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Other Evaluation Tests

Laboratory tests usually are not used to diagnose clear cell sarcoma; but to provide a baseline measurement of your child's organ function prior to starting chemotherapy and to make sure that treatment can be done as safely as possible. They are repeated during his or her treatment to track any changes in organ function. Lab tests are done by drawing a little bit of blood out of a vein. This can be done by a phlebotomist, who is specifically trained to draw blood from veins by using a needle. During treatment, blood can be drawn without sticking a needle into your child's arm, because usually a surgeon has placed a central venous catheter into his or her vein. The catheter is a tube running into a vein, where blood can be directly taken from using a syringe. The catheter can also be used to give medications safely and with much less pain or worry for the child.

Common test for examination of the blood include:

• Complete blood count (CBC) --Used to look for increased risk of infection, anemia, or low platelet counts.
• Calcium
• Creatinine levels to assess the function of the kidney
• Liver function tests to make sure that the liver is working well

It is also common to take a urine sample to:

• Examine for blood or evidence that the kidneys are not working well

Echocardiogram (ECHO)

An echocardiogram is a test used to determine the function and the strength of the heart, making sure that the heart pumps blood well. A jelly-like substance is put on the skin, and a wand is used to rub over the jelly. The wand is used to send and detect sound waves that bounce off of the heart. A computer is then used to create a picture of the heart using the sound waves.

During chemotherapy a drug call doxorubicin is routinely used. One possible side effect of this drug is an increased risk of heart problems. So, echocardiograms are routinely done throughout treatment, so that your child's physician can keep an eye on the heart function. This ensures that chemotherapy is given as safely as possible.

It is recommended to have an echocardiogram done before chemotherapy starts and at regular intervals during chemotherapy treatments.

Electrocardiogram (EKG)

An electrocardiogram is a test used to make sure that the electrical activity of the heart is normal. Small electrodes are placed on your child's wrists, ankles and chest. The electrical signals of the heart travel from the electrodes through wires to the EKG machine. The electrical currents in your child's heart stimulate their heart muscles to contract and relax. These electrodes record the electrical signals of your child's heart on a graph, and tell the doctor whether or not your child's heart is functioning properly, with normal heart rate and rhythm.

Audiogram

An audiogram is a record of how well a person can hear different sound frequencies. If the graph detects a decreased range of frequencies, then some hearing loss has occurred.

During chemotherapy in stage IV CCSK, a drug called carboplatin is used. One possible side effect of carboplatin is hearing loss. So, an audiogram is done to detect the extent of hearing loss. If hearing loss occurs, your child's doctor may need to adjust the chemotherapy, depending on the comparison of how serious the hearing loss is to how serious the tumor is.

An audiogram will be done at regular intervals throughout your child's treatment.