Should Surveillance for Seminoma include CT scan of remaining testicle?

[AlexG]

Hi all,
I have been doing surveillance for 1 year for stage 1 seminoma.
I get an Abdomen+Pelvic scan every 3 months.
Actually I get "two" scans each time - one with contrast and one without..
How common is it to have pelvic scan?
I asked and they said the pelvic scan *does* include the testicle.
What bothers me about it is that my remaining testicle is exposed to so much radiation during the pelvic scan.
Why can't they just stop at the pubic bone?
Since the testicle can be examined with ultrasound, there seems to be no need to scan it.
If i mention this concern to Docs or technicians, they just ignore me or tell me not to worry so much.
Thanks,
Alex

[Fed]

Hey Alex,
The reason for the pelvic CT scan is to check the lymph nodes in that area and not to see whether there are any masses in your remaining guy. Let's just say that the remaining testis is more of an innocent by-stander, since, as you correctly point out, an ultrasound gives a better picture of potential testicular masses. Although you do get more radiation from a CT scan than you would with, say, and X-ray, it is still considerably lower than what you would get from RT. Since you are already one year out, you only have two years left with the frequent follow-up schedule (CT scans every 3-4 months). Hope this clears things out a bit. Cheers,

[Krokar]

Hi,
CT is never done on remaining testicle, you should keep that in a good shape. That's why for remaining testicle US (ultrasound) is good choise. Normally every 6 months on surveilance also ultrasound of remaining testicle is a good choise.

Good luck.

[AlexG]

Thanks,
So Fed, Does your surveillance include a pelvic scan as well?
Typically I see only Abdominal CT recommended.

And why can't they cover the remaining testicle anyway during the pelvic CT since ultrasound is the preferred way to examine it?
Although the radiation is 'low', it is still equivalent to hundreds of x-rays/scan.
Thats greater than 1000 needless x-rays per year for us surveillance guys.

By the way, where do you have your scans? I also live around Boston.

Thanks,
Alex

[Fed]

So Fed, Does your surveillance include a pelvic scan as well?

Yup. So far I've gotten the whole package.

And why can't they cover the remaining testicle anyway during the pelvic CT since ultrasound is the preferred way to examine it?

I don't see how they could do it physically, considering the setup of the instrument. If they are looking at inguinal nodes, for example, they have to image right around your groin. I don't know whether there is a shield or a cup they could use...

By the way, where do you have your scans? I also live around Boston.

In the beginning I was having everything done at the Brigham, but now I get all of my radiology done here at Dana-Farber (I work here, and my oncologist is just an elevator ride away). The contrast agent used at DFCI is way better than the nasty chalky stuff they give you at the Brigham . Where do you go?