Tests

In this part of the website you will find information about:

Screening means doing a test to look either for early signs of cancer, or for body changes that might develop into cancer if left untreated. In this section you can find out about...

Breast screening can detect early cancer through a test called a mammogram. It is an x-ray of the breasts.

A free breast screening test is available every three years to all women aged 50 and over.

If you are aged 50-64 you will automatically get a letter inviting you for screening. (By 2004, women aged 50-70 will be invited.)

At the moment, if you are 65 or over and would like screening, you should make your own appointment (see below for contact details). The test is still free.

For more information...

For the latest information on breast screening, including leaflets and information to download, try the NHS cancer screening programmes website.

Breast screening services in the North of England Cancer Network

Newcastle, North Tyneside, Northumberland and Derwentside
There is a breast screening centre at Newcastle General Hospital.

There are also two mobile units that travel around to sites in other areas. The units visit 19 of these other sites, once every three years. Women are invited to attend a site near their home.

If you have any queries about the service – or if you are over 65 and want to make an appointment for breast screening – phone the breast screening office on (0191) 282 0202.

Gateshead, South Tyneside, Sunderland, Chester-le-Street and parts of Durham
Gateshead women are screened in a breast screening centre in the grounds of the Queen Elizabeth Hospital, Gateshead.

Sunderland women are screened at Sunderland Royal Hospital.

There is also a mobile unit that travels around to sites in the other areas. Women who need to be recalled after their first appointment are invited to attend the Gateshead centre.

If you have any queries about the service – or if you are over 65 and want to make an appointment for breast screening – phone the breast screening office on (0191) 403 2554.

North Cumbria
There are breast screening units based at Cumberland Infirmary, Carlisle and at West Cumberland Hospital, Whitehaven. Women who need to be recalled after their first appointment are invited to attend the unit at Cumberland Infirmary.

If you have any queries about the service – or if you are over 65 and want to make an appointment for breast screening – phone the breast screening office on (01946) 693 181 ext 3370.

Cervical screening can help prevent cancer by detecting early changes in the cells of the cervix (the neck of the womb).

The first stage of cervical screening is a smear test.

Your GP or nurse takes a sample of cells from the cervix. The sample goes to a laboratory to see if any of the cells look abnormal. Some women who have an abnormal smear may need to have treatment to stop cancer developing in the future.

Remember, though, that most women who have an abnormal smear do not go on to develop cancer. Often, a repeat smear shows that all is well.

All women aged 20-64 can have a free smear test every 3-5 years. You will automatically get an invitation letter. (Make sure that your GP has your correct, current address.)

Because of cervical screening, invasive cervical cancer is now an uncommon disease in this country.

For more information...

NHS cancer screening programmes website
You can use this to get the latest information on cervical screening, including leaflets and information to download.

Understanding cervical smears
Cancerbackup booklet. It explains what a smear test is, what an abnormal smear may mean, and how cervical cancer and pre-cancerous conditions are treated. You can view this on-line, or contact Cancerbackup for a printed copy.

Cervical cancer information on this website
For information about cervical cancer – including the treatment of pre-cancerous changes – go to the cervical cancer section of this website.

There is no national screening programme for bowel cancer.

However, the Department of Health is currently running a pilot scheme to help find out whether a national screening programme should be introduced.

The pilot involves carrying out a simple test on people (aged 50-69) who are registered with participating GPs in certain areas of the country. If your GP is part of the pilot, you will automatically receive details of the test. If your GP is not part of the pilot, you will not be able to have the test.

For information on the screening pilot, try the NHS cancer screening programmes website.

There is no national screening programme for prostate cancer.

Instead, there is a prostate cancer risk management programme. Its aim is to give full and accurate information about the risks and benefits of asking for a PSA blood test. You can find out more about it on the NHS Cancer Screening website.

For more information about prostate cancer, go to the prostate cancer section of this website.

Cancerbackup produces a booklet about the PSA test. It can be downloaded from their website, or you can call the helpline 0808 800 1234 and ask for a copy to be sent to you at home.

The National Electronic Library for Cancer website has information on the risk management programme, as well as a choice of patient information leaflets about the PSA test. You can download the leaflets from the website.

In this section you will find basic information about many of the tests that doctors may use to find out whether you have cancer or another illness.

You may be offered some of these tests after you have been diagnosed and while you are being treated. This could be to see if the treatment is working to reduce your cancer.

You may undergo some of these tests to establish that you are well enough for surgery.

Some of the tests will be given after your treatment is over, to establish how succesful it has been.

After your cancer has been treated, and you return to hospital for follow up appointments, there may also be tests carried out to ensure that you do not have a recurrence or a secondary cancer.

If the test you are looking for has not yet been written for this site, it will not appear in the list below. You may find it in the list of tests on the CancerHelp website. There is also a helpline number listed on the site that you can call if you need to speak to one of the information nurses about cancer tests.

You may find it useful to have a look at the barium room of the Virtual Hospital Departments from The Royal College of Radiologists.

A barium enema is a special x-ray of the colon and rectum. The colon and rectum are also called the large bowel.

The bowel doesn’t show up well on normal x-rays. To make better pictures, a substance called barium is put into the bowel.

The barium coats the inside of the bowel and makes it easier to see on the x-rays. Radiological images are created by passing small, highly controlled amounts of radiation through the body and capturing the resulting shadows and reflections on film.

Your bowel must be empty so that the doctor can see clearly inside it. For 48 hours before the test you will need to follow a special diet and take a laxative preparation, drink only clear liquids like juice, tea, black coffee, cola, or broth, and avoid dairy products

The hospital will send you instructions with your appointment letter. If in doubt, please ask.

A radiographer or a radiologist (x-ray doctor) will carry out the test in the x-ray department. S/he will explain what is going to happen, and answer any questions you have.

You will change into a gown and lie on your side on a couch. A thin tube is put a little way into your rectum (back passage) and barium liquid is put into the bowel, followed by some air. The air expands the lining of the bowel a little, to give a clearer view of the inside. This may feel a bit strange, but it doesn’t hurt. You may feel the urge to move your bowel, but this is quite normal. The end of the enema tube is designed to help you hold in the barium.

The person carrying out the test will be able to see the inside of your bowel on a video screen. S/he will then take some x-ray pictures.

During the test you will be asked to change position, and the couch may be moved so that the barium liquid can flow around the bowel.

The test usually lasts between 20 and 40 minutes, but it may take a little longer.

If you have had the test as an outpatient, you should be able to go home straight away. You can start eating and drinking normally.

Your bowel will still contain barium liquid and air, and you may need several visits to the toilet to clear this. Drinking some extra fluids will help. Staff at the hospital may suggest you use the toilet there, to get rid of some of the barium before you leave for home.

You may notice your stools become paler for a few days – don’t worry, this is normal. If you become constipated, drink more liquids and take a mild laxative. If it hasn’t cleared up after a couple of days, tell your nurse or GP.

The barium looks a bit like cement in the toilet and it can take several days to flush it away.

Barium enema is a safe test, but there is a very small risk that the bowel may be damaged. If this happens, surgery may be needed.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don't have a date for this, please ask.

You will go to the x-ray department of a nearby hospital. This test is offered at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your barium enema, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

Although your doctor may use several tests to learn more about your illness, a biopsy of some sort may be needed, to find out for sure whether you have cancer.

The doctor takes a sample of cells or tissue from the suspected cancer. The sample then goes to a laboratory to be looked at under a microscope.

The doctor may take the sample from a lump that you have - but this isn’t always the case, because people with cancer don’t always have lumps. For instance, the doctor may take a sample of bone marrow if s/he thinks you have a disease such as myeloma.

In the laboratory a specialist doctor (a pathologist) looks at the sample to see whether there is any cancer there. Biopsies may also be used to find out whether the cancer has spread, or how fast-growing (aggressive) it may be.

The study of samples taken from lumps of tissue is called histology.
The study of cells smeared onto a slide is called cytology.

There are different ways of getting the biopsy sample...

• the doctor may remove a whole lump or part of a lump (this is an excision biopsy). Slices of the suspected cancer can then be looked at under the microscope
  
  
• cells may be sucked up through a thin needle into a syringe – for example, from a lymph node or the bone marrow. This is called fine needle aspiration biopsy. The cells are smeared onto a glass slide, ready for the microscope
  
  
• a fine core of tissue (rather than just some cells) may be taken up through a needle. This is a core biospy
  
  
• some cells may be scraped off the body tissue and put onto a slide (eg from a wart on the skin, or from the inside of the uterus or womb)
  
  
• the doctor may take small tissue samples through a special instrument put into a body opening. For example, lung samples can be taken by putting a bronchoscope through the nose or mouth and down into lungs; bowel samples can be taken through a colonoscope.

For some biopsy tests the doctor uses an x-ray or an ultrasound scan to find out exactly where to take the sample from.

More information about biopsies...

• Fine needle aspiration (FNA) - breast
• Lung biopsy

Our main tests menu also lists other tests where biopsies may be taken (such as bronchoscopy, ERCP, endoscopy).

It is a way of getting some cells from the lungs. The cells are then examined under a microscope.

You may have a lung biopsy because there is a shadow on your chest x-ray, and the doctor needs to find out what it is.

The doctor gets the cells by putting a fine needle through the skin and into the lung.

You don’t need to do anything special – but bring an overnight bag with you to hospital, just in case you can’t go home the same day.

Your hospital will send you any instructions with your appointment letter. If in doubt, please ask.

You will have the test either in the hospital's CT scanner room, or in a special x-ray room.

Your nurse or doctor will explain the test to you, and answer any questions you have. S/he will ask you to sign a consent form to say that you agree to have the biopsy done.

You may need to undress and put on a hospital gown.

You lie on a couch while the test is done. Some local anaesthetic is injected into your skin so that you won’t feel pain.

When you are ready, you lie still and hold your breath as the doctor puts a very fine needle though the skin and into the lung. S/he may need to do this a few times to get enough cells.

The doctor uses an x-ray picture or CT scan or ultrasound scan to see where the needle should go.

You will stay at the hospital for a few hours, until you are well enough to leave.

You may be able to go home the same day, but sometimes an overnight stay is needed.

You may have one or two further x-rays before you leave the hospital.

Bleeding
The biopsy may make you cough up a little blood. In rare cases, there may be serious bleeding.

Air leak
When the needle is put into the lung, it may cause some air to leak out.

If the air leak is small, it may not cause any problems. If a lot of air leaks out, it could build up around your lung making you short of breath. The doctor may need to put a small tube in your chest for a while, so that the air can escape.

The sample of cells will be sent to the laboratory for examination. It may be a few days before the results are known.

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don’t have a date for this, please ask.

This test is offered at most North of England Cancer Network hospitals. You will go to the Radiology Department.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember your doctors and nurses are here to help you. If you have any questions about your symptoms or your lung biopsy, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

This is a test to look for any areas of bone where there is a lot of activity.

The activity could be bone breaking down, or bone repairing itself. There are several possible reasons for bone activity - cancer is one of them, but other reasons include arthritis, fractures and bone infections, so the test results need to be carefully interpreted.

For the test, a mildly radioactive substance is injected into a vein in the arm. Then a large machine called a gamma camera takes a scan of the body. The radioactive substance helps to show up any active areas of bone – these are called hot spots.

A bronchoscopy is a test to examine the parts of the body that allow you to breathe.

The doctor uses a thin, flexible telescopic instrument called a bronchoscope. It is passed through the nose or mouth and down into the airways. It allows your doctor to:

• see your windpipe (trachea) and airways (bronchi)
  
  
• look for anything unusual
  
  
• take photographs
  
  
• take samples of lung tissue (biopsies) or of secretions, which can then be examined under a microscope.

You will be asked not to eat or drink anything for four hours before the test. If you are diabetic, you will get some special instructions to follow.

If you take regular medication, take your tablets as normal (with a small amount of water, if you need it).

The hospital will send you instructions with your appointment letter. If in doubt, please ask.

Your nurse or doctor will explain the test to you and answer any questions you may have. S/he will ask you to sign a consent form to say that you agree to have the test done.

Your heartbeat, blood pressure and oxygen levels will be checked throughout.

If you have false teeth, you will take them out.

Your nose and throat will be sprayed with a local anaesthetic – or you may be given a lozenge to suck. It means you won’t feel any pain as the bronchoscope goes in.

You don’t need to be put to sleep for this test, but your doctor may offer you a mild sedative injection, especially if you are feeling anxious. It will make you feel drowsy and relaxed.

When you are ready, the doctor passes the bronchoscope into your nose or mouth, through the vocal chords and down into the windpipe and lung.

This won’t hurt, but most patients say it is uncomfortable. You may feel as if you can’t catch your breath. Don’t worry – you aren’t going to choke. The feeling will pass, and once the bronchoscope is in place, the worst is over.

As the doctor puts the bronchoscope in, s/he may spray some more anaesthetic into your voicebox. This won’t hurt, but it might make you cough a little.

Please don’t worry that you won’t be able to breathe. There is plenty of room around the bronchoscope for oxygen to reach your lungs. The doctor can also give you extra oxygen through a thin tube put into your nostril.

If your doctor needs to take some samples of lung tissue, this can be done easily and painlessly.

Occasionally the doctor may wash the lungs with sterile water. The water is then painlessly sucked back out of the lungs.

Once your doctor has finished the examination s/he will gently remove the bronchoscope, and the test is over.

All of this normally takes about 10-20 minutes.

You will stay in the hospital until your nurse is sure you can swallow normally and are fit enough to go home. This is usually two or three hours after the test.

When you get home, take it easy for the rest of the day. You should be able to go back to work the next morning.

If you had a sedative injection before your test, there are some extra precautions to take...

• Ask a responsible adult, with transport, to take you home.
  
  
• Don’t drive, operate machinery or drink alcohol for 24 hours.
  
  
• Don’t make important decisions (for example, signing papers) for 24 hours.
  
  
• If you live alone, you may like to ask someone to stay the night with you. Alternatively, your doctor may suggest that you stay in hospital overnight.

After-effects
You may have a slight nose bleed after the test – or you may notice some blood in your phlegm. This is normal, and it will usually settle within 24 hours.

Your throat may be a little sore, and you may have a hoarse voice. This should ease within a day or two.

Bronchoscopy is a safe test, but there is always a small risk with procedures of this kind. A few patients bleed from the place where the tissue samples were taken. Some patients get infections.

Major complications after a bronchoscopy are rare (less than one case in every thousand).

A copy of the results will go to the person who sent you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don't have a date for this, please ask.

This test is offered at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your bronchoscopy, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

A colonoscopy is an examination of the lining of the bowel (the colon or large intestine) with a long, flexible instrument called a colonoscope.

It is passed into the rectum (back passage) and around the colon. On the end of it is a tiny camera that sends pictures to a video screen. Your doctor or nurse uses the pictures to look for anything unusual.

S/he may also take small tissue samples (biopsies) from the bowel lining during the test. These will be sent to the laboratory to be looked at under a microscope.

Your bowel must be empty, so that the doctor or nurse can see clearly inside.

You will be given a laxative to take at home. It is also important to drink lots of clear liquid before you come in, to help clear the bowel. Avoid fizzy drinks.

The hospital will send you instructions with your appointment letter. If in doubt, please ask.

The endoscopist (doctor or nurse carrying out the test) will explain what is going to happen, and will answer any questions you have. S/he will ask you to sign a consent form to say that you agree to have the test done. S/he will also complete a health checklist with you.

You may need to change into a hospital gown. Alternatively you can wear loose, comfortable clothing.

You will go to a treatment room and lie on a couch, on your left hand side.

A sedative will be injected into a vein to make sure you don't feel too much discomfort. You may be sleepy.

When you are ready, the doctor or nurse will pass the colonoscope through the rectum and into the large bowel. Some air is put into the bowel. This expands the lining slightly, to give a clear view of the inside of the bowel. The pressure of the air may give you stomach pains or cramps.

The doctor or nurse may also take some samples of tissue (biopsies) from the lining of the bowel. These will go to the laboratory later.

Once your doctor or nurse has finished the examination s/he will gently remove the colonoscope, and the test is over.

Most tests take around 30 minutes, but some last a bit longer.

You will stay in the hospital until you are awake. When you feel ready to leave, you will need someone to take you home.

Once you have recovered from the sedative you should be able to eat and drink as normal.

You may have stomach cramps for a while because of wind in your bowel. It may help to have warm drinks at home, and to keep walking around.

If the doctor or nurse took tissue samples, you may pass a small amount of blood. This should settle down in a few days.

The hospital will give you a contact telephone number for further advice in case you have any problems.

Colonoscopy is a safe test.

Rarely, it can tear the bowel wall. This happens in fewer than 1 in every 1,000 tests - but patients may need urgent surgery if it does.

A few patients have a reaction to the drugs used to relieve any pain and relax the muscles.

A copy of the results will go to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don't have a date for this, please ask.

You will go to the x-ray department of a nearby hospital. This test is offered at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your colonoscopy, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

The charity Beating Bowel Cancer has made a video about the colonoscopy test. You may be able to borrow one free from your hospital – please ask. You may also be able to watch the video in one of our Cancer Information Centres.

You may find it useful to have a look at the ct room of the Virtual Hospital Departments from The Royal College of Radiologists.

It is a type of x-ray of the inside of the body. CT stands for computerised tomography. The test may also be called a CAT scan.

CT scans are much more detailed than ordinary x-rays. The scanner sends several radiation beams through the body at the same time, and from different angles. An ordinary x-ray sends just one beam.

The scan makes detailed pictures of the body’s internal organs on a computer screen. The pictures are cross-sections (slices) of the body.

Doctors can use these pictures to look for signs of cancer.

It depends which part of your body is going to be scanned. You may not have to do anything at all.

If your abdomen or pelvis is to be scanned, you will come along about 30 minutes to one hour before the test to drink a special liquid called contrast medium. This liquid outlines the stomach and the rest of the gut, to make the x-ray pictures clearer. You may be asked not to eat for a little while beforehand.

The hospital will send you full details with your appointment letter. If in doubt, please ask.

Please tell the hospital as soon as possible if...

• you are being treated for diabetes, or you use an inhaler (you may need to follow some special instructions before the scan)
  
  
• you have any allergies
  
  
• you think you might be pregnant (x-rays can harm an unborn baby).

Preparation
You will have your test in the x-ray department. You will take off most of your clothes and put on a hospital gown.

The person carrying out the test (a doctor or radiographer) will explain what is going to happen, and answer any questions you have.

You may have an injection or drink of a special liquid called contrast medium. This helps the doctor or radiographer to get the clearest possible scan pictures. Afterwards the liquid passes harmlessly out of the body.

Rarely – depending on the part of the body being scanned – liquid may be put into the rectum (back passage), or a tampon may be put into a woman’s vagina. The procedure varies from hospital to hospital.

The test
To have the scan done, you lie on your back on a couch.

The scanner is shaped like a large polo mint. Once you are ready, the couch starts to move through it very slowly.

The test doesn’t hurt, but you may feel a bit uncomfortable because you have to lie still on the hard couch.

You may be asked to follow some instructions – for example, you may need to hold your breath for a few seconds.

The scan itself may take anything from a minute or two, up to half an hour. It depends on the type of machine being used. However, your visit will take longer than this – for example you may be asked to arrive a little while beforehand to prepare for the test.

You may be asked to stay for a short time, while the doctor or radiographer checks that the pictures are good enough.

Then you will probably be able to go home. If you don’t need any more tests, you can start eating and drinking normally. There are no after effects.

A CT scan takes several x-rays, rather than just one. In general the fewer x-rays you have, the better... so doctors will order a CT scan only when there is a good reason.

X-rays can harm an unborn baby, so please tell your doctor or radiographer before the scan if there is any chance you might be pregnant.

A few patients are allergic to the contrast medium that may need to be injected into a vein. If you know you have any allergies, tell the doctor or radiographer before they give you the injection.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don't have a date for this, please ask.

This test is carried out at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your CT scan, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

This is a tracing of your heart to check for any abnormalities. Small adhesive pads are attached to your chest and a tracing of your heart is taken. The test itself is not painful or uncomfortable but you do need to lie very still for a short time.

This test combines an endoscopy with ultrasound. It can give a very clear and accurate picture of your gullet (oesophagus), stomach, pancreas and bile duct. The procedure is the same as for an endoscopy. An endoscope is a long, flexible tube with a bright light and a camera on the end of it. It is used for looking inside the body. In EUS, this is combined with high frequency sound waves, transmitted from an ultrasound probe at the tip of the endoscope. This allows a scan of the surrounding organs.

Preparation: The hospital will give you clear written information about will happen. You will be asked not to eat or drink anything for at least 6 hours before the scan. You will be given a sedative injection in your arm with a drug to make you sleepy and relaxed.

Procedure: When you are ready, a thin tube will be put in to one nostril to give you some extra oxygen, and a plastic mouthpiece will be put gently between your teeth to keep your mouth open. The endoscope is passed through the mouthpiece, down the gullet, into the stomach, and into the small bowel. You will be able to breathe normally. It will take about 20 minutes to complete the examination. During this time your pulse and oxygen levels are monitored. If there is too much saliva in your mouth, a nurse will use a suction hose to suck it out.

Afterwards, you will be taken to a recovery room. Any discomfort should soon go.

If you have been sedated, you will have side-effects. You will be sleepy and forgetful. For this reason you must have someone to take you home and stay with you whilst you rest for the day. For the 24 hours following the injection, you must not drive a car or motorbike, operate machinery, take any alcohol or sign legal documents.

The procedure is safe. However there is a small risk of problems. These include bleeding, tearing of the bowel, and an allergic reaction to sedative drugs. Your doctor will explain the risks to you beforehand.

It is a test that lets the doctor look at the lining of your:

• oesophagus (gullet)
  
  
• stomach
  
  
• duodenum (the first part of the small intestine).

The test is done with a thin, flexible telescopic instrument called an endoscope. It is passed through the mouth and down into the stomach. The doctor can look for anything unusual, and take samples of tissue (biopsies) to be examined under a microscope.

You will be asked not to eat anything for about four hours beforehand, and not to drink for about two hours. Your stomach needs to be empty so that your doctor can get as clear a picture as possible.

If you are diabetic, you will get some special instructions to follow.

If you are taking prescribed medicines, take them as normal with sips of water. However, ulcer-healing drugs (eg Tagamet, Zantac) need to be stopped for four weeks before the test.

The hospital will send you full details with your appointment letter. If in doubt, please ask.

You nurse or doctor will explain the test to you and answer any questions you have.
S/he will ask you to sign a consent form to say that you agree to have the test done.

You may need to undress and put on a hospital gown. If you wear false teeth, glasses or contact lenses you will remove them.

You will be asked whether you would like a spray to numb your throat, or a sedative injection.

If you choose the spray, some anaesthetic is put onto the back of your throat to numb it. It means you won’t feel any pain as the endoscope goes in.

If you choose the sedative injection it will make you feel drowsy, relaxed and less anxious. It won’t put you to sleep, but you will be unlikely to remember anything afterwards.

To have the test you lie on your side, on a trolley. Your nurse stays with you all the time and your pulse and oxygen levels are checked throughout. A plastic guard is placed in your mouth to protect your teeth and the endoscope.

When you are ready, the doctor or nurse passes the endoscope over the tongue, down through the gullet and into the stomach. The endoscope is about the thickness of your little finger.

Don’t worry – you aren’t going to choke, and you will be able to breathe normally.

During the test some air is passed through the endoscope and into the stomach. This is to make the stomach bigger and give the doctor a clearer view. It doesn’t hurt, but it may feel a bit uncomfortable. The air is sucked out at the end of the test.

If your doctor needs to take some tissue samples (biopsies) this can be done painlessly through the endoscope.

It normally takes just a few minutes for the test to be completed. Then, the endoscope is gently removed.

If you had an anaesthetic spray you will usually stay in the hospital until your nurse is sure you can swallow normally and are fit enough to go home. This is usually two or three hours after the test.

When you get home, take it easy for the rest of the day. You should be able to go back to work the next morning.

If you had a sedative injection there are some extra precautions to take...

• Ask a responsible adult, with transport, to take you home.
  
  
• Don’t drive, operate machinery or drink alcohol for 24 hours.
  
  
• Don’t make important decisions (for example, signing papers) for 24 hours.
  
  
• If you live alone, you may like to ask someone to stay the night with you.

After-effects
Your throat may be a little sore, and you may have a hoarse voice. This should ease within a day or two.

You may feel a little bloated if there is still some air in your stomach. This will soon pass.

The upper GI endoscopy is a safe test, but there is always a small risk with procedures of this kind.

Possible problems include bleeding, tearing of the bowel and an allergic reaction to sedative drugs. These complications are rare (less than one in every 1,000 tests) but those affected may need urgent medical treatment.

There is a small risk that the test could damage crowned teeth or dental bridge work. Tell the doctor or nurse if you have these.

A copy of the results will go to the person who sent you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don’t have a date for this, please ask.

This test is offered at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your endoscopy, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

ERCP stands for endoscopic retrograde cholangio-pancreatography.

It is a procedure that lets your doctors look at your pancreas and bile duct through a thin, flexible telescopic instrument called an endoscope. It is passed into the mouth and down as far as the stomach and duodenum (the start of the small intestine).

It allows the doctor to:

• look for anything unusual
  
  
• take x-rays
  
  
• take samples of tissue (biopsies) to be examined under a microscope.

The ERCP will help your doctor to find out what sort of illness you have.

The procedure has other uses too. It can be used to treat certain conditions (stones in the bile duct can be removed this way). If cancer has blocked the bile duct, the doctor may put a tube in place (a stent) to keep the duct open. ERCP can be used to insert the stent.

You will be asked not to eat or drink anything for at least six hours before the test. Your stomach and duodenum need to be empty so that your doctor can get as clear a picture as possible.

If you are diabetic, you will get some special instructions to follow.

If you take regular medication, take your tablets as normal (with a small amount of water, if you need it).

The hospital will send you full details with your appointment letter. If in doubt, please ask.

If you can, leave any jewellery or metal objects at home, because you can’t wear them during the test. It is better not to bring them with you.

Your nurse or doctor will explain the test to you and answer any questions you have. S/he will ask you to sign a consent form to say that you agree to have the ERCP done. Please tell your nurse or doctor if you have been examined through an endoscope before, or if you have had any allergies or reactions to drugs in the past.

You may need to undress and put on a hospital gown. You will take out any false teeth or contact lenses.

You may be given an injection of antibiotics, to help prevent an infection later.

Your throat will be numbed with a spray – or with a lozenge that you suck. This means you won’t feel any pain as the endoscope goes in.

You don’t need to be put to sleep, but your doctor may offer you a mild sedative injection. It will make you feel drowsy, relaxed and less anxious.

To have the test you lie on a table. A fine, soft tube is placed into one nostril to give you a little oxygen to breathe. Your pulse and oxygen levels are checked throughout.

When you are ready, the doctor or nurse passes the endoscope over the tongue, down through the gullet and into the stomach and the first part of the bowel. The endoscope is about the thickness of your little finger.

This won’t hurt, but it may feel uncomfortable. Don’t worry – you aren’t going to choke. The feeling will pass, and once the tube is in place, the worst is over.

A liquid called contrast medium is then injected through the endoscope. This lets the doctor see your pancreas and bile duct more easily on the X-rays. Afterwards the liquid passes harmlessly out of the body.

As well as looking at your body organs the doctor may take some samples of tissue (biopsies) to be looked at later under a microscope.

The procedure normally takes about 30 minutes. Then the endoscope is gently removed.

If you had an anaesthetic spray...

You will stay in the hospital until your nurse is sure you can swallow normally and are fit enough to go home. This is usually two or three hours after the test.

When you get home, take it easy for the rest of the day. You should be able to go back to work the next morning.

If you had a sedative injection...

There are some extra precautions to take...

• Ask a responsible adult, with transport, to take you home.
  
  
• Don’t drive, operate machinery or drink alcohol for 24 hours.
  
  
• Don’t make important decisions (for example, signing papers) for 24 hours.
  
  
• If you live alone, you may like to ask someone to stay the night with you. Alternatively you may stay overnight in hospital and go home the next day.

After-effects

Your throat may be a little sore, and you may have a hoarse voice. This should ease within a day or two.

There is always a small risk with procedures of this kind. The ERCP may lead to complications, and sometimes these can be serious.

There are four main complications...

• in about 1 in 50 patients the ERCP causes acute pancreatitis (inflammation of the pancreas). If you develop this you may have to stay in hospital, and occasionally an operation is needed
  
  
• ERCP may lead to an infection in the bile duct (cholangitis). This can usually be treated with antibiotics, but occasionally it may be serious
  
  
• ERCP may cause bleeding. This can usually be stopped by an injection given through the endoscope, but if it is serious an operation may be needed
  
  
• ERCP may tear the bowel, and an operation may be needed to put this right.

Remember, though, that ERCP is generally a safe test and complications are quite rare.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don’t have a date for this, please ask.

ERCP tests are carried out at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your ERCP, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

What is an exercise tolerance test?

This is an examination to find out how your heart will respond under stress. This is important to know if you are having major surgery.

You will be asked to walk on a treadmill while some basic readings of your heart are made. The test starts off at a very easy rate and is gradually made harder by increasing the speed and slope of the treadmill. The test lasts for about 15 minutes. If you have pains in your chest or become breathless, the tests will be stopped.

It is a way of getting some cells from your breast, so that they can be looked at under a microscope.

The doctor gets the cells by putting a fine needle through the skin and into the part of the breast that needs to be examined.

Your nurse or doctor will explain the test to you, and answer any questions you have.

The doctor will then feel your breast to find the area s/he wants to sample.

If the area cannot be felt, the radiologist (x-ray doctor) will need to do the FNA. S/he will use an x-ray or ultrasound machine to find the exact area to be sampled.

If the FNA is to be done using x-ray guidance you will sit in a chair, with your breast held in the x-ray machine while the needle is positioned.

Further x-rays will be taken to ensure that the needle is in the right place. This is called stereotactic FNA.

If the FNA is to be done using ultrasound guidance, you will lie on a couch.

Whichever method is used to find the right area, a very thin needle will then be passed into your breast to take a sample of cells.

Sometimes another needle test - known as a core biopsy - may also be needed. For this, a local anaesthetic is used to numb the area. The doctor makes a small cut in the skin and inserts a needle to take a two or three small pieces of tissue from the breast. You will hear a loud click as the samples are taken.

After the test you may experience some tenderness. This is quite normal. Taking mild painkillers (such as paracetamol) should help.

There may be some bruising around the area. This is normal and should fade as any other bruise would.

You may be more comfortable wearing a good supporting bra in bed for the first couple of nights.

The small dressing applied after the test can be removed the next day.

You can bathe or shower as usual, and may find warm baths soothing.

As all women are different, so is the discomfort that they may feel during the test. Most women say this test is uncomfortable and compare it to having a blood sample taken from the arm.

The sample of cells will be sent to the laboratory for examination. You may be able to get the results on the same day as your test.

Your doctor or nurse will make other arrangements with you if this isn't possible.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your FNA, don't be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

These are both a type of X-ray, in which a dye (contrast medium) is used to show up the blood supply, or the lymph system, in the liver. A special chemical that is taken up by any tumour, called Lipiodol, is also used. A series of quick X-ray pictures are taken that make up a real-time film of the movement of blood or lymph within the liver. This helps your doctors to see how your liver is working, and to pinpoint any blockages.

The test will take place in an operating theatre that has X-ray equipment. You may be given a sedative, to help you to relax. The dye is given to you through a thin tube line put into a vein, usually in the groin. The test takes up to an hour to complete. You will be able to go home soon afterwards?

Tests are carried out at the radiology department.

After the test, you may have a follow-up CT scan.

A laparoscopy is an examination of the inside of the abdomen (the pelvis or belly) using a fibre-optic light, and a telescope attached to a microchip camera, which are passed through a thin rigid tube (a laparoscope). The surgeon can see what is inside the abdomen by looking at the camera’s pictures, shown on a video monitor. Some laparoscopes have tubes through which fine operating instruments can be passed.

You will need a general anaesthetic.

The Royal College of Anaesthetists have a series of leaflets all about anaesthetics.

Two small cuts (less than 1 centimetre long) are made in the skin and muscle of the abdomen. A hollow needle is passed through one, and carbon dioxide gas is injected to stretch the abdomen and separate the wall of the abdomen from the organs inside. This makes it easier and safer for the laparoscope to be passed in through the second cut, and gives a good view of all the organs.

Sometimes ultrasound is used as well, to help the surgeon position the ‘scope.
Laparoscopes are also used in surgery. To do laparoscopic surgery, several other laparoscopy tubes are passed into the abdomen and specially designed, long thin tools are passed through the tubes. Surgeons who do this sort of surgery have training to learn the techniques needed.

Laparoscopy is used to look inside the abdomen and pelvis to help diagnose your problem. It may be used to find the cause of abdominal pain, or to see the spread of disease (including cancer), before deciding whether to do a major operation. If needed, biopsies can be taken. It is used when X-rays and ultrasound examinations are not sufficient.

Types of key-hole surgery can be performed through a laparoscope.
Your surgeon will discuss with you the reasons for your laparoscopy, and how it is to be done. Afterwards, your surgeon will discuss what has been found, and whether further surgery or treatment may be needed.

To prepare for the general anaesthetic, you will have a chest and heart examination, and blood tests, to check your general health. You will not be able to eat for some hours before the test. You may be asked to take a laxative to clean out your bowel.

On the day of the laparoscopy, you will be asked to sign the consent form.

Sometimes you are asked to consent to a laparotomy too, if the surgeon believes it may be necessary. A laparotomy is an operation in which a large cut is made, to open up your whole abdomen. This may be needed because the laparoscopy has shown problems that require immediate surgery, or because it is not possible to carry out an operation properly or safely without more direct access to your internal organs. Very occasionally it is because of accidental damage to one of your internal organs.

You will usually have some pain around the cuts that have been made. You may feel generally uncomfortable around your abdomen. Some patients report pain at their shoulder tip. This is caused by the carbon dioxide gas used in the laparoscopy, which may irritate the underneath of your diaphragm (the lining between the abdomen and the upper chest). This pain soon passes. Pain killers are always given.

You may have a little bruising or bleeding around your skin cuts, or bruising on your abdomen.

Occasionally, because there is fluid (e.g. blood, lymph, saline) in your abdomen, a drain has to be attached to your wound for a few days.

After a simple laparoscopy (with no surgery) most patients are fully recovered and pain-free within two or three days.

Most laparoscopies are carried out as day-cases. Because you have had a general anaesthetic, you will be kept for observation for a few hours, and then allowed home. You will not be fit to drive, and should have someone come to collect you.

After laparoscopic surgery you will need to stay in hospital overnight, and possibly for several days longer.

All operations carry some risk.

There is a small possibility that a laparoscopy can lead to accidental damage to the bowel or to blood vessels in the abdomen or pelvis. Ask your surgeon about this.

The risk in having a general anaesthetic is low, but depends on a number of things, including the type of operation you are having, and your general health. You will meet your anaesthetist before hand, and he or she will explain what you can expect.

Ask your consultant, anaesthetist or clinical nurse specialist.

You may find it useful to have a look at the mri room of the Virtual Hospital Departments from The Royal College of Radiologists.

MRI stands for magnetic resonance imaging.

It is a test that uses a magnet and radio waves to build detailed pictures of different areas of the body.

Doctors can use these pictures to look for signs of cancer or other diseases.

Because the MRI scanner uses a powerful magnet, you may not be able to have the test if there is metal in your body. Your doctors will need to check that the test is suitable for you. For example, you may not be able to have it if:

• you have a pacemaker
  
  
• you have certain types of artificial joints or heart valves
  
  
• you have clips in the head following brain surgery
  
  
• you have metal fragments in your body

People with dental fillings and bridges, hip and knee replacements can all be scanned safely.

We also prefer not to scan women in the early stages of pregnancy, although this is not known to be harmful.

It depends which part of your body is going to be scanned. Unless you are told otherwise, you don’t have to do anything special. If you suffer from claustrophobia, it is a good idea to discuss this before the date of the scan. There will be a telephone number on your appointment letter. 

If your abdomen or pelvis is to be scanned, you may not be able to eat for a while before the test. This is so that your doctors can get the best possible pictures.

The hospital will send you full details with your appointment letter. If in doubt, please ask.

You will not be able to take any metal or magnetic objects (keys, jewellery, money, credit cards, watches etc) into the scanning room with you. Leave them at home if you can – or remember to ask hospital staff to lock them safely away.

It would also help if you could wear clothes that don't have metal parts (eg zips and hooks).

Preparation
You may be asked to take off some of your clothes, and to put on a hospital gown. You will be asked to remove false teeth, hearing aids and make up. There will be somewhere aoutside the room for you to store your personal items.  

The person carrying out the test (usually a radiographer) will explain what is going to happen, and answer any questions you have. S/he will go through a health checklist with you, to make sure it is safe for you to go into the scanner.

Some patients have an injection of a special liquid called contrast medium. This helps the radiographer to get the clearest possible scan pictures. Afterwards, the liquid passes harmlessly out of the body.

You may be given the opportunity to chose form a menu of CDs to listen to through headphones. You might like to bring your own along, in case it is possible to listen to them in the scanner.

The test
To have the scan done, you lie on your back on a couch. The scanning machine is a large tube that is open at both ends. The radiographer may position your body to help obtain the best images. You may also be given a button to press during the scan in the case of an emergency.

Once you are ready, the couch starts to move through the tube. You relax and lie still while the scanner takes pictures of you. A special aerial or coil is positioned around the area to be examined, to receive information during the scan.

The scanner makes a tapping noise that can be quite loud at times. You may get earplugs to wear.

During the scan your radiographer will leave the room – but s/he will be able to see and hear you throughout, and will talk to you during the scan.

The scan usually takes between 30 minutes and one hour to complete.

You may be asked to stay for a short time, while your doctor or radiographer checks that the pictures are good enough.

Then you will probably be able to go home. You may drive if you wish. There are no after effects.

MRI is a safe test. There are no known risks.

A few patients are allergic to the contrast medium that may need to be injected, but this is rare.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days after getting the results. If you don’t receive a date for this, please ask.

The following hospitals are able to carry out MRI scans:

Durham
University Hospital of North Durham (Durham City)

Newcastle
Freeman Hospital
Newcastle General Hospital
Royal Victoria Infirmary

North Cumbria
Cumberland Infirmary, Carlisle
West Cumberland Hospital, Whitehaven

Sunderland
Sunderland Royal Hospital

To save you from waiting, your doctor may arrange for you to have the scan at a private hospital (such as the Nuffield Hospital in Newcastle). You do not have to pay anything for this.

You can get practical information about hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your MRI scan, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

What is a pulmonary function test?

This is a test to check how well your lungs are working. It involves breathing into a machine, which measures the strength and volume of your breath. It is not painful or uncomfortable, but can sometimes feel like hard work!

A flexible sigmoidoscopy is an examination of the left side of the bowel.

The doctor or nurse uses a flexible instrument called a sigmoidoscope. It is passed into the rectum (back passage) and up the left side of the large bowel. This area is called the
sigmoid colon.

On the end of the instrument is a tiny camera that sends pictures to a video screen. Your doctor or nurse uses the pictures to look for anything unusual.

S/he may also take some small tissue samples (biopsies) from the bowel lining during the test. These will be sent to the laboratory to be looked at under a microscope.

Your bowel must be empty, so that the doctor or nurse can see clearly inside it.

You may be given a laxative or enema to take at home, or you may have an enema at the clinic.

The hospital will send you full details with your appointment letter. If in doubt, please ask.

The endoscopist (doctor or nurse carrying out the test) will explain what is going to happen, and will answer any questions you have. S/he will ask you to sign a consent form to say that you agree to have the test done. S/he will also complete a health checklist with you.

You may need to change into a hospital gown. Alternatively you can wear loose, comfortable clothing.

You will go to a treatment room and lie on a couch, on your left-hand side.

When you are ready, the doctor or nurse passes the sigmoidoscope into your rectum. Some air is put into the bowel. This expands the lining slightly, to give a clear view of the inside of the bowel. The pressure of the air may give you stomach pains or cramps.

The doctor or nurse may also take some samples of tissue (biopsies) from the lining of the bowel. These will go to the laboratory later.

Once your doctor or nurse has finished the examination s/he gently removes the sigmoidoscope, and the test is over.

Most tests take around ten minutes, but some last a bit longer.

You will stay in the hospital for a little while, until the staff are sure you are well enough to go home. This shouldn’t take long.

You may have stomach cramps for a while because of wind in your bowel. It may help to have warm drinks at home, and to keep walking around.

If the doctor or nurse took tissue samples, you may pass a small amount of blood. This should settle down in a few days.

The hospital will give you a contact telephone number for further advice in case you have any problems.

Flexible sigmoidoscopy is a safe test.

Rarely, it tears the bowel wall. This happens in fewer that 1 in every 2,000 tests - but patients may need urgent surgery if it does.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don’t have a date for this, please ask.

You will go to the x-ray department of a nearby hospital. This test is offered at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your sigmoidoscopy, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

It is a test that uses sound waves to make pictures of the inside of the body.

If you have been pregnant in recent years you may well have had a scan like this to check the age, health and position of your growing baby.

Sound waves from the ultrasound machine pass through the skin and bounce off the body organs, like echoes. These echoes make pictures on a screen.

Doctors can use the pictures to look for anything unusual, such as a tumour.

They can also use ultrasound to help them take samples of tissue (biopsies) from the suspected cancer. The ultrasound pictures act as a guide, so that the samples are taken from the right place.

The procedure for most ultrasound scans is straightforward, and is described here.

The test may be done a differently in some cases. For example, we can scan the womb and ovaries by placing a probe in the vagina. (This is called a transvaginal ultrasound.) We can scan the prostate gland by placing a probe in the rectum. (This is called a transrectal ultrasound or TRUS.) If you are to have either of these tests, your hospital will explain the procedure to you.

It depends which part of your body is going to be scanned. You may not have to do anything at all.

If your pelvic area is to be scanned, you may have to drink quite a lot of liquid beforehand, so that your bladder is full when the test is done.

If your abdomen is to be scanned, you may be asked not to eat anything for five or six hours before your appointment time.

The hospital will send you full details with your appointment letter.

If you are diabetic, the hospital will need to make some special arrangements for you. If in doubt, please ask.

You will lie on a couch alongside the ultrasound machine. The room may be darkened a little.

The person doing the test (a doctor or sonographer) puts some gel onto the skin, over the area to be scanned.

The doctor or sonographer then passes a small probe over your skin. The probe looks like a hand-held microphone. It doesn’t hurt, but it may feel a bit uncomfortable if the doctor/sonographer has to press down quite firmly in places.

The gel makes good contact between the probe and the skin, and helps the sound waves to pass more easily through the skin. You may need to change position on the couch during the test, so that pictures can be taken from different angles

When all the pictures have been taken you can wipe off the gel, and the test is over.

It usually takes around 20 minutes to complete.

You may be asked to stay for a short time, while the doctor or sonographer checks that the pictures are good enough.

Then you will probably be able to go home. There are no after effects.

No, this is a safe test.

A copy of the results will be sent to the person who referred you for the test (usually your GP or hospital doctor).

Your doctor will arrange an appointment so that you can talk about the test results a few days later. If you don't have a date for this, please ask.

Ultrasound tests are carried out at most North of England Cancer Network hospitals.

You can get practical information about these hospitals (eg maps, car parking) elsewhere on this website.

Remember, your doctors and nurses are here to help you. If you have any questions about your symptoms or your ultrasound scan, don’t be afraid to ask.

You may also like to contact one of our Cancer Information Centres for a wide range of information on cancer and related subjects.

If you have symptoms that could be caused by cancer your GP will send you to see a specialist doctor, usually at a nearby hospital. The specialist will find out more about your symptoms and arrange some tests to find out what is wrong with you.

The Department of Health has drawn up national cancer referral guidelines to help GPs decide when to send a patient to a specialist. Guidelines have now been published for many different types of cancer.

The guidelines tell GPs which symptoms to look out for. For some symptoms, a specialist should see the patient quickly (within two weeks). This is called an urgent referral.

Sometimes the GP doesn't need to arrange an urgent appointment, even if cancer is likely. For example, some skin cancers grow slowly, so treatment does not have to start immediately. If your GP thinks you have one of these cancers s/he will arrange for you to see a specialist, but you may not need to go straight away. On the other hand, if you have a fast-growing skin cancer, you must be seen quickly.

If your GP sends you to a specialist it doesn’t mean that you definitely have cancer - even if your referral is urgent. It is natural to feel worried, but there may be no need. Remember that your symptoms may be caused not by cancer but by another illness.

For more information...

NHS National Institute for Health and Clinical Excellence
Understanding NICE guidance - information for people with suspected cancer, their families and carers, and the public.

Why are genetic tests carried out?

All cancer is genetic, in that it is triggered by altered genes.

Genetic tests can be used to look for a possible predisposition to developing a disease like cancer as well as to confirm a suspected genetic mutation in an individual or family.

Cancer usually arises in a single cell. As the cancer develops, the cell appears to follow a series of distinct steps, each one controlled by a different gene or set of genes. Several types of genes have been identified as having a connection with cancer:

Oncogenes normally encourage cell growth, but when they mutate, they can give cells signals to keep on dividing.

Tumor-suppressor genes normally restrict cells from growing, but when they are missing or have a mutation, they allow cells to grow and divide uncontrollably. The inherited genes that can lead to a risk of breast and ovarian cancer, Li-Fraumeni syndrome, retinoblastoma, Wilms' tumor, and familial adenomatous polyposis are of this type.

Genes called DNA repair genes appear to trigger cancer - and perhaps other inherited disorders - not by affecting the way cells grow, but by failing to correct mistakes that happen as DNA copies itself.  The genes that have been linked to hereditary colon cancer are of this type.

Tests to determine genetic susceptibility to cancer are not offered routinely.

The tests can raise challenging issues in families and for relationships.

Inevitably there may be the prospect of medical choices to be made once you have the test results.

Useful links

Cancerbackup
has a comprehensive section about genes, cancer and genetic testing on their website for anybody who is worried that cancer might run in his or her family. It is also for people who have been advised, or who have decided, to see a cancer genetics specialist or genetic counsellor.

CancerHelp
if you would like to read more about the tests that are carried out for the breast cancer genes, there is a useful section on the website.

Breakthrough Breast Cancer
has created a website of information for those concerned about their family history of breast cancer

The Genetic Interest Group
has a website which aims to promote awareness and understanding of genetic disorders.

The Northern Genetics Service
is based in Newcastle upon Tyne at the Centre for Life.