The incidence of cancer in the United States is second only to that of heart disease. Yet when you consider that there are more than one hundred different forms of cancer, you begin to appreciate how rare the majority of them are, pediatric cancers in particular. Childhood leukemia, the most common form, strikes a mere two thousand two hundred youngsters a year. Consequently, a general adult oncologist may go for years without seeing a case of cancer in an adolescent. Although research in cancer therapy hasn’t produced any major breakthroughs since the early 1980s, enough small victories have been won that the overall cancer survival rate has crept from 51 percent of patients in 1982 to 60 percent in 1994. Unless a cancer specialist treats a particular cancer regularly, he may not be aware of the latest treatment guidelines. A lengthy 1999 report from the National Cancer Policy Board concluded that a “substantial” number of cancer patients “do not receive care known to be effective for their condition.”
Tests Used to Diagnose Pediatric Cancers
Acute Leukemias
Physical examination, complete blood count (CBC), bone-marrow biopsy, lumbar puncture (spinal tap), tumor-cell chromosome analysis, liver-function and kidney-function blood tests, imaging studies such as X rays, radionuclide bone scan, ultrasonography, computed tomography (CT scan) and/or magnetic resonance imaging (MRI scan)
Hodgkin’s Disease and Non-Hodgkin’s Lymphoma
Physical examination, imaging studies such as X rays, computed tomography (CT scan) and/or magnetic resonance imaging (MRI scan), lymphnode biopsy, bone-marrow biopsy
Brain Cancers
Physical examination, neurological exam, lumbar puncture (spinal tap), electroencephalogram (EEG), imaging studies such as magnetic resonance imaging (MRI scan), computed tomography (CT scan), positron emission tomography (PET scan), angiography, brain tumor biopsy
Sarcomas of the Soft Tissues and Bones
Rhabdomyosarcoma
Physical examination, soft-tissue imaging, tumor, biopsy
Osteosarcoma
Physical examination, imaging studies such as X rays, computed tomography (CT scan), magnetic resonance imaging (MRI scan) and/or radionuclide bone scan, bone biopsy
Ewing’s Sarcoma
Physical examination, imaging studies such as X rays, computed tomography (CT scan), magnetic resonance imaging (MRI scan) and/or radionuclide bone scan, bone biopsy, complete blood count (CBC)