What If a Safety Test — Comes Back Abnormal?
An abnormal result on a pre-treatment safety test is not the same as being told treatment cannot go ahead. It tells your team something specific about how your body handles a particular drug — and that shapes the plan.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026
- Treatment rarely stops — Most abnormal results prompt a plan adjustment, not a decision to cancel treatment.
- A different drug may be used — If a safer alternative exists for your cancer type, your oncologist may switch to it.
- Dose changes are a clinical decision — Any adjustment to how much drug you receive is decided by your oncologist, not by the result alone.
- Some findings are permanent — A pharmacogenomic result reflects your inherited biology and stays relevant for any future treatment with the same drug.
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An abnormal result on a pre-chemotherapy safety test rarely means treatment is stopped. Your oncologist will use it to make the plan safer — by switching to a different drug, changing how the drug is given, or repeating the test before starting. The test exists to prevent a serious reaction, not to block treatment.
Does an abnormal result mean treatment has to stop?
An abnormal result rarely means treatment is called off. The test is designed to find a risk early — and knowing about a risk early gives your team more options, not fewer.
Your oncologist will look at what the finding means for the specific drug in your plan. In most cases, the response is to adapt the plan, not to abandon the treatment approach altogether.
There is no automatic action that follows from an abnormal result. What happens next depends on the drug, the type of finding, and your overall clinical picture — and that decision belongs to your treating oncologist.
What does my oncologist do with an abnormal result?
One option is to use a different drug. Some chemotherapy drugs have alternatives that work in a similar way but are broken down differently by the body. If one is appropriate for your cancer type, your oncologist may switch to it.
Another option is to change how the drug is given — the schedule, the delivery method, or the amount. These are clinical decisions your oncologist makes based on the result and your full picture.
In rare cases, a finding is significant enough that a particular drug is not used at all. Even then, other treatment approaches are usually available.
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What should I ask my oncologist after an abnormal result?
- Ask what the abnormal result means for the specific drug in your plan.
- Ask whether a safer alternative drug exists for your cancer type.
- Ask whether the schedule or amount of treatment has changed because of this result.
- Ask how long updating the plan will take and when treatment can start.
- Ask whether your family members should be told about the finding.
- Ask for a written copy of the result to keep in your medical records.
Did you know?
Many pharmacogenomic variants that affect how the body processes chemotherapy are inherited — not caused by the cancer.
This means a result found before one round of treatment stays relevant for the rest of your life, and may matter for any family member who could one day be given the same drug.
Source: CPIC (Clinical Pharmacogenomics Implementation Consortium) guidelines
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Frequently asked questions
Does an abnormal result always mean the treatment plan has to change?
Not necessarily. Some variants have no clinical significance for the drug being planned, and your oncologist may conclude no change is needed. Others clearly call for a different approach. The result identifies a specific risk; it does not automatically trigger a specific action. Ask your oncologist directly what this particular finding means for your treatment and whether anything in the plan will change because of it.
Is the amount of chemotherapy likely to change because of the result?
It may. Adjusting how much of a drug is given is one option your oncologist may consider when a result shows your body handles the drug differently from average. Whether that is the right response depends on the specific result, the drug, and your full clinical picture. There is no standard formula — the decision belongs to your treating oncologist. Ask them directly whether the amount of treatment in your plan has changed and why.
Is a different drug always available if my result is abnormal?
Not always. Whether an alternative exists depends on the cancer type being treated and the specific drug planned. For some regimens an established alternative is available; for others, fewer options exist. Your oncologist will know what is accessible for your situation. Ask them specifically: if the planned drug is not ideal for me, what alternatives are there, and are any appropriate for my cancer type?
Will treatment be delayed while the plan is being updated?
Possibly, but usually briefly. If the result is straightforward and an alternative is already known, the plan can be updated within days. If a referral or a repeat test is needed, it may take longer. Ask your oncologist for a timeline so you are not waiting without a clear expectation. A short delay to finalise a safer plan is almost always preferable to starting with an identified risk that has not been addressed.
What if I was not tested before I started chemotherapy?
Availability of pre-treatment pharmacogenomic testing varies across centres and drug regimens. Not being tested before starting does not automatically mean the treatment is unsafe for you. If a reaction occurs during treatment, your team will investigate and may test at that point. If this question is weighing on you, raise it with your oncologist — they can tell you whether testing is relevant to your current regimen and whether it can be arranged.
Is pharmacogenomic safety testing available in India?
Testing is available in India, though not uniformly across all centres. Availability depends on the specific test, the laboratory handling the sample, and the drug being considered. Some tests can be done at major oncology centres and reference laboratories; others may require samples to be sent to a specialist facility. Your oncologist can tell you what is accessible from your treating centre and what the turnaround time is likely to be.
Does a pharmacogenomic result affect other members of my family?
Possibly. Many variants affecting how chemotherapy drugs are metabolised are inherited, meaning siblings and children may carry the same finding. A result in you does not mean they are definitely affected, but it may be worth mentioning — particularly if any family member could one day need the same class of drug. Your oncologist can advise whether your specific result has implications for family members.
Should I keep a copy of this result after treatment ends?
Yes, and this matters more than most people realise. A pharmacogenomic result reflects your inherited biology and does not change over time. It stays relevant any time you are treated with the same drug or drug family — for this cancer, a future cancer, or any other condition where the same drug might be used. Keep a written copy with your permanent medical records and mention it to any new treating team. Do not assume previous records will be transferred automatically.
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