Treatment of Solid Tumors

The treatment of children with Solid Tumors is complex and requires the coordinated care of many experts including pediatric oncologists, surgeons, radiation specialists, radiologists, nurses, and other professionals. For a successful outcome, all these individuals may be involved in the care of your child at one time or another.

Your child will undergo a series of blood tests and diagnostic imaging studies when they are admitted to St. Jude. These include:

• A complete blood count (CBC). This reveals whether your child has anemia, a low platelet count, or an infection.
• A set of blood chemistries (sodium, potassium, etc.). These tests tell your doctors whether your child's kidney and liver function are normal, and whether nutrition is adequate.
• A set of blood coagulation tests. These determine whether your child is prone to bleed or not.
• A urinalysis. This shows whether your child's kidneys are working well and whether there is blood in the urine.
• Bone marrow aspirate and biopsy. This is done to see whether the tumor has spread into the bone marrow cavity.

After these tests are done, several diagnostic imaging methods may be used, including:

• Magnetic resonance imaging (MRI) in the area of primary tumor involvement. This will show where the tumor is, how big it is, and if it can be safely removed by surgery.
• Computed tomography (CT, or "CAT" scan) of the affected area. This shows whether the tumor has spread.
• Nuclear medicine bone scan. This helps to determine whether the tumor has spread to the bones.

Finally, if your child has a tumor in the sinuses or near the orbit, a spinal tap will be performed to see whether the tumor has spread into the spinal fluid.

The results of these tests are used to determine what stage the tumor is in (I, II, III, or IV). It is very important to correctly stage the tumor, because the amount of treatment given to your child depends upon the tumor size and stage. After your doctors have established a diagnosis and have staged the disease, they will develop a treatment plan. The treatment plan will depend on the size of the tumor, the potential of surgery to remove the tumor, the amount of tumor left after surgery, the presence of cancer cells in regional lymph nodes, and whether or not there has been metastasis.