Sometimes blood tests and scans aren’t enough.

Your doctor may need to actually look inside part of your body, examine tissue more closely, or collect a small sample that can be studied in a laboratory.

Then you hear words like:

Endoscopy.

Colonoscopy.

Biopsy.

And suddenly a diagnostic test can feel much more serious.

For many patients, one word in particular causes immediate anxiety:

Biopsy.

It is easy to hear that word and think:

They must believe I have cancer.

But a biopsy is a diagnostic tool.

It means your healthcare team needs more information about some tissue or cells. It does not, by itself, tell you what that information will show.

Understanding why these procedures are performed can make the waiting and uncertainty a little easier to navigate.

Sometimes Doctors Need to See for Themselves

Imaging gives healthcare professionals remarkable views inside the body.

But sometimes they need another kind of information.

An endoscope is a thin, flexible instrument that allows a healthcare professional to see inside certain areas of the body.

During an upper endoscopy, for example, a flexible scope is passed through the mouth to examine the upper digestive tract.

During a colonoscopy, a scope is used to examine the colon.

These procedures can allow the physician to actually see areas that might not be fully evaluated through blood work or imaging alone.

And sometimes, while they are looking, they can collect a tissue sample.

Why Would I Need an Endoscopy?

There are many reasons a healthcare professional might recommend one.

You may have persistent symptoms that need further evaluation.

Another test may have raised a question.

Your doctor may need to look for a source of a problem or monitor something that was previously found.

Some procedures, such as colonoscopy, are also used for screening.

The important point is that having a scope doesn’t automatically mean your doctor expects to find something terrible.

It means direct visualization may provide information that other tests cannot.

A useful question is:

“What are you hoping this procedure will help you understand?”

What Exactly Is a Biopsy?

A biopsy involves removing cells or a small amount of tissue so it can be examined more closely.

There are many ways to obtain a biopsy.

Some involve a needle.

Some involve removing a small piece of skin or another accessible tissue.

Others are performed during procedures such as an endoscopy or colonoscopy.

Still others may use imaging such as ultrasound, CT, or MRI to help guide the healthcare professional to the correct location.

The sample is then sent to a laboratory, where a specialist—often a pathologist—examines it.A Biopsy Is a Question, Not an Answer

This may be the most important sentence in this article:

A biopsy is being performed because there is a question.

It isn’t the answer to the question.

Tissue can be examined for many reasons. A biopsy may help healthcare professionals identify or rule out different conditions, better understand an abnormal area, or determine what kind of treatment may be appropriate.

Yes, biopsies are commonly used when cancer is being considered.

But the decision to perform a biopsy does not mean cancer has already been diagnosed.

The entire reason for obtaining the tissue is to learn more.

If you’re frightened, you can say so.

“I’m worried because I hear the word biopsy and immediately think cancer. Can you explain what you’re looking for?”

That is a completely reasonable conversation to have.

Why Can’t the Scan Just Tell Them?

Sometimes imaging can show that something is there.

It may show its size, location, shape, or other characteristics.

But an image doesn’t always tell healthcare professionals exactly what something is.

Think of seeing an unfamiliar object through a window.

You may be able to describe its shape and size.

You may have a good idea what it is.

But examining it directly provides different information.

A tissue sample can allow specialists to study cells under a microscope and, when appropriate, perform additional laboratory testing on that tissue.

Imaging and pathology answer different kinds of questions.

Sometimes doctors need both.

What Happens Before a Procedure?

Preparation depends entirely on what procedure you are having.

You may be asked to stop eating or drinking for a certain period.

A colonoscopy usually requires bowel preparation beforehand so the physician can adequately see the lining of the colon.

You may need to discuss medications, particularly medications that affect bleeding.

You may need someone to drive you home if sedation is used.

Follow the instructions from your own healthcare team rather than relying on general instructions you find online.

And if something isn’t clear, call and ask.

Preparation can affect whether the procedure can be performed safely and whether the healthcare professional can get the information they need.

Ask About Your Medications

Make sure the healthcare team knows what you take.

That includes prescription medications, over-the-counter medications, vitamins, and supplements.

Don’t independently stop a medication because you read somewhere that it shouldn’t be taken before a procedure.

Instead ask:

“Do I need to change any of my medications before this?”

If the answer is yes, make sure you understand exactly which medication, when to stop it, and when to restart it.

What About Sedation?

Some procedures are performed with local numbing medication.

Others may involve sedation or anesthesia.

What is used depends on the procedure, your medical circumstances, and how the facility performs it.

If sedation is planned, ask what to expect.

Will you be awake?

Will you remember the procedure?

Will you need someone to take you home?

Are there restrictions afterward?

Knowing these things before you arrive can make the day much less stressful.

Then Comes the Waiting

Sometimes the procedure is over, but the hardest part isn’t.

You are waiting for results.

A physician may be able to tell you immediately what they saw during a scope.

But if tissue was removed, laboratory examination takes additional time.

Ask before you leave:

“When should I expect the results?”

“Who will contact me?”

“Will the result appear in my portal before someone talks to me?”

“Who should I call if I haven’t heard anything?”

That last question matters.

Don’t spend weeks assuming no news means good news.

Know what the follow-up plan is.

Your Portal May Get There First

Today, patients sometimes see pathology or procedure results electronically before they have spoken with the healthcare professional who ordered the test.

That access is important.

But medical reports are written primarily for communication between healthcare professionals, and the language can be difficult to interpret.

If you see terminology you don’t understand, try not to build an entire diagnosis from a few words in the report.

Write down your questions.

Then ask the person who ordered the procedure to explain what the result means for you.

Before You Leave, Know What Happens Next

Whether you’ve had an endoscopy, colonoscopy, biopsy, or another diagnostic procedure, you should leave with some basic understanding of the next step.

Ask:

Were you able to complete the procedure as planned?

Was anything sampled or removed?

When will those results be available?

Are there restrictions when I get home?

What symptoms should make me call?

Who do I contact with questions?

You don’t need to understand every medical detail before you walk out the door.

But you should understand the plan.

A Closer Look Is Still Just Another Piece of the Puzzle

Diagnostic procedures can feel more intimidating than having blood drawn or getting an X-ray.

They are more personal.

Sometimes they are uncomfortable.

And sometimes the reason for having them carries uncertainty that is difficult to ignore.

But try to remember what your healthcare team is doing.

They are gathering information.

A scope lets them look.

A biopsy lets specialists examine tissue.

A laboratory helps analyze what was collected.

And then those findings are placed alongside your symptoms, history, examination, imaging, and other test results.

It is still the same diagnostic process.

Just a closer look.

So if someone tells you that you need a biopsy, a scope, or another diagnostic procedure, you don’t have to pretend you aren’t worried.

Ask the question underneath the fear:

“What are we trying to find out?”

Because knowing why something is being done can make a very unfamiliar part of healthcare feel a little more manageable.

References

National Cancer Institute (NCI). Biopsy.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Upper GI Endoscopy.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Colonoscopy.

MedlinePlus, National Library of Medicine. Biopsy.