A sonogram, or ultrasound imaging, is recommended for cancer patients at various stages of their cancer journey, depending on their symptoms, risk factors, and the organ involved. It is an essential tool for diagnosis, evaluating suspicious masses, guiding minimally invasive procedures, and monitoring response to treatment—all while ensuring patient safety with its non-invasive, radiation-free approach. 

Introduction: The Role of Sonogram in Oncology
Ultrasound imaging has gained prominence as a first-line and recurrent diagnostic tool in cancer care. Unlike radiological tests involving ionizing radiation, ultrasound uses sound waves to produce internal images, making it suitable for repeated use in sensitive populations, including children and pregnant women. 

When Is a Sonogram Recommended?

1. Evaluation of Unusual Lumps or Masses
When a physical exam, mammogram, or CT scan detects a lump or unclear mass, a sonogram is often ordered to determine if the mass is fluid-filled (usually benign cyst) or solid (suspicious for cancer). This is particularly common for breast, thyroid, and testicular lumps, where sonography helps make an initial distinction that guides further testing or monitoring. 

2. Guiding Needle Biopsies
Sonograms provide real-time, accurate imaging that helps doctors perform needle biopsies safely and precisely. During a biopsy for a suspicious tissue or lymph node, ultrasound guidance ensures the needle reaches the right spot, improving the yield of useful tissue and minimizing patient discomfort or risk. 

3. Monitoring Tumour Progression and Treatment Response
Repeated ultrasound scans are recommended to track changes in tumour size, shape, and density either during cancer treatment or routine follow-up. It is especially valuable in cancers affecting the liver, kidneys, pelvis, or lymph nodes, where follow-up frequency is high and avoiding radiation exposure is needed. 

4. Assessing Organs Not Well Imaged by X-rays
Some organs and soft tissue structures, such as the liver, gallbladder, pancreas, uterus, ovaries, and prostate, are better visualized using sonogram than standard radiographs. When cancer is suspected of being monitored in these locations, ultrasound is often the preferred imaging test. 

5. Differentiating Cysts from Tumours
Distinguishing between benign cysts and malignant tumours is a critical step that guides the urgency and nature of further evaluation. Sonograms excel at this task, offering detailed characterizations that influence whether to observe, biopsy, or treat. 

Other Clinical Situations for Ultrasound in Cancer Care

1. Initial Cancer Staging: To assess spread or involvement of lymph nodes, liver, pelvic organs, and abdominal structures.
2. High-Risk Screening: In patients with genetic predispositions (such as BRCA1/BRCA2 mutations) or dense breast tissue, ultrasound complements mammography and MRI for early cancer detection.
3. Therapy Complication Assessment: During treatment, ultrasound helps identify complications like fluid collections, blood clots, or organ damage from therapies, ensuring any issues are detected early and managed promptly.
4. New Symptoms or Recurrences: If a cancer patient develops new pain, swelling, or palpable masses, ultrasound offers a rapid assessment to evaluate for recurrence or metastatic spread. 

Advantages of Sonogram for Oncology Patients
1. Safe for Repeated Use: No ionizing radiation; can be used frequently over months or years.
2. Real-Time Visual Guidance: Guidance for biopsies and minimally invasive procedures increases diagnosis accuracy and reduces risks.
3. Cost-Effective and Accessible: More affordable and available than MRIs or PET scans, making it widely used in settings such as ITM Hospital and Research Centre. 4. Versatile Across Tumour Types: Used in breast, liver, thyroid, pelvic, lymph node, prostate, testicular, and paediatric oncology.

Summary: Personalized, Safe, and Effective Cancer Care
Sonograms are recommended for cancer patients whenever accurate, safe, and cost-effective imaging is required across the cancer care continuum. They help evaluate suspicious findings, guide procedures, monitor response, and assess treatment complications while maintaining patient safety. At ITM Hospital and Research Centre, Gwalior, sonography forms a core part of our multidisciplinary cancer diagnostics and treatment, providing high-quality images, expert interpretations, and compassionate patient care.