Does a pathology perform genomic tumour profiling?

A pathologist first confirms what the sample contains and whether it is appropriate for testing. The laboratory then examines selected genetic changes in the tumour. Your oncologist combines the report with the cancer type, stage, previous treatment and your overall health when considering care options.

Profiling looks for molecular features within cancer cells that may help classify the tumour or identify a treatment worth considering. It is different from inherited genetic testing: tumour testing mainly examines changes in the cancer, although some findings may prompt a separate discussion about testing blood or saliva for an inherited change.

Not every stored sample has enough well-preserved tumour for a reliable result. The pathology team may select another tissue block, request a new biopsy, use a blood-based approach where clinically suitable, or report that testing could not provide an answer. A detected change does not automatically mean that a matching medicine is appropriate or available.

Ask the oncology team why profiling is being considered, which sample will be used and whether more tissue might be needed. Tell them about any previous tumour testing, biopsies or treatment received elsewhere so earlier material and reports can be located. Confirm who will explain the findings and how they could affect the current treatment plan.

Genomic profiling itself is performed on a sample and does not cause symptoms. If a new biopsy was taken, contact the clinical team promptly for worsening pain, spreading redness, increasing swelling, persistent bleeding, fever or fluid leaking from the biopsy site. Seek urgent medical help for severe bleeding, breathing difficulty, fainting or rapidly worsening symptoms.

Useful questions include: What decision could this test inform? Is my existing sample adequate? Could a finding have implications for my relatives? What happens if no actionable change is found? Ask whether the result should be reviewed by a multidisciplinary cancer team and whether genetic counselling may be appropriate.