Need of Histological confirmation of Advanced staged Cancer

Cancer is a lethal disease. However, cancer seldom lead to immediate death.
For patient in acute care setting, infectious disease, trauma and vascular events account for nearly all emergency collapse or demise of previously healthy patient.

Nowadays, we talk about personalised treatment of cancer, we need to know the type and DNA of the cancer cells to formulate a treatment plan for the patient.
In patient when cancer presented with advanced stage of disease, should the medcial personnel insist of obtaining histological or pathological confirmation before proceeding for treatment.

There is usually a dilemma. To obtain biospy of tumour. If deep seating tumour, the risk is considerable. And if the tumour has spread to important oragnas such as brain or heart, to touch this area means major suffering.
So the chance of cure, if absent, should not warrant aggressive biopsy.
However some lesser invasive means if done under good techniques will help obtaining tissue for lung cancer.

They are:

Video assisted pleural biopsy of effusion drainage- targeted pleural biospy and effusion drainage

Bronchosocpic biopsy or transbronchial biopsy under sedation and locan anaesthetics

Endobronchial ultrasound transbronchial fine needle aspiration of paratracheal and carinal lymph nodes

Percutaneous fine needle imaging guided biospy of lung

By obtaining biopsy sample , the nature of cancer can be defined. The genetic and DNA studies of cancer cells can be pursued.

Personalised treatment and palliation of cancer can be achieved.

Yet, those method are however expensive.

Judicious choice of investigation will determine the success rate. Do need to seek specialist advise. For lung cancer, a cardiothoracic surgical specialist is essential.