DSRCT and Diagnostics

Introduction

Warning: This information is provided for information purposes. You should always discuss your individual case with your own physician. Keep in mind that there are different stages of DSRCT tumors, from one local tumor to metastatic disease. Please find out which stage your physician considers your tumor to be.

The following are the tools used by the medical field to diagnose or keep an eye on DSRCT tumors (well, all types of cancer). Please be aware that in stage IV disease some of these diagnostic tools do not pick up the extent of cancer that can be present within the abdomen. This information is based on numerous reports from patients with DSRCT who have had an abdominal CT or PET scan and than during surgery it is discovered there is widespred disease. This is possibly due to the fact that DSRCT seems to come in a variety of sizes from volley ball sized abdominal tumors to golf ball size to nodules to microscopic seeding.

Patients should be aware that CT and PET scan reports of 'no visible evidence' of disease can mean that the diagnostic tools can't spot the cancer because it is too small. The only way to determine if a patient has no disease is from biopsy or exploratory surgery or from the passage of time (nothing shows up).

It is hoped that this information will help patients establish a dialogue with their physicians as they try to determine the best course of treatment.

Biopsy

Sarcoma tumors are rare. Desmoplastic small round cell tumors are even rarer. Because of this a biopsy from a suspected sarcoma should be reviewed by a sarcoma pathology specialist.

It is critical before treatment begins to know exactly which type of sarcoma you have.

There are two types of biopsies that can be done, either a needle biopsy in the doctors office or incisional biopsy in the hospital. In the majority of DSRCT cases the biopsy is done in the operating room. A small incision will be made and a sample of tissue removed.

With DSRCT diagnosis has been known to take up to a week or more. It is important to get a correct diagnosis as quickly as possible. Sometimes DSRCT can be mistaken for Rhabdomyosarcoma, Germ Cell tumor, or Uterine sarcoma. Because DSRCT is rare the biopsy may need a second or third opinion.

Computed Tomography (CT)

Computed tomography (CT)is often used to locate tumors which are in the abdomen, pelvis, or chest. In the case of DSRCT it should be noted that the scans can pick up large tumors, but often misses smaller nodules and will not pick up the extent of microscopic disease.

Your oncologist will probably order a 'baseline' CT to be used as your treatment begins. The baseline CT will be compared to future CT to see if there is any change in your tumors as you undergo chemotherapy or radiation.

The CT is a useful tool for the oncologist to keep track of disease progress. Oncologists will use a CT to see if the chemotherapy or radiation treatments are reducing the size and amount of disease. When the tumors reach a certain size than the oncologist will often recommend surgery to remove the bulk of the tumors. If the CT reveals that the tumors are progressing, than the oncologist will determine that the chemotherapy is not working and will try to change the protocol.

CT can also be used in conjunction with a PET scan to give the oncologist even more information about the location and size of tumors.

Positron Emission Tomography (PET)

Positron emission tomograpy (PET) produces a three dimensional image or map of functional processes in the body. This machine is used in Nuclear Medicine and works for cancer by looking at the metabolic activity of cells in the body. Malignant tumor cells have an active metabolism and therefore can be seen on a PET scan.

In the case of DSRCT, if there are any active cancer cells than the image will 'light' up as spots.

An oncologist will order a PET scan to use as a baseline and compare the image with future PET scans. Sometimes a PET scan will be used in conjunction with a CT to give the oncologists more information about the disease.