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Navigating tests and reports

Ongoing monitoring as you go through treatment and in follow-up involves a certain number of tests, including laboratory tests and imaging techniques. It’s important to keep a copy of the test results available so they can be discussed with your healthcare team so that you clearly understand the meaning and their implications.

 

Imaging techniques

A CT scan is an imaging method that uses x-rays to create cross-sectional pictures of the abdomen, chest or head. CT stands for computed tomography.

A magnetic resonance imaging (MRI) scan of the abdomen is similar to a CT scan. Under special circumstances, it may be better suited than a CT scan. It is devoid of radiation. MRI may be less accessible than CT scans.

Ultrasound is an imaging procedure used to examine the internal organs of the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. The blood vessels that lead to some of these organs can also be looked at with ultrasound. For example, an ultrasound of the heart (cardiac echo) can be performed prior to starting therapy to confirm good heart function. An ultrasound can be performed to look for liver metastases.

A bone scan is a test performed with weak radioactive substances (at a hospital department of nuclear medicine) that can identify bone metastases.

A skeletal survey is a series of x-rays of all bones that is used to look for bone metastases. Some bone metastases may not show on a bone scan.

A MUGA scan is a test performed with weak radioactive substances to examine heart function. It provides similar information to a cardiac echo (see Ultrasound).

A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm. A chest x-ray can be used to follow the extent of lung metastases. Alternatively, it may be used to ensure that the lungs are not damaged by some medications.

A positron emission tomography (PET) scan is an imaging test that uses a radioactive substance (called a tracer) to look for metastases. It identifies areas of the body that may harbour cells that are more active than usual. Cell activity may imply cancer activity. PET scans may therefore detect sites of metastases that cannot be otherwise detected by CT or MRI.

BLOOD CHEMISTRY

Kidney cancer can affect the levels of certain chemicals in the blood. Blood chemistry tests evaluate such things as electrolytes (sodium, potassium, chloride, bicarbonate), blood urea nitrogen (BUN), calcium, and creatinine. These substances indicate whether the patient can or cannot tolerate certain treatments. For example, some medications may affect renal function. Serum creatinine provides information on whether renal function is or is not adequate. These blood levels are routinely measured before and during therapy.

 

LIVER FUNCTION TESTS

These tests assess levels of albumin, ALP (alkaline phosphatase), ALT (alanine transaminase), AST (aspartate aminotransferase), gamma-glutamyl transpeptidase (GGT), prothrombin time, serum bilirubin, and urine bilirubin. These substances indicate whether the patient’s liver can or cannot tolerate certain treatments. These are routinely measured before and during therapy.

 

COMPLETE BLOOD COUNT

  • The number of red blood cells (RBCs)
  • The number of white blood cells (WBCs)
  • The total amount of hemoglobin in the blood
  • The fraction of the blood composed of red blood cells (hematocrit)
  • Average red blood cell size (MCV)
  • Hemoglobin amount per red blood cell (MCH)
  • The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC)
  • Platelet count

These substances indicate whether the patient’s red blood cells (allow the functioning of all organs), white blood cells (immune cells) and platelets (coagulation) are adequate to tolerate certain treatments. These are routinely measured before and during therapy.

 

URINALYSIS

Analysis of substances present in the urine. Some medications may affect renal function and the presence of these substances may be detected in the urine. For example, protein is usually not present in the urine. Excessive amounts of protein may imply kidney damage.

Further detail can be found at MedLine Plus (a service of the U.S. National Library of Medicine and the National Institutes of Health) at www.nlm.nih.gov under Renal Cell Carcinoma.

 

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