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Diagnosis and Treatment

ByMcKenzie Stabile, BSN, RN

Diagnosis and Treatment Options in Pediatric Cancer

Has your child or loved one been experiencing unusual and concerning health issues, causing you to make a doctor’s appointment for further testing? After googling symptoms, you might be overwhelmed and thinking to yourself, could this be cancer? Experiencing generalized symptoms such as unexplained weight loss, headaches, nausea, fatigue, pain, lumps, or bruising may lead one to question their overall health. After recognizing abnormal signs and symptoms and seeking medical attention, you might be wondering what sort of diagnostic testing you can expect will be done to formulate an accurate diagnosis.  Let’s explain in detail how physicians may diagnose pediatric cancer and formulate individualized treatment plans.

Diagnostic Testing

Many diagnostic tests are used in pediatric cancer patients to arrive at a final diagnosis, leading to a specialized treatment plan. Physicians will make individualized diagnoses and treatment plans to adapt to the needs of the specific cancer your child has. Below is a list of various diagnostic testing used in pediatric cancer:

  • Blood Tests
  • Biopsy
  • Bone Marrow Aspiration
  • Lumbar Puncture
  • Ultrasound
  • CT scan (Computed Tomography Scan)
  • MRI (Magnetic Resonance Imaging)
  • PET scan (Positron Emission Tomography Scan)
  • Sputum Cytology

Tests

Blood Tests are typically drawn with an intravenous catheter and sent to the lab for examination. This type of testing can only detect cancers in the blood, such as leukemia and lymphomas. Typically, a physician would combine a blood test with additional diagnostic procedures. However, a simple blood test can tell a great deal about a patient’s overall health. If red or white blood cell levels are too high or too low, it will flag that a health issue may be present.

Biopsies will take a sample of either tissue, fluid, a mass, or a tumor in which a doctor suspects your child may have cancer. For instance, if a mass is protruding from an extremity or region of the body, the doctor will obtain a sample from that location for the pathologist to assess.

Bone marrow aspirations obtain samples from the bone marrow that produces red blood cells. This procedure serves as an effective detector for bone cancer. A doctor inserts a needle into the bone to gather a sample of the bone marrow, and they inject a dose of local anesthetic beforehand to make the process as pain-free as possible.

Lumbar puncture is a procedure that collects a sample of the clear fluid surrounding the brain and spinal cord, known as cerebrospinal fluid (CSF). This fluid can contain abnormal cancer cells if the area is affected. A physician performs the lumbar puncture by inserting a needle into the lower part of the spine to withdraw CSF for lab testing. They also use a local anesthetic for this procedure. If they detect cancer, physicians inject chemotherapy agents into the brain or spinal cord using a similar method.

Scans

Ultrasound is a painless, noninvasive diagnostic test to look at your internal organs. An ultrasound machine is a small, portable device typically brought to the bedside. It provides images on the screen guided by an ultrasound tech or other healthcare professional operating the machine. They use a tool labeled a transducer and glide it across an area of the body, such as the abdomen, with gel lubrication to produce images using sound waves directly during the scan. The ultrasound images will be on the screen during the scan in real-time.  

CT scan is a painless and noninvasive diagnostic test that takes quality images of your bones, muscles, blood vessels, and organs. This large machine requires a patient to lie on a bed that moves inside an open circular machine that captures the needed images of the body. It can be an extended procedure, and you must remain completely still to take the pictures accurately. Additionally, CT scans use X-rays in pediatric cancer testing, which emit radiation.

Imaginary

MRI takes high-quality images of the internal soft tissue parts of your body using magnetic radio waves. MRIs are a frequently used diagnostic tool in the healthcare industry. The machine used to obtain an MRI is similar to a CT scan, an open or closed circular machine. It is vital to disclose to your medical provider if your child has any internal metal implants such as pacemakers, vagal nerve stimulators, cochlear implants, or metal joint prostheses. Metal may be a contraindication to obtaining an MRI due to the possibility of implant disruption with magnetic waves used.

A PET scan produces internal images of your organs and tissues. A healthcare professional injects a harmless radioactive chemical called a radiotracer for this scan. If disease or cancer cells are present in the body, they will soak up the injectable radiotracer. A highlighted radiotracer would alert the physician of the area of concern. You will slide into a scanner machine lying flat, just as you would with a CT and MRI.

Sampling

Sputum cytology is a sample of your saliva or mucous and can be used to detect lung cancers. The saliva sample will be placed into a cup and sent to the lab for further testing.

Once your child or family member has been through the diagnostic testing and procedures that accurately detected and pinpointed their cancer, it is time to discuss treatment plans.

Treatment Types for Pediatric Cancers

You recently received the devastating news that your child or family member has cancer. Now what? Doctors create individualized treatment plans based on the child and their type of cancer. These plans vary by age, cancer type, and stage. Common cancer treatments include chemotherapy, radiation therapy, immunotherapy, and surgery.

Chemotherapy is a treatment that uses specific medication to destroy cancer cells. Physicians will prescribe chemotherapy in many forms, including oral, topical, and intravenous. It will depend on which body part the chemotherapy agent needs to enter.

Radiation Therapy is a treatment that involves emitting high doses of radiation to either a localized or systemic part of the body to damage or shrink a tumor and cancer cells.

Immunotherapy is a treatment used to boost the immune system and help the body protect itself against harmful cells. Children with cancer tend to have a significantly weakened immune system, which makes it nearly impossible to protect themselves and heal from a sickness.

Surgery is a treatment method that involves removing a piece of the body containing cancer. That could include skin, muscle, tissue, organs, bone, etc. Depending on what part or how much of the body a physician is removing, your child may need either local or general anesthesia throughout the procedure.

Maneuvering a Pediatric Cancer Diagnosis and Treatment Plan: Child Life Specialist

After receiving a devastating cancer diagnosis and then immediately having to decide on a treatment plan, it can be entirely overwhelming. Juggling the ups and downs and emotions that come with that kind of news is where a Child Life Specialist can help support you and your child or family member. Child life specialists help children and families navigate the entire process of a cancer diagnosis. They not only support the patients and family members in completely understanding and navigating a cancer diagnosis, but they also provide developmentally appropriate ways to help your child understand and prepare for the process.

Child Life Specialists support children and their families from diagnosis through treatment, hospital stays, and beyond. Support and collaboration with a child life specialist can help ease a tremendously stressful situation for you and your family. Having a shoulder to lean on to help navigate an incredibly stressful time is why a child life specialist is so valuable. The Sassy Carmen Foundation dedicates its nonprofit to supporting children and families throughout the entire process of a pediatric cancer diagnosis and treatment plan. Families need as much assistance and support as they can get with the devastating news of a cancer diagnosis, and Sassy Carmen is here to help.

References

Mayo Clinic College of Medicine and Science. Child Life Specialist. college.mayo.edu/academics/explore-health-care-careers/careers-a-z/child-life-specialist

National Cancer Institute. About Cancer: Diagnosis and Staging. cancer.gov/about-cancer/diagnosis-staging/diagnosis

Cleveland Clinic. Childhood Cancer: Diagnosis and Tests. my.clevelandclinic.org/health/diseases/24960-childhood-cancer#diagnosis-and-tests

Cleveland Clinic. CT (Computed Tomography) Scan. my.clevelandclinic.org/health/diagnostics/4808-ct-computed-tomography-scan

Cleveland Clinic. Magnetic Resonance Imaging (MRI). my.clevelandclinic.org/health/diagnostics/4876-magnetic-resonance-imaging-mri

Cleveland Clinic. PET Scan. my.clevelandclinic.org/health/diagnostics/10123-pet-scan

National Cancer Institute. About Cancer: Diagnosis and Staging. cancer.gov/about-cancer/diagnosis-staging/diagnosis

National Cancer Institute. About Cancer: Treatment Types. cancer.gov/about-cancer/treatment/types

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