First, there needs to be enough tumor tissue available for testing. A “fine needle aspiration” or “FNA” biopsy may not provide enough tissue. A “core needle biopsy” usually does. If you had your tumor surgically removed, there likely will be enough tissue. In the future there may be a role for testing the blood for circulating cancer cells or tumor DNA, but this is still under investigation.
Second, you need to be your own advocate and speak to your oncologist about being tested. You may be required to undergo another procedure to obtain enough tissue, but it is clear that the benefits of knowing the mutation status of your tumor far outweigh the risks of most biopsies. Your doctor would be the one to order the tests; you need to make sure the doctor orders the right tests as discussed above.
Because targeted therapy and tumor testing for lung cancer is still a relatively new form of treatment, some doctors and oncologists may not be familiar with this new line of research. It is very acceptable and strongly advisable to get a second opinion, especially if your doctor is not familiar with tumor testing and targeted therapy. There are lung cancer experts all across the country at various medical centers and cancer centers that are available to offer second opinions.