be a bit uncomfortable. It usually takes between 5 and 15 minutes.

The radiographer leaves the room during the scan, but can see you through a screen. You can talk to them through an intercom while you are having the scan.

During the scan, the bed moves slowly through the middle of the scanner while the camera takes the pictures (x-rays).

After the scan

You can usually go home straight after the scan.

Any test using radiation can slightly increase your risk of developing a cancer when you are older. However, this is not common, and the risk is very small compared to the benefit of having the test. Your doctor can tell you more about this.

It can take from a few days up to a couple of weeks to get the results. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or need more support.

Why do I need tests to check my heart?

Some types of cancer treatment can affect the way your heart works. You might have one or more of these tests to check your heart is working normally before, during and after treatment.

Before the tests

These types of tests are done in the outpatient department. The person doing the tests (technician) will tell you what will happen. They might ask you to change into a gown. If you wear a bra, you might need to remove it for the tests.

None of these tests are painful, but you will need to lie still while you are having them.

Electrocardiogram tests (ECG)

This test checks the electrical activity of your heart.

The technician places 12 small, sticky plastic discs onto your chest, arms and legs and attaches a wire to each disc. The wires are linked to a machine that records the electrical activity of your heart. You need to lie still during the test, but it only takes a few minutes.

Echo cardiogram

This test uses ultrasound waves to build up a picture of your heart. You will have an ECG at the same time to check the electrical activity of your heart.

The specialist first places some small, sticky plastic discs onto your chest area for the ECG.

They then move a small device (like a microphone) over the left-hand side of your chest. The device sends out sound waves that create echoes when they bounce off your body. These echoes are picked up by the device and recorded on a machine. The echoes help doctors to know how your heart looks. This is the echo cardiogram test. You may have to lie on your side for some of the test. This test usually takes between 30 and 40 minutes.

Multiple-gated acquisition (MUGA) scan

An MUGA scan looks at how well your heart is pumping blood through your body.

This test usually takes about an hour. There are three main parts to the test:

• two injections 
• an electrocardiogram (ECG) 
• the scan.

The injections

If you don’t have a Hickman® or PICC line, the person doing the test will gently insert a small plastic tube (cannula) into a vein to give you the injections. This is usually in your arm or hand.

They will give you the first injection. After 20 minutes, they will give you the second injection.

Next, you lie on a narrow bed to have an ECG and the scan.

The scan

You lie still on the bed, while a special camera takes pictures of your chest area from different angles.

After tests to check your heart

You can usually go straight home after these tests, unless you are staying in hospital for treatment. You will usually get the test results after a few days, once your doctor has looked at them. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or need more support.

What is a test to check my kidneys?

You may have this test before and during your treatment to check how well your kidneys are working. It is sometimes called EDTA or GFR.

Why do I need to have this test?

Your treatment might be planned based on how well your kidneys are working – for example it helps your doctors know how much chemotherapy you should have. Also, some chemotherapy and targeted therapy drugs can affect the way your kidneys work.

This means you may have a kidney test before starting treatment and sometimes during and after. You will also have regular blood tests to check your kidneys during treatment.

What happens?

The nurse will put a small, plastic tube (cannula) into a vein in your arm. Some people might find having the cannula put in a little uncomfortable. If you are worried about it hurting, you can ask to have an anaesthetic cream or a cold spray to numb the area.

After this, they give you an injection of a small amount of radioactive dye into your cannula. They then take blood samples from your other arm every hour for up to four hours. The results of these tests show how well your kidneys are working to get rid of the dye.  

After the test

They will take your cannula out and put a plaster over the area. You can usually go home straight after the test.   

The results go straight to your doctor and are used to plan your treatment. 

What is a lumbar puncture?

This test takes a sample of the fluid called cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. A lumbar puncture can also be used to give certain drugs.

Why do I need to have this test?

Lumbar punctures are done for different reasons, including:  

• to look for any cancer cells in the CSF
• to give chemotherapy
• to give drugs to relieve pain
• to look for possible signs of infection
• to check the pressure of the fluid in the brain.

What happens?

Before the test

Your doctor or specialist nurse will explain what will happen. You can have a family member or a friend with you during the test, if you want to.

You might have this test under a general anaesthetic. This means you will be asleep and will not be aware of what is happening, or be able to feel anything. You will be asked to not eat and drink for six hours before having general anaesthetic

Or you might have it under a local anaesthetic. This means you will stay awake, but the doctor will give you an injection to numb the area so you can’t feel it.

During the test

During the test, you either sit forward in a chair, or lie on your side with your knees curled up. You will feel some pressure or pushing, but it should not be painful. The doctor or nurse gently puts the needle in-between two of the bones in your lower back (vertebrae). Then they use the needle to take out a small amount of the fluid for testing. Or they can inject chemotherapy drugs in through the needle. What happens during the test depends on why you are having a lumbar puncture.

When they have finished, they take the needle out and put a small dressing on the area.

After the test

If you had a general anaesthetic, you might feel a bit tired or sick for a few hours afterwards. Your nurse can give you drugs to help with any sickness. If you had local anaesthetic, you will not feel sick.

Some people might have a headache afterwards. Your doctor or nurse may ask you to lie down for a while to help stop this happening. Drinking more fluids may also help. The nurse will tell you when you can go home. They can give you advice and tell you what painkillers to take.

You might have some backpain or a headache for a couple of days. If you notice any bleeding or oozing from the area, let your doctor or nurse know. Contact your GP or the hospital if you:

• feel unwell
• develop a temperature
• have a headache for more than two days.

Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.                                                                                                                              

What are tests to check my lungs?

You may have different tests to check how well your lungs are working. They are sometimes called pulmonary function tests or PFTs.

Why do I need to have these tests?

Lung problems, such as scarring from previous chest infections or problems caused by some cancer treatments, can affect how well your lungs work. Treatments that can affect the lungs include some chemotherapy drugs, radiotherapy or surgery to the chest.

You might have lung function tests to check your lungs before, during and after treatment.

What happens?

Before the tests

The hospital sends you information about the tests, so you know what to expect. They will tell you if there is anything you need to do to prepare for the tests. For example, it is important not to exercise, eat a large meal, smoke or drink alcohol right before the test. These things could affect the results.

During the tests

The person doing the tests (technician) asks you to breathe in and out through a mouthpiece that is connected to a machine. You may have different tests to check your lungs, for example:

• breathing out quickly to see how fast you can blow air out of your lungs
• sitting in a see-through booth and having different breathing tests that check how much air your lungs can hold
• breathing in and out a harmless gas to measure how well oxygen moves from your lungs to your blood
• exercising on a treadmill to check how well your lungs work while exercising.

The tests are not painful. They can take about 30 minutes in total. Some people feel out of breath or a bit dizzy after doing the breathing in and out exercises. But you will be given time to rest in between the tests. There will be someone with you all the time, so if you start to feel dizzy, let them know.

After the tests

You can usually go straight home afterwards. The technician will tell you when you will get your results. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.

What is an MRI scan?

An MRI scan uses magnetism to build up a picture of the inside of your body. MRI stands for magnetic resonance imaging.

Why do I need to have this scan?

Doctors might use an MRI scan to show:

• if a lump or abnormal area is cancer or not
• the size of the cancer and if it has spread.

What happens?

Before the scan

The hospital sends you information about the scan so you know what to expect. If you are having a scan of your tummy (abdomen), you might be asked to not eat anything for a few hours before the scan. This helps to get a clear picture.

Let your GP know a few days before the scan if it is difficult for you to lie still, or if you get anxious about being in small spaces. They can arrange for you to take a tablet (sedative) before the scan to help you relax.

On the day of the scan, the radiographer will tell you what you need to do. You can ask them any questions you have. You can also tell them if it is difficult for you to lie still, or if you get anxious about being in small spaces. They will give you lots of support.

Because the scan uses magnetism, you will need to remove all jewellery and metal before the scan. This includes hair clips, bra straps and mascara as these can interfere with the scan. Let the person doing the scan (radiographer) know if you have any metal inside your body. This is especially important if you have a shunt or a pacemaker. Some shunts may need to be re-programmed after an MRI.

You can usually wear your own clothes if they do not have metal zips or buttons. Don’t worry if you do not have clothes without metal, you can change into a gown.

You might need to drink a dye called contrast. This is sometimes given as an injection. The dye makes parts of your body show up more clearly on the scan. This can sometimes make you feel hot all over for a few minutes.

During the scan

The MRI scanner looks a bit like a giant doughnut, with a narrow bed that goes through the middle.

The scan is not painful, but lying still on the bed during the scan can be a bit uncomfortable. It usually takes between 15 minutes and an hour. The scanner is very noisy and you will hear a banging noise during the scan.  

The radiographer leaves the room during the scan, but can see you through a screen. You will be able to talk to them through an intercom while you are having the scan. You can also listen to music through headphones.

You will need to lie still on the bed as any movement can affect your results. If you get uncomfortable, let the radiographer know. The bed moves slowly through the middle of the scanner (a short tunnel that is open at both ends). Some people find it helpful to close their eyes while they are in the tunnel.

Some tattoos contain metal, especially those with red dye in them. These can cause a warm, or sometimes burning feeling during the scan. This is only in the area of skin where the tattoo is. If this happens, let the radiographer know straight away.

After the scan

You can usually go home straight after the scan.

You will usually get the results within a couple of weeks. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or need more support.

A PET-CT scan is a combination of a PET (positive emissions tomography) scan and a CT (computerised tomography) scan. Cancer cells are usually more active than other cells, so they show up on the scan. The PET scan shows how active cells are in different parts of the body. The CT scan takes a series of pictures (x-rays) to build this information into 3D pictures of the inside of body.

Why do I need to have this scan?

Doctors might use a PET-CT scan to show:

• if a lump or abnormal area is cancer or not
• the size of a cancer and if it has spread
• how well cancer treatment is working.  

What happens?

Before the scan

The hospital sends you information about the scan so you know what to expect. You will probably be asked not to eat or drink anything except water for six hours before the scan. This depends on the part of your body that is being scanned. You may also be asked to eat a low-carbohydrate diet for 24 hours before the scan. Carbohydrates are foods like potatoes, bread, rice, pasta or cereal. If you are diabetic, talk to the hospital before the scan, as you need to make sure your blood glucose is well controlled. You will be told all of this before your appointment.

On the day of the scan, the person doing the scan (radiographer) will explain what will happen. You can ask them any questions you have.

You can usually wear your own clothes if they don’t have metal zips or buttons. If there is any chance you might be pregnant, let the radiographer know.

The radiographer will give you an injection of a slightly radioactive glucose (type of sugar). This is usually given into a vein in your arm or hand. The radioactive glucose helps show up the activity of cells in the area being scanned.

After the injection, you usually rest for about an hour before the scan. This gives the glucose time to go around your body. You will usually be asked to go to the toilet to empty your bladder just before the scan.

During the scan

You lie on a narrow bed that moves into the scanner. The scan usually lasts for around 30 minutes. Having a PET-CT scan is not painful, but lying still on the bed can be a bit uncomfortable. Tell the radiographer if you think you might find it difficult to lie still.

The radiographer leaves the room during the scan, but can see you through a screen. You can talk to them through an intercom while you are having the scan. You can also listen to music through headphones.

After the scan

You can usually go home straight after the scan.

The radiographer will tell you about any precautions you need to take. For example, they might ask you to avoid being near pregnant women and young children for the rest of the day. This is because the glucose injection contains a low dose of radiation. After this time, you can be around people as normal.

Any test using radiation can slightly increase your risk of developing cancer when you are older. However this is not common, and the risk is very small compared to the benefit of having the test. Your doctor can tell you more about this.

It can take 1 to 2 weeks to get the results. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or need more support.

What is an ultrasound scan?

This scan uses sound waves to build up a picture of the part of the body being scanned.

Why do I need to have this scan?

An ultrasound scan can show changes in different organs inside the body. It helps doctors to know if a lump or abnormal area is cancer or not.

What happens?

Before the scan

The hospital sends you information about the scan so you know what to expect.

If you are having a scan of your tummy (abdomen), you might be asked to not eat anything for a few hours before the scan. This helps to get a clear picture.

If you are having a scan of your lower tummy (pelvis), they may ask you to drink lots of water before the scan it. Having a full bladder helps to get a clear picture.

During the scan

An ultrasound is not painful. It can take between 10 and 30 minutes. You have the scan lying on a narrow bed. The person doing the scan puts some cold gel on the area being scanned. They then move a small device that produces sound waves over this area. The sound waves build up a picture, which shows up on a screen.

Doctors sometimes use an ultrasound scan when they are doing a biopsy (removing a small piece of tissue). The scan helps to guide them to the exact area.

After the scan

It can take from a few days up to a week to get the results. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.

What is an x-ray?

An x-ray uses high-energy rays to take a picture of the inside of your body. There are different reasons why you might need an x-ray.

Why do I need to have this scan?

The type of x-ray you have depends on the part of your body the doctors want to examine. Some common types include:

• a chest x-ray to check your lungs are healthy, or to look for changes that may be caused by a cancer
• a bone x-ray to check whether there is a problem in a bone or joint, or to look for signs of cancer.

What happens?

Having an x-ray is not painful and only takes a few minutes. The person doing the x-ray (a radiographer) might ask you to change into a gown. You will be asked to remove any jewellery or anything containing metal.

You might have the x-ray sitting up, lying down or standing. This depends on the part of your body that is being x-rayed.

After the scan

You won't have any after effects from a standard x-ray.

Any test using radiation can slightly increase your risk of developing a cancer when you are older. However, this is not common, and the risk is very small compared to the benefit of having the test. Your doctor can tell you more about this.

You will usually get the results within a few days. Waiting for test results can be a worrying time. Talking to your family and friends about how you feel can help. You can also speak to your doctor or nurse if you have any problems, or if you need more support.