WHAT ARE METASTASES? Metastases refer to the spread of the tumor from its first location to other parts of the body. If germ cell tumors metastasize, or spread, the most common places are to the lungs, liver, and central nervous system (brain). WHAT IS STAGING?
Staging is a way of identifying the location and amount of tumor at the time of diagnosis. There are four stages of germ cell tumors: • Stage I . The tumor can be fully removed surgically, the tumor has not spread, and the tumor markers are normal. • Stage II and III. The tumor has spread to local tissues or lymph nodes and may not be removed fully with surgery alone. • Stage IV. The tumor has spread to at least one other part of the body. The treatment method suggested for your child depends upon the stage of disease at the time of diagnosis.
WHAT TESTS AND PROCEDURES WILL MY CHILD NEED? To diagnose a germ cell tumor and decide the extent of your child’s disease, a number of tests and procedures will be needed, including many of tests described in the paragraphs below. TUMOR BIOPSY A tumor biopsy is the removal of a small amount of tissue to be looked at under a microscope. This test is needed to confirm the diagnosis and decide what the best treatment is. The biopsy most often is performed in the operating room by a surgeon who removes an enlarged lymph node or a small part of a tumor. In some medical centers, the biopsy is done in the radiology department, where a needle is guided into the lymph node or tumor to obtain the biopsy sample (fine needle aspiration biopsy). In other cases, a surgical incision is made. Patients are often sedated for biopsies; your child’s comfort and anxiety level will always be considered in planning for this procedure. BLOOD TESTS Blood tests help diagnose medical problems and monitor for side effects of treatment. A specially trained nurse or technician uses a needle to collect blood from a vein. The blood samples are collected in tubes that are sent to a laboratory to be closely examined. In some cases, a finger prick may give enough blood for a test. These tests are usually done at the time of diagnosis to rule out other diseases and serve as a baseline for your child. Complete Blood Count Blood is made up of plasma (the liquid part of the blood) and cells floating in the plasma. There are three types of blood cells: white blood cells, red blood cells, and platelets. The white blood cells fight infection as part of the body’s immune system. The red blood cells carry oxygen throughout the body. The platelets stop bleeding by rushing to the site of an injury to form a clot. A complete blood count, or CBC, is a blood test that measures the amount and health of these three types of cells. The CBC is useful in diagnosing blood disorders. It also is used to diagnose cancers of the blood system, such as leukemia. Your child’s CBC results may change with each test because of other things going on in the body, such as infections or nutritional problems, or in response to medications like chemotherapy.
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