ULTRASOUND Ultrasound is a technique that uses the echoes from high-frequency sound waves to produce a picture of internal organs or tumors. In children with retinoblastoma Ultrasound is used to produce a picture of the inside of the eye. The picture can tell your doctor about the size and number of tumors. It is helpful for staging the tumor and monitoring response to treatment. An ultrasound is a painless test that does not use radiation. The child lies on a table for a short time, and a small, round handle is moved around to get a clear picture of the tissue or organ being examined. Sometimes a clear jelly may be applied to the eyelids (the jelly wipes off easily after the test). BONE MARROW ASPIRATION AND BIOPSY A bone marrow biopsy is a test done to determine whether tumor cells are in the bone marrow. Not all children with retinoblastoma will need a bone marrow aspiration and biopsy. If they do, it may be done only once, or may need to be repeated to monitor the effect of treatment. A needle is inserted into the middle of a large bone (usually the hip bone). Some of the bone marrow (the biopsy) and the fluid in the bone marrow (the aspirate) are collected. Patients undergoing bone marrow aspirations and biopsies may experience pain, so children are often sedated for this procedure. If your child is uncomfortable after the test, a mild pain medication such as acetaminophen (Tylenol®) may be given, but not ibuprofen (Motrin® or Advil®) or aspirin. A specially trained doctor (a pathologist or hematologist) examines the biopsy or aspirate under a microscope to look for any abnormal cells, such as tumor cells. During treatment, the bone marrow is checked regularly to determine response to the treatment. The number of cancer cells can be measured and will indicate how well the treatment is working. LUMBAR PUNCTURE A lumbar puncture is a procedure done to obtain a small sample of cerebral spinal fluid (CSF), which is the fluid that surrounds and protects the brain and spinal cord. CSF is made continually by our bodies, so the small amount removed is quickly replaced. The central nervous system (brain, spinal cord, and CSF) can be a hiding place for retinoblastoma cells and this test can help determine if any cancer cells have spread to the brain or spinal cord. Not all children with retinoblastoma will need a lumbar puncture. If they do, it may be done only once, or may need to be repeated to monitor the effect of treatment. In a lumbar puncture, also referred to as a spinal tap, a needle is inserted into the back between the spaces of the spinal bones (vertebrae) to obtain a sample of CSF. The needle enters the spinal column below the spinal cord to avoid injuring the cord. This test can be uncomfortable, so some children are sedated to help them lie still. The results will help the physicians determine the type of treatment your child will receive.
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Association of Pediatric Hematology/Oncology Nurses (APHON)
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