| Procedure/Test |
Purpose |
What is Done |
| General
|
A biopsy determines if a tumor is not cancerous (benign) or cancerous (malignant). If the biopsy is "positive," cancer is present. If it is "negative," cancer cells were not seen.
|
A doctor removes part or all of the tumor or part of the bone marrow. A pathologist, a doctor who specializes in recognizing changes caused by disease in humans, looks at the tissue under a microscope.
|
| Bone marrow aspiration or bone marrow biopsy
|
This type of biopsy examines the bone marrow under a microscope to see if leukemia is present or if the treatment is working. For other cancers, this test tells whether the disease has spread to the bone marrow.
|
For young people, a bone marrow test is most often done in the hip bone. The child lies on his or her stomach with a pillow under the hips. A needle is put through the skin and into the middle of the hipbone, and a small sample of marrow is quickly drawn into the syringe. The most painful part of the test lasts for a few seconds.
|
Blood Studies
Procedure/Test
|
Purpose |
What is Done |
| Tumor markers
|
This type of test searches for substances that may increase in the blood of a person with cancer. It can help to diagnose cancer and to find out how well the child is responding to treatment.
|
A sample of blood is usually obtained through a needle inserted in a vein or by pricking the tip of the finger and squeezing out a few drops of blood. Sometimes blood is obtained via tubes (catheters) that have been surgically placed through the chest and into one of the major blood vessels leading to the heart.
|
| Complete Blood Count (CBC)
|
A CBC test checks the white blood cells, hemoglobin, hematocrit, and platelet count in a sample blood.
|
See above.
|
| White blood cell (WBC) count
|
A WBC count measures the number of WBCs in the blood and is also used to find certain types of immature cells - called blast cells - typical of leukemia. WBCs protect the body from infection. Chemotherapy and other treatments can lower the number of WBCs, increasing the risk of infection. If the test reveals a low WBC count, treatment may need to be delayed until the count goes up.
|
See above.
|
| Hemoglobin
|
Hemoglobin is the substance in red blood cells that carries oxygen to the body's tissues. Low hemoglobin indicates anemia. Anemia can cause your child to look pale and feel weak and tired. It may be a side effect of chemotherapy or a sign that the cancer has returned.
|
See above.
|
| Hematocrit
|
Hematocrit determines the size, function, and number of red blood cells. A low hematocrit also may mean that anemia is present.
|
See above.
|
| Neutrophils (also called ANC-absolute neutrophil count)
|
This blood study tests for the body's ability to fight bacterial infections.
|
See above.
|
| Platelet count
|
This test measures the number of platelets. Platelets help the blood clot. A low platelet count, which may be due to side effects of medicine or to infection, or may mean that leukemia is present, could cause one to bleed or bruise easily.
|
See above.
|
| Procedure/Test |
Purpose |
What is Done |
| General |
Imaging tests take pictures of images of areas inside the body to see what is happening.
|
Tests are generally not painful, but the equipment may be frightening to children. Some machines, such as MRIs, make very loud noises.
|
| Angiograms |
An angiogram obtains an x-ray of the blood vessels and shows changes in the blood vessels and in nearby organs. Clogged blood vessels or blood vessels that have moved may mean that a tumor is present.
|
A special dye is injected into an artery and travels through the blood vessels. Then a series of x-rays is taken. The dye makes the blood vessels show up on an x-ray.
|
| Ultrasound |
Ultrasound obtains a picture of part of the body by using sound waves. The waves echo or bounce off tissues and organs, making pictures called sonograms. Tumors have different echoes than normal tissues, making it possible to "see" abnormal growths.
|
A small hand-held device called a transducer is used to send the sound waves to a site in the body. The transducer is rubbed firmly back and forth over the site after the skin has been lubricated with a special gel.
|
| Radioisotope scanning |
This test studies the liver, brain, bones, kidneys, and other organs of the body.
|
The child either swallows or has an injection of a mild, radioactive material that is not harmful. After a short wait, a scanning device is passed over the body to detect where the radioactive material collects in the body and allows the doctor to locate tumors. Your child will not be radioactive during or after these tests.
|
| CT scan (computerized tomography scan) or CAT scan |
This test obtains a three-dimensional picture of organs and tissues; ordinary x-rays give a two-dimensional view. Using pencil-like x-ray beams to scan parts of the body, a CT also gives better pictures of soft tissues than does an x-ray. It provides precise and very useful details about the location, size, and type of tumor.
|
While the child lies still, a large machine moves back and forth, taking pictures.
The scan takes 30-90 minutes. Sometimes a special dye is injected into a vein before the scan.
If your child has a central venous line in the chest, it generally cannot be used during a CT scan of the chest. It is important to prepare your child for an IV in the hand.
|
| MRI (magnetic resonance imaging) |
An MRI creates pictures of areas inside the body that cannot be seen using other imaging methods. MRI uses a strong magnet linked to a computer. Because an MRI can see through the bone, it can provide clearer pictures of tumors located near the bone. |
The child lies on a flat surface, which is pushed into a long, round chamber. Your child will hear a loud thumping noise, followed by other rhythmic beats. The test takes 15-90 minutes, during which your child must lie still.
Sometimes a special dye is injected into a vein before the test. |
