There's a growing recognition that the molecular profile of a primary tumor can differ significantly from its metastases. To guide treatment more accurately, the preferred practice is to biopsy an accessible metastatic lesion when possible, as this better reflects the biology of the active disease being treated.

True early cancer detection involves finding microscopic tumor DNA in blood samples. This can identify cancer years before it's visible on an MRI, creating an opportunity for a patient's own immune system to potentially eliminate it before it ever becomes a clinical disease.

A blinded central radiology review is not the absolute gold standard for assessing patient progression. Expert clinicians argue their holistic assessment, incorporating the patient's clinical status and other biomarkers alongside scans, provides critical context that a disconnected reviewer lacks.

Contrary to trends in wellness, a full-body MRI doesn't catch cancer early. A mass visible on an MRI already contains billions of cells and may have spread. Furthermore, it often leads to a rabbit hole of invasive tests for benign abnormalities, causing unnecessary harm.

Plasmacytoid bladder cancer spreads locally along the urothelium, which can be missed on imaging. Clinicians must push for a thorough examination under anesthesia (EUA) before surgery, even if a patient shows a complete radiographic response to therapy.

HER2 expression in cervical cancer can be heterogeneous and may emerge in metastatic sites even if the primary tumor was negative. Given the availability of effective HER2-targeting drugs, re-biopsying a metastatic focus is crucial to unlock previously unavailable treatment options for patients with recurrent disease.

Unlike in breast cancer, where HER2 IHC 2+ requires FISH confirmation, in gynecologic cancers an IHC 2+ result is often considered directly actionable for prescribing HER2-targeted ADCs like T-DXD. This reflects a different, less stringent clinical standard for biomarker-guided therapy in this setting.

NCCN now recommends PSMA PET as a potential replacement for traditional CT, MRI, and bone scans for initial staging of higher-risk prostate cancer and detecting recurrence. This shift is based on PSMA PET's superior sensitivity and specificity for finding micrometastatic disease, positioning it as a more effective frontline tool.

Despite focus on HPV vaccination in younger populations, a significant portion (20%) of cervical cancer diagnoses occur in women over 65. This highlights the need for continued vigilance and awareness in older age groups who may mistakenly believe they are no longer at risk.