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TESTS AND PROCEDURES

During your Journey, your physician may order a variety of tests. The purpose of these tests may be:

This may involve (but is not limited to):

Routine Blood work

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Histological/cytological exams

Here is a closer look at what these tests mean.

Blood work/Labs

Your Oncologist will determine when you require a blood test. The type of blood test and the frequency at which they are drawn depends on different factors. Examples of when you will have a blood test include:

Before treatment begins:Information from a blood test before treatment begins helps your health care team learn more about your body’s baseline and may serve as a means of comparison with blood tests repeated during and/ or after treatment.

While you are undergoing chemotherapy:It is important for your health care team to monitor the effects of the therapy/treatment that you are receiving. Some chemotherapy suppresses the bone marrow (a condition where the bone marrow is unable to produce the normal level of red blood cells, white blood cells & platelets). Verifying blood test results before treatment is a precaution that is taken to ensure safe administration of chemotherapy.

White blood cells are cells in your blood that fight infection in your body. Red blood cells are cells that carry oxygen throughout your body. Platelets are blood cells that help your blood to clot when you are injured.

After treatment:You will be followed by your Oncologist for some time after treatment. During follow-up appointments, your physician may order blood work to monitor your progress/response to treatment (possibly in conjunction with other tests).

Tumour markers:A tumour marker is a substance found in the blood, urine, or body tissues that can be elevated in cancer, among other tissue types. There are many different tu-mour markers, and they are used in oncology to help detect the presence of cancer. An elevated level of a tumour marker could indicate cancer; however, there can also be other causes of the elevation.

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Medical Imagery

X rays

An X ray is painless test that takes pictures of the inside of your body. It is used to study various parts of your body such as your bones, heart and lungs, etc.

Ultrasound

An ultrasound is a painless test which uses high frequency sound waves to create an image of the inside of your body. It can be used to examine blood vessels and organs (e.g. liver, kidneys, or stomach) that need to be studied.

Scans

COMPUTED TOMOGRAPHY SCAN (CT) A CT scan is an imaging test that uses special

x-ray technology to create a 3-dimensional image. Similar to a loaf of sliced bread, your doctor can study each of these slices separately or together. Typically, a CT scan is ordered by the physician to help get a closer look at internal structures such as organs, tissues, bones, and/ or blood vessels. This information may help your physician make a cancer diagnosis, to help guide treatment and/ or the cancer’s response to treatment, or as a means of monitoring your progress after treatment.

Some CT scans require a contrast medium to improve the quality of the image(s). The contrast may be injected through a vein by a technician, or you may be asked to drink a contrast solution; depending on the body structure that is being evaluated. You will be given specific instructions if and when a CT scan is planned for you.

POSITRON EMISSION TOMOGRAPHY (PET) SCAN A PET scan is based on the premise that cancer

cells/tumours use glucose at an accelerated rate (compared to “normal” tissue). This nuclear medicine test uses a form of radioactive sugar to display the functioning of the body at the cellular level.

Due to the very high cost of PET scan machines,

they are not readily available at all hospital centres in Canada. Although not currently available at St. Mary’s Hospital Center, patients requiring a PET scan are referred to another hospital in the area for the diagnostic test. The results are sent to your treating physician and discussed with you once available.

Specific instructions will be given to you about how to prepare for this test if and when your physician requests a PET scan.

A bone scan is an imaging test that helps diagnose and track several types of bone disease and evaluate the entire skeleton. It is an important tool for detecting cancer that has spread (metastasized) to the bones.

During a bone scan, you will receive an injection of a radioactive liquid into your vein. The radioactivity is not strong enough to cause you any harm. The liquid travels through your blood to the bones. As it wears away, it gives off radiation. This radiation is detected by a camera that slowly scans your body. The camera takes pictures of how much of the liquid has collected in your bones.

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Depending on your chemotherapy treatment, some medication could affect the heart muscle. During your treatment, your doctor may request monitoring of your cardiac function by means of the MUGA scan.

This MUGA scan creates video images of your heart ventricles to access proper heart muscle functioning.

MAGNETIC RESONANCE IMAGING (MRI)This test involves the use of powerful magnets and radio waves to create a picture of a specific part of your body. MRIs are used to give your treatment team more information about the cancer. Unlike x-ray and CT scans, MRI machines produce cross sectional, three-dimensional images of the body

without using the use of radiation. The area that is to be visualized is exposed to a strong magnetic field (which aligns all of the atoms of the “targeted” organ or area in one direction). An image is generated when the magnet is deactivated and the atoms return to their normal alignment. Your physician may order an MRI if other diagnostic tests are unclear, if the goal is to visualize “hard to see” areas or if investigation of neurological tissue is needed.

An MRI cannot be done if you have certain metal devices such as a pacemaker as the powerful magnetic force of the MRI machine could dislodge the device. If your physician orders an MRI, you will be given specific instructions as to how to prepare for the test.

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Bone marrow aspiration (biopsy)

Bone marrow is a spongy substance found inside our large bones, such as the femur (thigh), hips, and ribs. It is made up of cells called hematopoietic stem cells. Hematopoietic stem cells are “baby” cells that grow up to become white blood cells, red blood cells, or platelets. The bone marrow acts as a greenhouse for these cells, growing them and storing them until they are needed. Unfortunately, sometimes cancer cells can find their way into the bone marrow, making it difficult for the marrow to do its job of producing healthy blood cells.

Bone marrow aspiration and biopsy are tests to check the function of your bone marrow or to check for the presence of cancer cells. Bone marrow biopsy involves using a needle to take a small sample of the bone and marrow. You will be given a medication to freeze or numb the area and a medication to relax if needed. If your physician orders a bone marrow biopsy, you will be given specific instructions as to how to prepare for the test.