Name of the Procedure:

Metastatic Disease Assessment
Common name: Metastatic Workup
Technical term: Metastasis Diagnostic Evaluation

Summary

This procedure is a comprehensive evaluation performed when a patient is diagnosed with metastatic disease, meaning the cancer has spread from the primary site to other parts of the body. It involves various diagnostic tests to determine the extent and locations of cancer spread.

Purpose

The metastatic disease assessment aims to:

• Confirm the extent and locations of metastatic cancer.
• Help oncologists plan the most effective treatment approach.
• Provide prognostic information regarding the patient’s condition.

Indications

This procedure is indicated for patients who:

• Are newly diagnosed with cancer, and initial tests suggest metastasis.
• Have symptoms suggesting cancer has spread, such as bone pain or respiratory issues.
• Require comprehensive staging to guide treatment decisions.

Preparation

• Patients may need to fast for several hours before certain imaging tests.
• Medication adjustments might be necessary, especially if undergoing PET scans.
• Initial blood tests and physical examinations will likely be required.

Procedure Description

1. Imaging Tests:
   • CT Scans: Multiple cross-sectional images of the body to identify tumors.
   • MRI: Detailed images of organs and tissues.
   • PET Scan: Detects cancerous cells using a radioactive tracer.
2. Biopsies: Sample collection from suspected metastatic sites.
3. Blood Tests: Assess overall health and detect markers of metastasis.

Tools & Technology:

• CT and MRI machines
• PET scan technology
• Biopsy needles and surgical tools

Anesthesia/Sedation:

• Local or general anesthesia for biopsies as needed.

Duration

The entire metastatic workup can take several days to a week, depending on the tests required.

Setting

• Hospitals
• Outpatient imaging centers
• Specialized oncology clinics

Personnel

• Oncologists
• Radiologists
• Pathologists
• Nurses
• Medical laboratory technicians

Risks and Complications

• Imaging Tests: Rare allergic reactions to contrast agents.
• Biopsies: Risks of bleeding, infection, or tissue damage.
• Blood Tests: Minor bruising at the draw site.

Benefits

• Accurate staging of cancer.
• Informed treatment planning.
• Potentially improved prognosis by tailoring treatments to the cancer’s spread.

Recovery

• Minimal recovery is needed for imaging tests.
• Biopsies may require dressing changes and follow-up to monitor healing.
• Patients can typically resume normal activities promptly.

Alternatives

• Waiting for clinical changes before conducting a full metastatic workup.
• Initial use of less extensive imaging before proceeding to advanced tests.

Pros and Cons of Alternatives:

• Pros: Less immediate cost and medical intervention.
• Cons: Potential delays in identifying the full extent of cancer spread.

Patient Experience

• Patients may experience anxiety awaiting test results.
• Discomfort during biopsies can be managed with local anesthesia.
• Post-procedure, patients can expect to discuss findings and next steps with their oncologist. Pain management for biopsy sites will be provided as needed.