Blood Tests Blood tests are used throughout therapy to monitor your child’s response to treatment and possible side effects of therapy. Blood tests are done to monitor blood cells, body salts, and chemistries. A complete blood count (CBC) is useful in detecting a drop in the number of red blood cells (oxygen carriers), white blood cells (infection fighters), and platelets (cells that help blood clot properly). Blood chemistries such as blood urea nitrogen (BUN) and creatinine monitor changes in kidney function. Other chemistries, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin, may be done to assess liver function. Blood tests for tumor markers may also be done. Tumor markers are substances that can be found in abnormal amounts in blood, urine, or tissues of some patients with cancer. Different tumor markers are found in different types of cancer. For example, the tumor markers AFP and bhCG are found in germ cell tumors and the tumor marker AFP is found in liver tumors. In adrenocortical carcinoma, hormone levels are tested. Tumor markers help with diagnosis, treatment follow-up, and in determining if the cancer has returned. Venous Access Device (VAD) Often, if chemotherapy is to be given, a surgeon will insert a small plastic tube called a venous access device (VAD) or line (“port”) into a large blood vessel, usually under the collarbone. The VAD can be used for blood tests, medications, chemotherapy, blood products, and nutritional support when needed. You and your treatment team will decide whether your child needs a VAD. The VAD is usually left in place until treatment is finished and then is removed. n HOW ARE RARE TUMORS TREATED? The goal of treatment for rare tumors is to cure the disease while minimizing the treatment-related side effects or adverse reactions. The most common therapies are surgery, chemotherapy, and radiation therapy. Surgery Surgery is one type of treatment used in the care of children with rare tumors. The role that surgery plays in the treatment depends upon the type, location, and extent of the cancer. Surgeries are classified according to the primary purpose that they serve in treatment. Primary surgery removes all or most of the tumor at the time of diagnosis. In some cases, the tumor is too big or is in an area of the body where it cannot be safely removed. In these cases, primary surgery is done after chemotherapy or radiation therapy, which help reduce the size of the tumor. Chemotherapy Chemotherapy involves administering medicines that will help kill the cancer cells and prevent the cancer from spreading to new places. A variety of medications are given in combination to kill the cancer cells, but no one chemotherapy medicine can control the disease by itself. Many different chemotherapy combinations are possible. The exact combination of chemotherapy agents used depends on the stage and type of cancer and other treatment considerations. Each of the medications kills the cancer cells in a different way, which is why chemotherapy medications are usually given in combinations.
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