Honest procedure guides

What happens during a biopsy?

A biopsy involves removing a small sample of tissue so it can be examined under a microscope. It is usually how a diagnosis is confirmed. There are several types depending on what is being sampled and where.

A needle biopsy uses a thin needle to remove tissue, guided by ultrasound or CT scan. It is done under local anaesthetic and takes around 30 to 60 minutes including preparation. You may feel pressure and some discomfort but it should not be acutely painful. You are usually able to go home the same day. The area will be sore for a day or two.

A surgical biopsy removes a larger piece of tissue and is done under general or local anaesthetic depending on the location. Recovery varies from same-day to a few days depending on the site and procedure.

Results typically take between 5 and 10 working days. If you have not heard back within two weeks, call the specialist's rooms. Waiting for results is one of the hardest parts of diagnosis. This is normal, and there is nothing wrong with calling to ask whether results are back.

Before any biopsy, ask: what type will this be, will I be awake, how long will it take, will it hurt, when will results be ready, and who will call me with the results?

What should I expect from a CT scan?

A CT scan (computed tomography) takes a series of X-ray images from different angles and combines them into a detailed picture of the inside of your body. It is one of the most common diagnostic tools for serious illness and is used to detect, stage, and monitor disease.

The scan itself takes around 10 to 20 minutes. You will lie on a table that moves slowly through a large ring-shaped machine. It is not enclosed like an MRI and most people do not find it claustrophobic. The machine makes a quiet humming sound.

Many CT scans use a contrast dye injected into a vein to make certain structures more visible. Before this, you will be asked whether you have kidney problems or an allergy to iodine. The contrast can cause a brief warm or metallic sensation as it enters your bloodstream. This is normal and passes within seconds. Healthdirect (healthdirect.gov.au) has a plain-language guide to CT scans that covers what to expect and how to prepare.

You may be asked to fast for a few hours before the scan. You can usually drive yourself home afterwards unless you have been given a sedative. Results are typically available within a few days.

What should I expect from an MRI?

An MRI (magnetic resonance imaging) uses magnetic fields and radio waves to produce detailed images, particularly of soft tissue. It is especially useful for imaging the brain, spine, liver, and other organs. It does not use radiation.

The machine is a large, tube-shaped magnet. You will lie inside it for 20 to 60 minutes depending on what is being scanned. The machine is louder than a CT scanner and produces a series of rhythmic banging and clanking sounds. You will be given earplugs or headphones. Some people find the enclosed space uncomfortable. If you have concerns about claustrophobia, tell the radiology staff beforehand. There are open MRI machines available in some locations, and sedation is possible if needed.

Because of the strong magnet, you cannot have an MRI if you have a pacemaker, certain metal implants, or some types of cochlear implants. Tell the radiology department about any implants or devices when you book.

Like CT scans, an MRI may involve a contrast injection. You are usually able to go home immediately after.

What should I expect from a PET scan?

A PET scan (positron emission tomography) uses a mildly radioactive substance to show areas of high metabolic activity in the body. Active disease cells typically show up as bright spots. PET scans are often combined with a CT scan (PET-CT) to show both the metabolic activity and the anatomy.

Before the scan, a small amount of radioactive tracer is injected into a vein. You will then wait for about 60 minutes while the tracer circulates. You will need to rest quietly during this time. You are then scanned, which takes a further 20 to 30 minutes.

You will need to fast for at least 4 to 6 hours before the scan, and avoid strenuous exercise for 24 hours beforehand. You should drink plenty of water. The radiation exposure is low and the tracer is eliminated from the body within a few hours.

Results are usually available within a few days. PET scans are not available everywhere. Your specialist will arrange one if needed.

What is a port or central line?

If you are having treatment that involves frequent intravenous (IV) access, your medical team may recommend placing a port or central line to avoid repeated needle insertions into peripheral veins.

A port (also called a port-a-cath) is a small device implanted under the skin, usually in the chest. A needle can be inserted into it for treatment without finding a vein each time. The port sits flat under the skin and is not visible. Implanting a port is a minor surgical procedure done under local or general anaesthetic. It can stay in place for the duration of your treatment and is removed when no longer needed.

A PICC line (peripherally inserted central catheter) is a thin tube inserted into a vein in the upper arm and threaded to a large vein near the heart. It is inserted in a treatment room, not an operating theatre, and takes about 30 to 45 minutes. A PICC requires regular flushing and dressing changes, usually weekly.

Ask your treatment team which type is recommended for you, what the insertion involves, how to care for it, and what signs of infection to watch for.

What do I need to know before and after any procedure?

Before any procedure, there are consistent questions worth asking your medical team. What exactly will happen and in what order? Will I be awake or sedated? How long will it take? How will I feel afterwards? How long before I am back to normal? Who do I call if something seems wrong after I go home?

After a procedure, watch for signs that something is not right: unusual pain, swelling, redness or warmth at the site, fever, difficulty breathing, or any symptom that feels unexpected. If in doubt, call the specialist's rooms or the hospital ward where the procedure was done. Do not wait until your next scheduled appointment.

It is also worth planning for the day of a procedure. Bring someone with you if possible. Arrange not to drive yourself home for anything involving sedation or general anaesthetic. Have comfortable clothes. Bring headphones or something to read for waiting times.

A procedure that seems routine to the medical team may feel significant to you. It is. You are allowed to feel anxious, ask questions, and take your time before proceeding.