Your child's healthcare provider will ask about your child's health history and symptoms. He or she will examine your child. This will include a neurological exam. The exam tests reflexes, muscle strength, eye and mouth movement, and coordination. Your child's healthcare provider may refer your child to a doctor specializing in the nervous system (neurologist or neurosurgeon) or to cancer specialist (oncologist). Your child may have tests such as:
- CT scan. A CT scan uses a series of X-rays and a computer to make detailed pictures of the body.
- MRI. An MRI uses large magnets, radio waves, and a computer to make detailed pictures of the body. Contrast dye may be injected into your child's vein. It helps cancer cells be seen more clearly.
- Lumbar puncture. A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. This is done to check the brain and spinal cord for cancer cells. A small amount of cerebral spinal fluid (CSF) is removed and sent for testing. CSF is the fluid around the brain and spinal cord.
- Positron emission tomography (PET) scan. For this test, a radioactive sugar is injected into the bloodstream. Cancer cells use more sugar than normal cells, so the sugar will collect in cancer cells. A special camera is used to see where the radioactive sugar is in the body. A PET scan can sometimes spot cancer cells in different areas of the body, even when they can’t be seen by other tests. This test is often used in combination with a CT scan. This is called a PET/CT scan.
- Biopsy. Tumor cells are removed and sent to a lab for testing. This is done to determine the type of tumor and how quickly it is likely to grow.
- Blood tests. Blood tests may be done to check for substances that are released by some tumors. These are called tumor markers.
These tests will show where and how much cancer there is in your child's body. These are important things to know when deciding how to best treat the cancer and what outcomes to expect. Some types of cancer use standard staging systems of numbers and letters to note this information and whether the cancer has spread. Brain tumors are not staged this way because they usually don't spread. Instead, when planning treatment and predicting outcomes, your child's doctors will look at things like:
- The exact type of tumor
- The location and size of the tumor
- Whether the cancer has spread to the CSF, spinal cord, more than one part of the brain, or beyond the brain
- How the tumor is affecting your child
- Your child's age
- Whether the tumor can be removed with surgery
The doctor will also consider the grade of the cancer cells. This is a measure of how quickly the cells are likely to grow and spread based on much the cancer cells look like normal cells. High-grade cancer cells look very different from normal cells and are more likely to grow and spread quickly.
Your child's doctor will talk to you about these things and recommend treatment for your child. These can be long and complex discussions. Be sure to ask questions and have the doctor explain things to you in a way you understand so you can make the best decisions for your child.