Too many CT scans?

[fuse929]

Hey all,

Tomorrow I have my first 2-month CT scan, and I have a question I'd like to ask. From what I've been reading here and other places, it seems like CT scans every 2 months is quite a bit. Should I ask my urologist to consider 3 or 4 month cycles instead? I can understand 2 months for the first scan, but I really don't want to subject my body to over-kill, especially since my tumor was found and removed so early.

The day-before-scan-worry took it's time to get here, but I have no reason to believe tomorrow won't be full of good news!

Bobby

[Margaret]

Hi Bobby, first of all..Good luck tomorrow, I know it will go great!!

Secondly, every 2 months is pretty standard. They will increase the time in between scans as you get farther into your survall. I hate the scans too because I always worry about too much exposure. But it sounds like your doc is doing a very common cycle.

Not sure if it matters but Boyce has to do blood draws every 30 days and CT scans every 60 days. Looks like you are on a blood draw and CT every 60 days.

Can't wait to hear the good news.

M.

[Fed]

Yo Bobby,

If I remember correctly, I alluded to the frequency of your CT scans some time ago when you began posting. The bimonthly scan schedule is most commonly indicated for people on surveillance for non-seminoma. You had seminoma, so such frequent CT scans are not indicated, primarily because seminoma grows very slowly. There's a paper in the reference library section ("Evidence-based Guidelines for Following Stage 1 Seminoma"; Martin, et al. Cancer 2007, 109, 2248) that you may be able to get at your school's library and find extremely useful. It's a great read, and its from the place where surveillance guidelines for TC were developed (Princess Margaret Hospital in Toronto).

The day-before-scan-worry took it's time to get here, but I have no reason to believe tomorrow won't be full of good news!

That's quite normal, but I don't doubt that you will receive an all-clear. Best of luck!

[mstlyn]

Anthonys oncologist said that CT scans should not be taken lightly. A CT scan is equivalent to about 300 x-rays (according to the oncologist).

Which is the greater risk, missing cancer by having fewer scans, or risking more health problems by having too many? I have no idea, but it's a question that is on my mind too, and maybe it's something we should be asking. I think some doctors DO consider this and some do not, yet, the protocols are there so ...

It's a really crappy position to be in

[fuse929]

Thanks guys. Fed, I remember you commenting on the 2 months cycle in my previous thread, which is one of the main reasons I wanted to bring up the question again. I think at the time of diagnosis, I was so excited hearing that I was almost definitely cured, that I didn't really give much though to surveillance concerns (too much radiation). Now that I have had some time to think about it, I agree that every 2 months seems a bit excessive, compared to most other people with a stage 1 seminoma. I'm definitely gonna check out the paper you recommend tonight, and have a discussion with my urologist tomorrow.

Bobby

[Sans rt1]

Every 2 months is too much. Refer to the NCCN Guidelines for Stage 1A seminoma surveillence:

http://www.nccn.org/professionals/physician_gls/PDF/testicular.pdf

It is nice to get a scan to show you are all clear, but as Fed stated, seminoma typically grows slowly, hence the recommendations for less frequent scans.

[Margaret]

Bobby, sounds like for Stage 1A seminoma I was off. Sorry about that

It says for my husband's cancer, he sould get a CT every 2-3 months. But it just so happens that it was on my calendar to call and get his next CT scan lined up...so we called today and they are moving my husband to blood draw every 60 days and a CT scan every 4 months.

Now he jus had the RPLND in December and 4 rounds BEP...does this sound right to you? It sounds like they are waiting too long in between CT scans and blood draws to me. I just want to be careful and not just accept their advice with out asking you guys

Thanks

[fuse929]

Margaret,

The NCCN guideline that Sans posted, if I'm reading it correctly, says that after "full response" to chemo or RPLND, CT scans should be every 6 months for the first year then every 6-12 months for the 2nd year with CXR every 3-4 months. It doesn't mention anything about blood draws. I hope that helps!

Bobby

[AlexG]

mstlyn said "Anthonys oncologist said that CT scans should not be taken lightly. A CT scan is equivalent to about 300 x-rays (according to the oncologist)."

Well, each "scan visit" includes 2 scans...one with contrast and one without.
So that's 600 x-rays per scan visit.

That's why I think they should provide a testicle shield, since the pelvic scan goes right through the testicle. Each time I do a scan I ask about it. They just smile and tell me not to worry.

My surveillance scan schedule for Stage 1 seminoma is Abdomen+Pelvis scan every 3 months for 1st year.

-AlexG

[fuse929]

I just got off the phone with my urologist, and he told me that after tomorrow's scan, he is moving the surveillance to 1 scan every 4 months. He said he must have made a mistake when he told me every 2 months, because it is not something he would ever recommend. He said he only likes to do the first scan after 2 months to be sure there was no metastasis.

Haha.......I dunno what I would do without advice from you guys.

[Fed]

He said he only likes to do the first scan after 2 months to be sure there was no metastasis.

It was the same with me; my first scan was in Feburary, 2 months after the I/O. It's been every 4 months since then, with the next one slated for October (right before the LIVESTRONG Challenge in Austin!)

Best of luck tomorrow, champ!

[BeachTech]

mstlyn said "Anthonys oncologist said that CT scans should not be taken lightly. A CT scan is equivalent to about 300 x-rays (according to the oncologist)."

Well, each "scan visit" includes 2 scans...one with contrast and one without.
So that's 600 x-rays per scan visit.

That's why I think they should provide a testicle shield, since the pelvic scan goes right through the testicle. Each time I do a scan I ask about it. They just smile and tell me not to worry.

My surveillance scan schedule for Stage 1 seminoma is Abdomen+Pelvis scan every 3 months for 1st year.

-AlexG

Check this out X ray comparison. An chest xray = 10 days of Natural Background Radiation, a CT scan = 3 years

If I had no history of cancer, there is no way I would get a "Full Body Scan" (a voluntary CT scan for healthy people that YOU pay for) HOWEVER, I had cancer, and that 3 years of Natural Background Radiation every 3 months is worth it.

In medicine, it is all about "risk vs. benefit". Sure a CT scan is a lot of radiation, but it's better (IMO) that missing cancer again. Hey, I was lucky I found it the first time...I don't want to risk it again.

As far as non-seminoma, the west coast expert Dr. Skinner told me the typical protocal is every 3 months during year one, every 4 months on year two, and every 6 months for year three. Beyond year three, CT scans are not considered necessary.

Lastly, my doctor told me that there is a low risk that all of those CT scans would brain my damage.
________
red head girl Cams

[AdrianB1971]

.

In 2 years of surveillance I had 2 CAT scans : first right after chemo [to see the curative effects] and the second after one year. Now i'm preparing for the third and after that i'll do regulary scans from 2 to 2 years. Bealive or not, o've read some studies about the negative effects of CAT radiation [increasing risk of malignacies and heart diseases]. Even more dangerous it seems to be XRays scans. Of course, doing only the blood work checkup for such o long period implies some risks

[petep]

My first year was chest and blood work every month with a CT scan every 3 months...so 4x in one year.

BUT...in practice I had scans...

april 2006 (one week after my last bleo)
july 2006
oct 2006
jan 2007 was skipped - doc said with 3 good scans in a row he would skip one

april 2007

after my april scan (my one year anniversary), I now go every other month for chest/blood and ct scan every 4 months...

I do not know if this is true or not, but where I go, everything is digital (they do the xrays/scan and it is immediately on all the cancer centers computers) and I am told less radiation relative to the film scanners....but I have not researched this.

pete

[Margaret]

Maybe this has already been addressed (if so forgive me) but is a CT scan better or worse than the PET scan?

It used to make me mad when the doc would say 'we are going to do a full CT scan, but I am sure if we see anything we will also have to do a more detailed PET scan'...so I would say since you are likely going to do a PET scan anyway, why don't we just do that first and save him the radiation?

He said okay and they just did the PET scan. But Boyce has been scanned more than I care to print.