Further tests for primary bone cancer
If your tests show that you have bone cancer, the doctor may want to do some further tests to see whether the cancer has spread outside the bone.
Tests may also be arranged to see how well your kidneys, heart and other organs are working, as these may be affected by any treatment that you have.
The tests may include any of the following:
In primary bone cancer the most common place for the cancer to spread to is the lung. A chest x-ray can show whether the lungs have been affected.
CT (computerised tomography) scan
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A CT scan can also be used to check whether a cancer has spread to the lungs.
A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10-30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with.
You will be asked not to eat or drink for at least four hours before the scan.
You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.
You’ll probably be able to go home as soon as the scan is over.
This test is only needed if you have, or are likely to have, Ewing’s sarcoma. Very occasionally, a Ewing’s sarcoma can spread to the bone marrow, which is the spongy material inside bones where blood cells are made.
A small sample (biopsy) of bone marrow is taken from the hip bone. Adults will be given a local anaesthetic injection into the area around the bone to numb it. Children will usually have a general anaesthetic. The doctor will then pass a special needle through the skin into the bone. When the needle is in position, the doctor will draw a small liquid sample from the bone marrow into a syringe. You may feel some discomfort when this is being done but it should only last for a few seconds. You can be given painkillers if you need them.
The test is usually done in the outpatient department and takes about 10-15 minutes.
Sometimes a small core of marrow is needed (a trephine biopsy). This procedure takes a few minutes longer. A special type of needle is passed through the skin to the bone marrow. The needle has a tip that can cut out a sample of the bone marrow. You may feel bruised after the test and have an ache for a few days. This can be eased with mild painkillers.
Your bone marrow samples will be sent to a laboratory to be looked at under a microscope. It may take 7-10 days to get the results.
If you’re going to have chemotherapy, you will also have tests to check your kidneys, heart and hearing.
Some chemotherapy drugs can affect how well you hear high-pitched sounds. So you may have hearing tests (audiograms) before and during your course of chemotherapy.
To check how well your kidneys are working, you may have a small amount of mildly radioactive liquid injected into a vein in your hand or arm. The radioactive liquid will be carried through your kidneys then passed out in your urine. A few hours after the injection, a nurse will take blood samples from you. These will show how well your kidneys are working.
You may also have an electrical trace taken of your heartbeat (an ECG), an ultrasound scan of your heart (echocardiogram) or a MUGA (multiple-gated acquisition) scan. A MUGA scan shows the movement of the heart and is used to assess heart function. If you need a MUGA scan your doctors will give you more information about it.