Your child's health care provider will ask about your child's health history and symptoms. He or she will examine your child. Your child may be referred to a specialist. This may be a bone specialist (orthopedic surgeon) or a bone cancer specialist (orthopedic oncologist). Your child may have tests such as:
- X-ray. An X-ray uses a small amount of radiation to take pictures of bones and other body tissues.
- Blood tests. The blood may be tested to look for signs of Ewing sarcoma.
- CT scan. This test uses a series of X-rays and a computer to make detailed images of the body.
- MRI. This test uses large magnets, radio waves, and a computer to make detailed images of the inside of the body.
- Bone scan. A small amount of radioactive dye is injected into a vein. The whole body is scanned. The dye shows up in areas of bone where there may be cancer.
- 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.
- Bone marrow aspiration or biopsy. Bone marrow is found in the center of some bones. It’s where blood cells are made. A small amount of bone marrow fluid may be taken. This is called aspiration. Or solid bone marrow tissue may be taken. This is called a core biopsy. Bone marrow is usually taken from the hip bone. This test may be done to see if cancer cells have reached the bone marrow.
- Tumor biopsy. A sample of the tumor is taken. It may be taken with a needle or by a surgical cut (incision). It is checked under a microscope for cancer cells. A biopsy is needed to diagnose sarcomas.
After a diagnosis of Ewing sarcoma, your child may have other tests. These help the health care providers learn more about the cancer. They will show how much and how far the cancer has spread (metastasized) in your child's body. A stage grouping is then assigned.
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 cancer 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 health care provider to explain the stage of your child's cancer to you in a way you can understand.