Pediatric Cancer Diagnosis and Stages
UT Southwestern Medical Center partners with Children’s Health to treat children with blood cancer, brain tumors, sarcomas, and other cancers. Our multidisciplinary teams provide an optimal level of care and support for pediatric patients and their families, and it begins at evaluation and diagnosis.
U.S. News & World Report’s Best Children’s Hospital 2021-2022 list ranks our pediatric cancer program No. 22 in the nation.
Pediatric cancer is rare, so it’s important for patients to receive prompt evaluation of symptoms from experienced pediatric oncologists. We treat a high volume of patients, offering a high level of expertise and experience.
Diagnosing Pediatric Cancer
Our cancer specialists begin an evaluation with a:
- Discussion of symptoms and possible risk factors
- Review of personal and family medical history
- Physical exam
Further diagnostic tests may be needed to confirm a diagnosis. Depending on the type of cancer suspected, this might include a biopsy, which is the removal of a small piece of tissue. This is often the main way to confirm a diagnosis.
For example, if a pediatric blood cancer is suspected, the doctor may perform a bone marrow biopsy, using a needle to remove a small sample of bone marrow (the tissue inside bones that produces blood cells) as well as a piece of the bone. The sample is then analyzed in a lab for abnormal cells.
If the child has a brain tumor or solid tumor, we may perform a biopsy so we can make a diagnosis and determine the type of tumor.
Other diagnostic tests for pediatric cancer include:
- Blood tests: We take a small sample of blood, usually from a vein in the child’s arm, to measure the amount of certain substances in the blood. This provides important information about organ function and could indicate the presence of cancer cells.
- Imaging tests: Procedures such as bone scans or X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, positron emission tomography (PET)/CT scans, and ultrasound produce detailed images of the organs, bones, and soft tissues from inside the body and help us identify areas of concern.
- Lumbar puncture: This test, also called a spinal tap, checks for leukemia or lymphoma cells in cerebrospinal fluid, the liquid that surrounds and protects the brain and spinal cord. The doctor uses a thin needle to take a small sample of fluid for testing.
- Neurological exam: If a brain tumor is suspected, we’ll perform a neurological exam to evaluate the child’s nervous system (brain, spinal cord, nerves). This exam may include an evaluation of the patient’s hearing, vision, balance, reflexes, and strength.
Stages of Pediatric Cancer
Staging is a way to measure the spread of the cancer beyond its original site. It’s one of the factors that doctors take into consideration when forming a treatment plan.
Many cancers have stages – 1, 2, 3, or 4 – with some stages divided into substages. The lower the number, the more contained the cancer is. A higher number indicates that the cancer is more advanced.
However, not all pediatric cancers follow this system. Blood cancers have unique designations that depend on the age at presentation, genetics of the cancer, and other factors. For example, acute lymphoblastic leukemia is grouped by “standard risk” and “high risk.”
Cancerous brain tumors do not follow a staging system. Instead, doctors typically use a grading system that measures how fast the tumor might spread and how abnormal the cancer cells are.
Parents should consult their doctor about their child’s cancer stage and how it affects their treatment plan.