The healthcare provider will ask questions about your child's medical history and current symptoms. He or she will examine your child, paying close attention to areas with lumps, pain, or other symptoms. Your child may need to see a cancer specialist (pediatric oncologist). Your child may have tests such as:
- Blood tests. These tests check for signs of disease, look at liver and kidney functions, and look for tumor cell markers. Certain genes may also be checked for problems.
- Biopsy. A sample of tissue is removed from the tumor and checked with a microscope for cancer cells. This can be done during surgery or by using a needle. A biopsy is the only way to know for sure if the tumor is cancer.
- CT scan. A series of X-rays and a computer are used to make images of the body.
- MRI. Large magnets, radio waves, and a computer are used to make detailed images of the inside of the body.
- X-ray. A small amount of radiation is used to make images of internal tissues, bones, and organs.
- Ultrasound (sonography). Sound waves and a computer are used to create images of blood vessels, tissues, and organs.
- Bone scan. A small amount of dye is injected into a vein. The whole body is scanned. The dye shows areas where there may be tumors.
- 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.
After a diagnosis of germ cell tumor, your child will have other tests. These help healthcare providers learn more about the tumor. They will show how much and how far the cancer has spread (metastasized) in your child's body. A stage grouping is then assigned. In some cases, a stage grouping isn't assigned until after surgery is done to remove the tumor.
Stage groupings can have a value of 1 to 4. They are written as Roman numerals I, II, III, and IV. The higher the number, the more advanced the tumor is. Letters and numbers can be used after the Roman numeral to give more details.
The stage of a cancer is one of the most important things to know when deciding how to treat the cancer. Be sure to ask your child's healthcare provider to explain the stage of your child's cancer to you in a way you can understand.