Tests for cancer in young people

Some tests are done to diagnose cancer and some are to assess how far the cancer has spreadDoctors and nurses were usually very kind to the young people we interviewed who were having tests. When possible young people were able to have one of their parents with them, to hold their hand, distract them with talk or crossword puzzles, or reassure them about what was happening. Sometimes it was only during the initial tests that young people became aware that there was something seriously wrong with them.

Realised that there must be something seriously wrong when the man doing the ultrasound suddenly…

Age at interview 24

Gender Male

Age at diagnosis 16

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People didn’t always understand what the tests were for, or what would happen. One girl said, “I was having all these things done to me, and I didn’t really understand what they were doing” (Interview 08). Others were frustrated when nobody told them that their test results had come back, which sometimes caused days of unnecessary worry.

Tests to discover the diagnosis

Initial tests are likely to include blood tests and x-rays. If the tests suggest that something is wrong, then further tests, including scans and biopsies (when tissue samples are removed to be tested), may be needed to help the doctors to make a diagnosis. These tests are also used to clarify the position and spread of the cancer, and so establish the ‘stage’ of the cancer. (See also ‘Hearing the diagnosis‘.) Cancers occur in different parts of the body and some cancers are easier for doctors to access than others.

Explains the different stages (I to IV) of Hodgkin’s lymphoma and describes the tests that…

Age at interview 19

Gender Male

Age at diagnosis 14

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It took a few months and several tests before he was diagnosed with Burkit’s lymphoma.

Age at interview 23

Gender Male

Age at diagnosis 23

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Had a biopsy quite quickly but waited 3 months for treatment because his rare cancer was hard to…

Age at interview 21

Gender Male

Age at diagnosis 16

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Different tests are used to diagnose different cancers. Surgical biopsies are used to obtain small amounts of material from lumps in the body that are suspected to be tumours. These biopsies are then examined under a microscope.

A diagnosis of leukaemia involves many blood tests, bone marrow tests and spinal fluid tests. Many of the teenagers we interviewed had scans – CT, PET, bone or MRI scans – at diagnosis stage and throughout treatment.

Talks about his blood tests and his lung test he had before radiotherapy.

Age at interview 19

Gender Male

Age at diagnosis 15

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Describes her biopsy, which was done after a CT scan showed a ‘big lump.

Age at interview 21

Gender Female

Age at diagnosis 18

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Explains what happened when he went for a ‘bone marrow’ biopsy.

Age at interview 18

Gender Male

Age at diagnosis 18

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Going for diagnostic tests takes up a lot of time, especially for those who had to travel to another city for specialist tests and scans. Many of those interviewed were still going to school every day and kept busy with school work and revising for their GCSEs or A level exams. Others were worried but found it difficult to ask questions at this stage. Few thought that it could be cancer.

Tests and procedures before and during treatment

Before any course of chemotherapy a blood test is done to show that there are adequate white blood cells, especially neutrophils (to fight infection), enough platelets (needed for blood clotting) and a normal haemoglobin level (enough red blood cells). Other tests include heart and lung tests, kidney tests and hearing tests to check that the young person is well enough to have their treatment. Further chemotherapy is not given without having a blood test to confirm that the bone marrow had recovered from the previous course of chemotherapy. During treatment tests such as lumbar punctures (LPs) and scans are important to show whether the cancer is responding.

Describes his first CT scan and how the strange warm feeling (from the injection of the dye in…

Age at interview 25

Gender Male

Age at diagnosis 22

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Describes what it is like having a PET scan.

Age at interview 19

Gender Male

Age at diagnosis 14

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An ophthalmologist (eye doctor) recommended an MRI scan after doing various visual tests.

Age at interview 26

Gender Male

Age at diagnosis 17

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Tests for the cause of infections, or to locate infections, are common for all cancer patients. Chest X-rays are sometimes used to look for chest infections and ultrasound scans of the abdomen are sometimes used to look for fungal infections.

Lumbar punctures (LPs), where a needle is inserted into your back, between your vertebrae into the fluid surrounding your spinal cord, are sometimes used throughout treatment to find out if cancer cells are present in your spinal fluid and to give regular injections of chemotherapy into the spine, to treat cancer cells and to prevent spread of the cancer to the brain and spinal cord.

Lumbar punctures are done under local or general anaesthetic, some people we talked with were given fas and air, or what some called ‘happy gas’ and there were different opinions about which was better (some people get nauseous after a general anaesthetic while others much prefer to be ‘knocked out’). After a lumbar puncture it is necessary to lie still for a few hours, which some young people found very difficult.

Felt nauseous after a general anaesthetic so had his next lumbar puncture under local anaesthetic.

Age at interview 18

Gender Male

Age at diagnosis 14

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Had his lumbar punctures and intrathecal operations under sedation.

Age at interview 17

Gender Male

Age at diagnosis 11

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Some forms of cancer need to be treated by having a ‘bone marrow’ transplant. This is because treatment with chemotherapy and/or radiotherapy may need to be so intensive that it destroys the cell-making bone marrow (bone marrow produces blood cells). Before starting intensive treatment some bone marrow cells are extracted via a needle, for later use. Otherwise someone else’s bone marrow (a matched donor who may be a brother or sister or relative or just someone from the general public) may also be used. After treatment when all the bone marrow may be ‘knocked off’ (damaged and no longer able to produce healthy blood cells), people are then given back either their own stored bone marrow cells, or those of the matched donor.

Describes having a bone marrow transplant and being in strict isolation afterwards.

Age at interview 19

Gender Male

Age at diagnosis 15

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Going to your GP

Cancer is rare in young people. Therefore when a GP sees a young person with certain signs or symptoms they tend to think of the...

Hearing your diagnosis of cancer

Young people are usually told about their diagnosis (what their illness is) by their hospital consultant. What the doctor says is based on the results...