The doctor may order a bone scan if concerned that your child’s cancer has spread to a bone.
Some doctors order regular bone scans to look for potential tumours in children and adult survivors with a constitutional RB1 mutation. Routine scans are not recommended for these individuals as the radiation exposure increases risk of second cancers.
Bone scan radiation is equivalent to 200 regular X-rays.
Before the Scan
Bone scans are done in the nuclear medicine or medical physics department. 2-3 hours before the scan, your child will be given an intravenous injection of a radioactive material. Abnormal bone absorbs more of this than healthy bone, and shows brighter on the scan.
The radiographer will ask if your child has asthma, because some people with asthma react to radionuclide. If your child has asthma, a pre-scan steroid will be prescribed to prevent a reaction.
The radionuclide injection may make your child feel hot and flushed for a minute. The injection does not hurt, but she may cry if she is unprepared for the sensation.
After the injection your child will be free to leave the department for a few hours. However, you may not be allowed into play areas with other children. Ask what the restrictions will be ahead of time, and plan accordingly.
Your child will be encouraged to drink lots during this time to help flush the radionuclide through the body. The radiographer will also ask your child to pass urine before the scan. This removes radionuclide from the bladder so it does not interfere with the scan. Check with the radiographer whether you can bring your child’s favourite drink to encourage drinking.
During the Scan
Your child may be asked to undress and put on a hospital gown, and will need to lie very still on the scanner bed. Young children are often given a short acting general anaesthetic at this point, but with good child life support, children as young as 2 years can complete the scan awake.
The painless scan takes about an hour, using a large machine called a gamma camera. Your child’s body will be slowly moved through the doughnut shaped scanner. She will be able to hear, and speak to, the radiographer through a microphone.
The radiographer leaves the room during the scan. Many hospitals allow parents to stay if the scan is done awake. You have the right to request this. Do advocate to stay with your child as your presence can be very reassuring. You will be asked to wear a lead apron to protect you from radiation exposure.
Some people feel claustrophobic inside the scanner, so prepare your child for this beforehand. You can often arrange a pre-scan visit with your child to familiarise yourselves with the machine.
After the Scan
If your child completes the scan awake, you will be free to go as soon as it is over. If she has sedation or a general anaesthetic, you will usually be taken to recovery or a day care ward. You will be allowed to leave once she is fully awake and has had something to drink.
The body can take up-to 24 hours to completely remove all the radionuclide. Drinking plenty of fluids will speed up the process. The radiographer or nurse will explain any precautions you need to take for the rest of the day. If you are unsure about what is expected or what the risks are, ask for clarification before leaving the hospital.