Cancer Staging and Tumour Markers
Comprehensive imaging, biopsy, and blood tumour marker assessment to determine cancer type, extent of spread, and molecular characteristics guiding treatment selection.
Overview
Overview
Cancer Staging and Tumour Marker Assessment is the systematic process of determining the exact extent of cancer spread throughout the body to guide the most appropriate treatment, predict prognosis, and monitor response to therapy. Staging uses a combination of cross-sectional imaging (CT, MRI, PET-CT), tissue biopsy, and blood tumour marker measurement. Molecular and genomic profiling of the tumour biopsy identifies specific targetable mutations that enable precision oncology treatment selection. Accurate staging is mandatory before any cancer treatment is initiated, and all staging results are reviewed at a multidisciplinary team (MDT) meeting before a treatment plan is agreed.
Types of Cancer Staging and Tumour Markers
- Clinical staging — determined by physical examination, imaging, and biopsy results before any treatment is given
- Pathological staging — determined from the surgically resected tumour specimen providing the most accurate assessment
- PET-CT functional imaging — detects metabolically active cancer deposits not visible on anatomical CT or MRI imaging
- Molecular and genomic tumour profiling — identifies actionable mutations (EGFR, HER2, BRAF, BRCA, MSI) guiding targeted therapy eligibility
- Serial tumour marker monitoring — regular blood measurements of cancer-specific proteins (CEA, CA125, PSA, AFP) to track treatment response and recurrence
Risk Factors of Cancer Staging and Tumour Markers
- New diagnosis of a confirmed malignant tumour requiring accurate staging before treatment planning begins
- Suspicion of metastatic spread based on symptoms, clinical examination, or elevated tumour marker levels
- Requirement for molecular profiling to determine eligibility for targeted therapy, immunotherapy, or clinical trials
- Post-treatment surveillance requirement to detect early biochemical or radiological recurrence before symptoms develop
- Rising tumour marker levels during or after treatment indicating possible disease progression or recurrence
- Complex or unusual tumour presentation requiring comprehensive multi-modality staging workup at a specialist centre
Symptoms of Cancer Staging and Tumour Markers
- Unexplained weight loss exceeding 10% of body weight over 3 to 6 months suggesting advanced or metastatic malignancy
- Persistent fatigue and reduced performance status not explained by anaemia or other reversible causes
- New bone pain particularly at night or at rest suggesting skeletal metastatic deposits
- Breathlessness or persistent cough suggesting pulmonary metastases or malignant pleural effusion
- Jaundice and right upper quadrant pain suggesting hepatic metastatic involvement or biliary obstruction
- Abdominal distension and palpable mass from intra-abdominal tumour growth or malignant ascites
- Neurological symptoms including confusion, weakness, or new-onset seizures suggesting brain metastases
- Night sweats, fever, and drenching sweats (B symptoms) in lymphoma and haematological malignancies
Key Benefits
Discover the advantages of choosing our cancer staging and tumour markers services.
Accurate staging directs the most effective and appropriate treatment strategy from the outset
Molecular profiling identifies patients eligible for highly effective targeted therapies
MDT approach ensures all relevant expertise contributes to the treatment recommendation
PET-CT detects additional disease that would lead to inadequate treatment if missed
Early staging identifies curative surgical candidates before metastatic spread occurs
Clinical Features
The technology, techniques and clinical approach behind our cancer staging and tumour markers.
PET-CT detects occult metastatic disease changing treatment intent in 15 to 20% of patients
Tissue biopsy mandatory before starting any systemic cancer treatment
Molecular tumour profiling identifies targetable mutations and immunotherapy eligibility
MDT discussion of all staging results before treatment recommendation is made
All imaging reports reviewed against original scans by specialist radiologist
Preparation Instructions
Attend fasting for 4 to 6 hours before PET-CT scan. Avoid vigorous exercise for 24 hours before PET-CT. Bring previous imaging on CD if available. Inform the team of any metal implants, pacemaker, or known contrast allergies before CT or MRI.
The Procedure
Step-by-step guide to what you can expect during your cancer staging and tumour markers procedure.
Clinical Assessment and History
A detailed oncological history documents symptom onset performance status weight loss and all relevant medical background. A systems review identifies any symptoms suggestive of metastatic disease.
Cross-Sectional Imaging CT and MRI
CT of chest abdomen and pelvis characterises the primary tumour identifies regional lymph node involvement and detects distant metastatic deposits. MRI provides superior soft tissue resolution for brain liver rectal and gynaecological staging.
PET-CT Functional Imaging
PET-CT uses radioactive glucose tracer taken up by metabolically active cancer cells to detect disease that may be anatomically normal on CT. It detects occult metastatic disease changing treatment intent in 15 to 20% of patients.
Tissue Biopsy and Histopathological Confirmation
Image-guided core needle biopsy confirms the tissue diagnosis and provides tumour for molecular and genomic profiling. Histopathological diagnosis is mandatory before starting any systemic cancer treatment.
Molecular and Genomic Tumour Profiling
Immunohistochemistry and molecular testing identifies actionable targets (EGFR HER2 ALK BRAF MSI BRCA) transforming treatment selection for lung breast colorectal ovarian and melanoma cancers.
Multidisciplinary Team Discussion
All staging results are presented at the MDT meeting before the evidence-based treatment recommendation is formulated and discussed with the patient.
What to Expect
Blood tests are taken first. CT and MRI scans are performed in the radiology department -- you will lie still for 20 to 45 minutes and may receive intravenous contrast dye. PET-CT involves a small injection of radioactive glucose tracer followed by 60 to 90 minutes rest before scanning. Your oncologist will review all staging results at a dedicated results appointment.
Recovery
Results typically take 5 to 14 days. Bring a trusted person for support at results appointments. Prepare questions in advance. A specialist nurse key worker is assigned to support you through the diagnostic and treatment pathway.
Frequently Asked Questions
Common questions about cancer staging and tumour markers.
Related Services
Explore other services in our Oncology department.
Chemotherapy Administration
Radiation Therapy
Targeted Therapy and Immunotherapy
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.