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After your biopsy

Do You Need More Tests — Before Treatment Starts?

Getting a list of further tests after a biopsy can feel like the finish line has moved. It has not. Each test answers a specific question your biopsy could not — where the cancer is, what drives it, and what treatment your body can safely handle.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • Your biopsy answered one question — It confirmed cancer is present. The tests that follow tell your team where it is, how it behaves, and what to do about it.
  • Staging finds spread — Scans map how far the cancer has and has not gone — the most important factor in deciding which treatment approach is used.
  • Molecular tests personalise treatment — Some tumours carry specific markers that make targeted therapy or immunotherapy an option, or rule it out entirely.
  • Fitness tests protect you — Blood tests and performance checks confirm the planned treatment is safe for your specific body right now.
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Yes — your biopsy confirmed cancer is present, but it does not show where it has spread, what drives it at a molecular level, or whether your body can safely handle the planned treatment. Staging scans, biomarker tests and fitness checks each answer one of those questions. Your oncologist decides which apply to your specific situation.

What tests happen between your biopsy result and the start of treatment?

  1. Staging scans — where has the cancer spread?

    A CT scan, MRI, PET-CT or bone scan maps how far the cancer has reached. Your oncologist chooses which imaging suits your cancer type. PET-CT is coordinated with partner imaging centres. The staging result is the single most important factor in deciding the overall treatment approach.

  2. Molecular and biomarker testing — what drives the tumour?

    This is done on tissue from your biopsy, so a new procedure is usually not needed. The laboratory looks for markers such as PD-L1, HER2, EGFR or microsatellite instability, depending on your cancer type. A positive marker may open the option of targeted therapy or immunotherapy. A negative result points your team toward a different approach. Results typically take one to two weeks.

  3. Blood tests and organ function — can your body handle treatment?

    Blood tests check how your liver, kidneys and bone marrow are working. Chemotherapy and many targeted therapies are processed by these organs, and if they are not working well, your dose or drug choice may need adjusting before treatment begins. A heart function test may also be ordered if certain drugs are being considered.

  4. Fitness and performance assessment — will you tolerate the planned treatment?

    Your oncologist will assess how well you are managing daily activities — this is called a performance status check. It is not a test you pass or fail. It helps your team choose a treatment intensity that is safe for you. Existing conditions such as diabetes or heart disease are reviewed at the same time.

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Can any of these tests be skipped?

Some tests are standard for almost everyone; others apply only to your cancer type or the treatment being considered. Your oncologist decides what is and is not needed — not every patient needs molecular testing, and not every staging scan applies to every cancer.

Staging scans are rarely skipped, because treatment for localised cancer is often completely different from treatment for cancer that has spread. Skipping staging to save time can result in entirely the wrong approach.

If you are worried about the cost or travel for a particular test, say so directly to your team. They can sometimes sequence tests so that the first result determines whether the second is still needed.

Did you know?

Molecular testing of tumour tissue has changed the treatment approach for several common cancers. ASCO guidance now considers biomarker testing a standard part of the diagnostic workup for a range of cancer types, because the result can change the treatment recommended — sometimes completely.

Two people diagnosed with the same cancer type on the same day may be recommended entirely different treatments based on what their molecular results show.

Source: ASCO: Molecular Testing for Cancer

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Common questions

Frequently asked questions

How long will all these tests take before treatment can start?

The timeline varies by which tests are ordered, but most people complete their pre-treatment workup within a few weeks of receiving the biopsy result. Blood test results come back quickly, often the next day. Staging scans are typically booked within a few days. Molecular testing takes the longest — usually one to two weeks. If your cancer needs urgent treatment, your oncologist may begin on partial results while the rest are pending. Ask your team for a specific timeline for your situation.

Do I need all of these tests, or just some of them?

Most people need some but not all of them. Which tests apply depends on your cancer type, the stage suspected, and which treatments are being considered. Your oncologist selects the minimum set that answers the questions needed to plan treatment safely. If you are unsure why a particular test has been ordered, ask — you are entitled to a clear answer about what it will tell your team.

Can we start treatment while waiting for molecular test results?

Sometimes yes, sometimes no. For some cancers, staging information alone is enough to begin treatment while molecular results are still pending. For others — especially where targeted therapy or immunotherapy is a real possibility — starting before those results are back could mean choosing the wrong treatment entirely. Your oncologist makes that call based on how urgent treatment is and what information is still outstanding. Do not push to start before your team is ready unless they say it is safe.

My PET-CT has been booked at a different centre. Is that normal?

Yes. PET-CT requires a short-lived radioactive tracer and specialist equipment that is not available at every cancer clinic. CION coordinates PET-CT through partner imaging centres. The report comes back to your oncologist at CION and is reviewed as part of your case. You do not need to bring the images yourself — the centres communicate directly.

What happens if a test result is unclear or the biopsy sample is not enough?

This happens and it does not mean your diagnosis is wrong. A borderline molecular result may be sent to a reference laboratory for more detailed analysis. If the biopsy tissue is too small or degraded to test, a repeat biopsy or a liquid biopsy — a blood test that detects tumour DNA — may be considered. Your oncologist will explain the next step. It adds time, which is frustrating, but treating without the right information carries its own risks.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

How to Read a Biopsy Report: Terms Explained →

IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

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