Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of retinoblastoma, including:
- medical history and physical examination
- eye examination
- blood tests
- urine tests
- medical imaging, which may include
- ultrasound of the eye
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- bone scan.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with retinoblastoma, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is, which nearby organs are involved and whether the cancer has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.
There are different ways to assess the stage or extent of disease. One of the most common ways to describe stages for retinoblastoma is the International Retinoblastoma Staging System:
- Stage 0 – the tumour has not spread beyond the eye and was treated without surgery, and the eye has not been removed.
- Stage I – the tumour has not spread beyond the eye, the eye has been removed, and there are no cancer cells left.
- Stage II – the tumour has not spread beyond the eye, the eye has been removed, but some cancer cells are left.
- Stage IIIa – cancer has spread to tissues in the eye socket.
- Stage IIIb – cancer has spread to nearby lymph nodes.
- Stage IVa – cancer has spread to the blood but not the brain or spinal cord, and there may be secondary tumours in other parts of the body.
- Stage IVb – cancer has spread to the brain or spinal cord, and possibly other parts of the body.
The American Cancer Society describes other systems for staging retinoblastoma.