What a Precision Oncology Programme — Should Actually Include

It depends on the regimen. Chemotherapy given every three weeks, or immunotherapy with straightforward monitoring, can sometimes be delivered closer to home once the plan is established. Complex regimens, first cycles of a new treatment, or cases requiring multidisciplinary input usually benefit from a centre with full infrastructure. Ask your oncologist which parts of your treatment genuinely need the larger centre and which can be delivered closer to home — that is a question they should be able to answer specifically.

A tumour board is a scheduled meeting where your case is presented to oncologists from different disciplines — medical, surgical, and radiation — alongside a pathologist and a radiologist. The outcome is a consensus recommendation rather than a single doctor's judgement. What you want to know is whether your case will actually be reviewed, not simply whether the board exists. Ask: 'Will my case be presented at the next board meeting, and when will I hear the outcome?' A centre with a functioning board will have a straightforward answer.

Not necessarily. Some biomarker tests are part of standard care and included in treatment costs in many settings. Others are more expensive and may be discretionary. What matters is knowing which tests are clinically relevant for your cancer type — your oncologist should be able to say which markers are likely to change the treatment plan and which are not. Paying for a broad genomic panel when only one or two markers apply to your cancer type is expensive information with limited practical use, not more precise care.

Biomarker testing — including PD-L1, MSI, and relevant panel testing — is coordinated as part of treatment planning at CION across its 35+ centres. PET-CT is arranged through partner imaging centres. Immunotherapy is administered as day care. CION does not provide CAR-T or cell therapy; patients for whom those are being considered are referred to appropriate centres. If you want to discuss which tests are relevant for your diagnosis, bring your previous biopsy report and pathology results to the first appointment — that is the starting point.

The test report itself should name the laboratory, the methodology used, and the specific markers tested. For sequencing-based tests, it should state the genes or regions covered. If the report is vague — 'molecular testing done' without specifics — ask your oncologist or the centre's coordinator for the full laboratory report. Reputable laboratories issue structured reports that an oncologist can interpret directly. If you are uncertain about the interpretation, a second opinion on the pathology and molecular results is a reasonable request.

Yes — particularly for complex or rare cancers, cases where a biomarker result is borderline, or where first-line treatment did not work as expected. A second opinion is not a vote of no confidence; it is standard practice in any situation where the decision carries large consequences. Most oncologists at experienced centres will not be discouraged by a request for one. Ask for your records, pathology slides, molecular reports and imaging to be made available — the second-opinion centre will need all of them to give you a meaningful answer.