Ewing Sarcoma: Tests After Diagnosis
After a diagnosis of Ewing sarcoma, you’ll likely need more tests. These tests help
your healthcare providers learn more about the cancer. They can help show if it has
grown into nearby tissues or spread to other parts of your body. The test results
help your healthcare providers work with you to decide the best ways to treat the
cancer. If you have any questions about these or other tests, be sure to talk with
your healthcare team.
Some of the tests used after diagnosis include:
Imaging tests to look for cancer spread
CT scan
A CT scan is also called a CAT scan. It uses X-rays to make detailed 3-D pictures
of the inside of your body. After diagnosing Ewing sarcoma, a CT scan may be done
on your chest or belly (abdomen). A CT scan of your chest is commonly done to see
if the cancer has spread to your lungs.
To have the test, you lie still on a narrow table as it slowly slides through the
center of the ring-shaped CT scanner. Many X-rays are taken as the table slides through.
A computer uses the X-rays to make detailed pictures. A CT scan doesn't hurt. You
may be asked to briefly hold your breath a few times during the scans. A contrast
medium might be put into your blood through a vein in your hand or arm before or during
the scan. This helps tumor details show up better on the scans.
MRI
An MRI uses magnets, radio waves, and a computer to make detailed pictures of the
inside of your body. An MRI may be used to find out the exact size and extent of the
spread of the main tumor. It's also very useful for looking at nerves and blood vessels
near the tumor. MRI can be used to look for areas of cancer spread in other parts
of your body, too. In some cases, you’ll get a contrast dye injected into your blood
before getting the scan.
MRIs don’t hurt. But they can take a long time to do (up to an hour or so). During
that time, you’ll need to lie still on a narrow table that moves into a long, narrow
tube. If you have a fear of enclosed spaces or are a young child, your healthcare
provider may give a sedative to help you stay calm during the test. Newer, more open
MRI machines can sometimes be used instead. But the images are not as clear. You might
be given earplugs because there are loud banging and whirring noises during the test.
Bone scan
A bone scan looks at your whole skeleton. It's used to look for the spread of bone
tumors anywhere in your body. For this test, a small amount of a mildly radioactive
substance put into your blood through a vein in your arm or hand. The substance travels
through your bloodstream and collects where there's abnormal bone growth. A machine
then scans your body and makes images of the places where the radioactivity has collected.
These may be areas where the cancer has spread to your bones.
More detailed tests are then needed to get a close look at these areas. Many times,
a PET scan is used instead of a bone scan.
PET scan
A PET scan looks at your entire body.
For this test, a mildly radioactive sugar is injected into a vein. Cancer cells absorb
more of this sugar than normal cells, and the radioactive material shows up as "hot"
spots on the images taken during the scan. To have the scan, you’ll need to lie still
on a table that’s pushed into the PET scanner. The whole process may take several
hours. A PET scan is often combined with a CT scan (PET-CT scan). This allows areas
that show up on the PET scan to be compared to the more detailed images of the CT
scan. This test is very good for looking for cancer that has spread from where it
first started.
Procedures to learn more about the cancer
Bone marrow aspiration and biopsy
These tests are done at the same time and may be needed after Ewing sarcoma has been
diagnosed. They can help show if the cancer has spread to the bone marrow. This is
the soft, spongy, inner part of many bones. For these tests, your healthcare provider
uses hollow needles to take out tiny pieces (samples) of bone marrow and bone. The
samples are often taken from the back of your hip bones.
Teens and adults may be awake when this is done (with the area numbed). But children
are often given medicines to make them sleep during the test.
The bone and bone marrow samples are sent to a lab where tests are done to check for
cancer cells.
Blood tests
Blood tests are commonly done after Ewing sarcoma has been diagnosed. They can be
used to get an idea of your overall health. They can show how well your bone marrow,
kidneys, liver, and other organs are working.
Working with your healthcare provider
Your healthcare provider will talk with you about which tests you need. Get ready
for the tests as instructed. Be sure you know what the test will be like and why it's
being done. Ask questions and talk about any concerns you have. Also ask when and
how you'll get your results and who will talk to you about what they mean.