why ct scan instead of pet scan

On Oct 12 My husband will have his 4th round of chemo 5-fu, Oxaliplatin, Leucovorin and a study drug, but its a blind study, so we dont know if he's getting the real pill or not. Anyway the following week he will have a CT-SCAN. I thought they did PET-SCAN. I couldn't speak to Dr. Gibson at this weeks chemo because he had his tonsils out.I didnt want to talk to a PA or nurse. I wondering what steps others experienced with stage 4 esophageal cancer.
Chrissy

Comments

  • Callaloo
    Callaloo Member Posts: 135
    CT gives a clearer picture
    I get a CT san every 9 weeks, have never had a PET scan since the the one used to help stage last year. It has its place. Our clinic only uses to confirm an equivocal CT.
  • Donna70
    Donna70 Member Posts: 852 Member
    Callaloo said:

    CT gives a clearer picture
    I get a CT san every 9 weeks, have never had a PET scan since the the one used to help stage last year. It has its place. Our clinic only uses to confirm an equivocal CT.

    Ct scans at our clinic
    Our cancer institute does follow up CT scans and when I asked about PET scans they don't do them unless something shows up on the CT scan and having had a really wierd diagnostic PET scan that is fine by me. My cancer did not show up but had a lot of false positives everywhere else. Also insurance companies can be funny about getting too many PET scans.
    Take care,
    Donna70
  • chemosmoker
    chemosmoker Member Posts: 501
    PET VS CT
    Chrissy,
    I think everyone touched on this Already.
    The way MY oncologist explains it, The PET scan can only show rather blurry images without much detail, but with the glucose injection they do, it lights up where there is fast metabolic activity, as the cancer cells eat the glucose faster than any other cells (hence Chemo killing fast growing cells, along with hair and nails, etc.) and they light up. It is usually only used AFTER a CT scan shows something definitive that they need a closer look at in the sense of "is that cancer or something else" look.

    The CT is used to show much more detail. It takes over a million cancer cells to make a SPOT on a CT or PET the size of your fingernail. So detail is important, and it is not an easy thing, even with all of today's high tech machines, to "see" cancer. And why chemo is SO important AFTER any surgery, as you can't say you got every cell, or see it either!

    Hope this helps.

    -Eric
  • TerryV
    TerryV Member Posts: 887
    Our surgeon's take on CT or PET follow ups
    Nick was just released from his post-op surgical care and told to expect a follow-up CT in 4 - 6 months. I asked why CT and not PET. They told me that a CT would provide the state/status of any cancer. If anything new or suspucious were found, then a PET would be considered. The PET is substantially more expensive and because of that, the CT is the prefered scan (insurance preference, I'm sure) unless suspicion dictates something more is needed.

    Hope this helps.

    Terry
    Wife to Nick, age 48
    dx T3N2M0 05/19/11
    THE 09/08/11
  • NikiMo
    NikiMo Member Posts: 342
    TerryV said:

    Our surgeon's take on CT or PET follow ups
    Nick was just released from his post-op surgical care and told to expect a follow-up CT in 4 - 6 months. I asked why CT and not PET. They told me that a CT would provide the state/status of any cancer. If anything new or suspucious were found, then a PET would be considered. The PET is substantially more expensive and because of that, the CT is the prefered scan (insurance preference, I'm sure) unless suspicion dictates something more is needed.

    Hope this helps.

    Terry
    Wife to Nick, age 48
    dx T3N2M0 05/19/11
    THE 09/08/11

    Jeff is getting his first CT on Tuesday
    Hi Terry,

    I am a little surprised they are waiting 4-6 months for the first scan, we were told Jeff needs to get his baseline scan this Tuesday. Maybe it is different since Jeff is starting chemo again on October 20th, but they explained this scan would be taken and then they can compare future scans to this one. I am a little nervous, but trying to focus more on getting Jeff healthy again. How is Nick doing now, eating ok, walking more? We are slowly recovering over here.

    Take care,

    Niki
    Wife to Jeff
    dxT2N1M0 5/24/11
    IL 9/6/11
  • TerryV
    TerryV Member Posts: 887
    NikiMo said:

    Jeff is getting his first CT on Tuesday
    Hi Terry,

    I am a little surprised they are waiting 4-6 months for the first scan, we were told Jeff needs to get his baseline scan this Tuesday. Maybe it is different since Jeff is starting chemo again on October 20th, but they explained this scan would be taken and then they can compare future scans to this one. I am a little nervous, but trying to focus more on getting Jeff healthy again. How is Nick doing now, eating ok, walking more? We are slowly recovering over here.

    Take care,

    Niki
    Wife to Jeff
    dxT2N1M0 5/24/11
    IL 9/6/11

    Guessing the preSurgery PET is our "baseline"
    While this is only my guess, I believe the docs will be using Nick's last PET as his baseline. Not sure why so many differences in Nick's care as opposed to Jeff's - additional scan, continued chemo, etc.

    I haven't found numbers to indicate how much "insurance" post-op chemo offers. Nick's good with the care he's received and witout numbers, I'm not in a position to argue it with him.

    Finding the right balance in meal amounts is challenging, but doable. Nick is eating almost anything, but in very small amounts. He has yet to attempt steak or pork chops. I'm really surprised, but he is able to have his beloved Mountain Dew. I figured that would be off his meal list forever. Although unlike before, it takes him about 4 hours to drink 1 can now :)

    The Jtube was removed last Wednesday. Just 20 days after surgery! :) He was thrilled! At that time, he was down only 2 pounds from presurgery weight. Funny thing though, the removal of the Jtube did a bit of a head job on Nick. He had been eating really well and not using the Jtube since hospital release. They pulled the Jtube and it was like his security blanket pulled out from under him. All of a sudden, food didn't taste right, he couldn't swallow what he chewed, he became nauseated. I renewed his Dexamethazone/Emend script and that's helped tremendously. I am pretty certain that he was able to be arrogant about food while he had the fallback option, but once it was removed, he was scared and just didn't trust himself to make good choices. Hopefully we'll get past that too.

    We meet with the Radiology doc next Thursday and the Oncologist on 10/11. Then according to all reports so far - next appointment will be 4 to 6 months from surgery date.

    Glad you guys are moving forward as well. It is a slow progression :)

    Terry
    Wife to Nick, age 48
    dx T3N1M0 05/19/11 (just realized that I had the node count wrong!)
    THE 09/08/11
  • unclaw2002
    unclaw2002 Member Posts: 599
    Chrissy,
    I just wanted to

    Chrissy,

    I just wanted to encourage you to feel free to speak with Dr. Gibson's nurse and his PA. When my dad was getting his treatment in Pittsburgh they were both wonderful and always helpful and willing to speak with me. Also, Dr. Gibson and his staff all use email and I always found them to be very responsive to questions and concerns - often getting late night responses from Dr. Gibson. I hope that the treatment is going well for your husband.

    Good luck with the scan - hopefully it will show that the cancer is stable or even better that it has shrunk.

    Best,
    Cindy
  • NikiMo
    NikiMo Member Posts: 342
    TerryV said:

    Guessing the preSurgery PET is our "baseline"
    While this is only my guess, I believe the docs will be using Nick's last PET as his baseline. Not sure why so many differences in Nick's care as opposed to Jeff's - additional scan, continued chemo, etc.

    I haven't found numbers to indicate how much "insurance" post-op chemo offers. Nick's good with the care he's received and witout numbers, I'm not in a position to argue it with him.

    Finding the right balance in meal amounts is challenging, but doable. Nick is eating almost anything, but in very small amounts. He has yet to attempt steak or pork chops. I'm really surprised, but he is able to have his beloved Mountain Dew. I figured that would be off his meal list forever. Although unlike before, it takes him about 4 hours to drink 1 can now :)

    The Jtube was removed last Wednesday. Just 20 days after surgery! :) He was thrilled! At that time, he was down only 2 pounds from presurgery weight. Funny thing though, the removal of the Jtube did a bit of a head job on Nick. He had been eating really well and not using the Jtube since hospital release. They pulled the Jtube and it was like his security blanket pulled out from under him. All of a sudden, food didn't taste right, he couldn't swallow what he chewed, he became nauseated. I renewed his Dexamethazone/Emend script and that's helped tremendously. I am pretty certain that he was able to be arrogant about food while he had the fallback option, but once it was removed, he was scared and just didn't trust himself to make good choices. Hopefully we'll get past that too.

    We meet with the Radiology doc next Thursday and the Oncologist on 10/11. Then according to all reports so far - next appointment will be 4 to 6 months from surgery date.

    Glad you guys are moving forward as well. It is a slow progression :)

    Terry
    Wife to Nick, age 48
    dx T3N1M0 05/19/11 (just realized that I had the node count wrong!)
    THE 09/08/11

    Makes sense
    Hey Terry,

    That makes sense to use Nick's pet scan from before surgery. Jeff is not able to use his scan becuase he had those nodes light up but then had the clean pathology. I also think those nodes are the reason Jeff is doing post op chemo. You are right there are no studies that can quantify if post-op chemo will help, but we have decided to do it anyway. If it is to hard for him we can always call it quits. I am impressed that Nick is back near his pre-surgery weight. Jeff is still 12 pounds shy of post op weight, he has kept his feeding tube, but doesn't use it. Hopefully his appetite will return soon, but it seems like every time he eats there is pain and discomfort, I am my ropes end on what to give him that won't make him feel like crap.

    Glad to hear Nick is doing so well!

    Niki
  • TerryV
    TerryV Member Posts: 887
    NikiMo said:

    Makes sense
    Hey Terry,

    That makes sense to use Nick's pet scan from before surgery. Jeff is not able to use his scan becuase he had those nodes light up but then had the clean pathology. I also think those nodes are the reason Jeff is doing post op chemo. You are right there are no studies that can quantify if post-op chemo will help, but we have decided to do it anyway. If it is to hard for him we can always call it quits. I am impressed that Nick is back near his pre-surgery weight. Jeff is still 12 pounds shy of post op weight, he has kept his feeding tube, but doesn't use it. Hopefully his appetite will return soon, but it seems like every time he eats there is pain and discomfort, I am my ropes end on what to give him that won't make him feel like crap.

    Glad to hear Nick is doing so well!

    Niki

    Dexamethazone / Emend
    You might request a script for the above. It's a steriod that not only increases appetite but also aids in nausea control. It's been a *wonder* drug for us :)

    Terry
  • lilrusty
    lilrusty Member Posts: 49

    Chrissy,
    I just wanted to

    Chrissy,

    I just wanted to encourage you to feel free to speak with Dr. Gibson's nurse and his PA. When my dad was getting his treatment in Pittsburgh they were both wonderful and always helpful and willing to speak with me. Also, Dr. Gibson and his staff all use email and I always found them to be very responsive to questions and concerns - often getting late night responses from Dr. Gibson. I hope that the treatment is going well for your husband.

    Good luck with the scan - hopefully it will show that the cancer is stable or even better that it has shrunk.

    Best,
    Cindy

    Thank You
    Thank you everyone for all your answers. This cancer has got me going in circles. I'm afraid to ask to many questions, afraid I'm not asking enough questions. I don't think my husband wants to know? I guess we just have to wait till the 19th and see what the scan brings. All good I know, but sometimes I find myself hoping for the best but preparing for the worst. Does anyone else feel like this. I'm never negative around my husband or children always upbeat and postive but boy it gets hard. Anyway I'm getting off track here. Cindy, thanks for the boost about Dr.Gibson and his staff. They have been great with us. Again going back to I'm afraid to do something wrong in all this. I guess I gotta pull up my big girl underpants and ask away. Thanks Again, Love To You All.
    Chrissy
  • TerryV
    TerryV Member Posts: 887
    lilrusty said:

    Thank You
    Thank you everyone for all your answers. This cancer has got me going in circles. I'm afraid to ask to many questions, afraid I'm not asking enough questions. I don't think my husband wants to know? I guess we just have to wait till the 19th and see what the scan brings. All good I know, but sometimes I find myself hoping for the best but preparing for the worst. Does anyone else feel like this. I'm never negative around my husband or children always upbeat and postive but boy it gets hard. Anyway I'm getting off track here. Cindy, thanks for the boost about Dr.Gibson and his staff. They have been great with us. Again going back to I'm afraid to do something wrong in all this. I guess I gotta pull up my big girl underpants and ask away. Thanks Again, Love To You All.
    Chrissy

    You are NOT alone in this....
    Your comment

    "All good I know, but sometimes I find myself hoping for the best but preparing for the worst. Does anyone else feel like this. I'm never negative around my husband or children always upbeat and postive but boy it gets hard."

    I understand that sentiment completely! Nick choose to pull the ostrich technique and go head in sand. I can't do that. But researching something this frightening brings its own hazards. It *is* hard to remain constantly upbeat. But that's why you come here. You can be yourself and express your fears here. Believe me, someone here has felt the same way as you. And they will see your post and be able to share.

    Hugs & love to you both!

    Terry
    Wife to Nick, age 48
    dx T3N1M0 05/19/11
    THE 09/08/11

    Mom to 2 littles :) ages 9 & 11 - Smile, *always Smile* for them
  • jax568
    jax568 Member Posts: 57
    lilrusty said:

    Thank You
    Thank you everyone for all your answers. This cancer has got me going in circles. I'm afraid to ask to many questions, afraid I'm not asking enough questions. I don't think my husband wants to know? I guess we just have to wait till the 19th and see what the scan brings. All good I know, but sometimes I find myself hoping for the best but preparing for the worst. Does anyone else feel like this. I'm never negative around my husband or children always upbeat and postive but boy it gets hard. Anyway I'm getting off track here. Cindy, thanks for the boost about Dr.Gibson and his staff. They have been great with us. Again going back to I'm afraid to do something wrong in all this. I guess I gotta pull up my big girl underpants and ask away. Thanks Again, Love To You All.
    Chrissy

    Chrissy,
    I would have wrote

    Chrissy,

    I would have wrote the same words. You wrote: This cancer has got me going in circles. I'm afraid to ask to many questions, afraid I'm not asking enough questions. I don't think my husband wants to know?

    That is us! I can't ask too many questions with my husband around. I always need to call after the appointment. Thank goodness they understand and are very helpful. My husband only asks the minimum of questions. He understands how grave the situation is. So, in his mind he doesn't need to know details, his only job is to eat, keep active and stay positive. So far it has worked. Yesterday he started day 1 of the 4th cycle. CT scan next week. Doctor positive chemo is working just need to find out how well. My husband is still tolerating chemo well and is keeping weight up and gaining back all weight lost before diagnoses. He has no pain.

    I am the one that is up all night long watching him snore away. I worry about everything and feel extremely stressed at all times. We have young girls ages 11 and 8 So, I need to stay very postitive 24/7.

    You are not alone! You are doing everything right. Sending you strength.

    Jackie
    wife to stage IVb
  • Wpturner05
    Wpturner05 Member Posts: 114
    jax568 said:

    Chrissy,
    I would have wrote

    Chrissy,

    I would have wrote the same words. You wrote: This cancer has got me going in circles. I'm afraid to ask to many questions, afraid I'm not asking enough questions. I don't think my husband wants to know?

    That is us! I can't ask too many questions with my husband around. I always need to call after the appointment. Thank goodness they understand and are very helpful. My husband only asks the minimum of questions. He understands how grave the situation is. So, in his mind he doesn't need to know details, his only job is to eat, keep active and stay positive. So far it has worked. Yesterday he started day 1 of the 4th cycle. CT scan next week. Doctor positive chemo is working just need to find out how well. My husband is still tolerating chemo well and is keeping weight up and gaining back all weight lost before diagnoses. He has no pain.

    I am the one that is up all night long watching him snore away. I worry about everything and feel extremely stressed at all times. We have young girls ages 11 and 8 So, I need to stay very postitive 24/7.

    You are not alone! You are doing everything right. Sending you strength.

    Jackie
    wife to stage IVb

    just a thought
    Jackie,

    As you may remember, we have 2 children almost identical ages. Staying positive is a heavy burdent to put on yourself. Your girls need to see that you have emotions that range the full spectrum . . . and then that you are able to identify them, move on, put one foot in front of the other and keep going. This will model for them that emotion is okay to have, not scary. You have the opportunity to help them identify and handle the emotions that they are having and don't understand. It becomes a win-win. In this crazy journey of life right now you will probably be feeling so many things - fear, anger, sadness, frustration, happiness, joy, etc - so are your girls, except they do not know how to identify them. Let them see you cry, tell them you are sad. Let them see you be angry, tell them that you feel angry. Admit to them that you sometimes feel scared, explain to them how you get through those times. When you laugh and smile, tell them you are happy and why. They will learn from that and be able to know that it is ok. They will see that one day a person can feel sad, but the next day, they will feel better in their heart.

    Jackie - I am hoping we will be at Sloan every Wednesday from the 12th of October on - I hope we can meet up. I think I sent you my private email, if I did not, PM me and I will get it to you. I have been on this journey for almost a year - we can share my friend - I searched and yearned for ANYONE to understand. I CAN RELATE TO YOU. Your husband sounds similiar to mine as far as how he is handling it as well.

    Sending prayers, comfort and a huge hug through this site - straight to your heart.

    Whitney
    wife of Kevin
    stage IVb
  • Daisylin
    Daisylin Member Posts: 365

    just a thought
    Jackie,

    As you may remember, we have 2 children almost identical ages. Staying positive is a heavy burdent to put on yourself. Your girls need to see that you have emotions that range the full spectrum . . . and then that you are able to identify them, move on, put one foot in front of the other and keep going. This will model for them that emotion is okay to have, not scary. You have the opportunity to help them identify and handle the emotions that they are having and don't understand. It becomes a win-win. In this crazy journey of life right now you will probably be feeling so many things - fear, anger, sadness, frustration, happiness, joy, etc - so are your girls, except they do not know how to identify them. Let them see you cry, tell them you are sad. Let them see you be angry, tell them that you feel angry. Admit to them that you sometimes feel scared, explain to them how you get through those times. When you laugh and smile, tell them you are happy and why. They will learn from that and be able to know that it is ok. They will see that one day a person can feel sad, but the next day, they will feel better in their heart.

    Jackie - I am hoping we will be at Sloan every Wednesday from the 12th of October on - I hope we can meet up. I think I sent you my private email, if I did not, PM me and I will get it to you. I have been on this journey for almost a year - we can share my friend - I searched and yearned for ANYONE to understand. I CAN RELATE TO YOU. Your husband sounds similiar to mine as far as how he is handling it as well.

    Sending prayers, comfort and a huge hug through this site - straight to your heart.

    Whitney
    wife of Kevin
    stage IVb

    PET scan
    Lee never went for a PET scan, not even during the staging. We asked why, and they said that it was because the CT scan showed mets to the liver, the rest did not really matter overly much. They already knew he was a stage ivb, and the treatment would not change, regardless of what a PET would show. I think it is likely a cost thing too, us Canadians are a bit more conservative with our testing, I find.

    On the other hand, Lee's mom was diagnosed with lung cancer, and they did a PET on her, to determine if there was any mets. This was ironically prescribed by the same doctor, same day and with appointments an hour apart from each other. If I recall correctly, they did a CT on her, found no mets, then did the PET to scan the whole body. Thankfully nothing else was found on her scans. So I guess that a stage iv is a stage iv, and additional mets won't change the course of treatment.

    Sounds like you have your plate full Whitney, I hope you are coping as best you can under the circumstances. I often think of all of you with small children at home, and how that affects your ability to cope and deal with your own emotional issues as a caregiver.
    Be well,
    Chantal
  • jax568
    jax568 Member Posts: 57
    Daisylin said:

    PET scan
    Lee never went for a PET scan, not even during the staging. We asked why, and they said that it was because the CT scan showed mets to the liver, the rest did not really matter overly much. They already knew he was a stage ivb, and the treatment would not change, regardless of what a PET would show. I think it is likely a cost thing too, us Canadians are a bit more conservative with our testing, I find.

    On the other hand, Lee's mom was diagnosed with lung cancer, and they did a PET on her, to determine if there was any mets. This was ironically prescribed by the same doctor, same day and with appointments an hour apart from each other. If I recall correctly, they did a CT on her, found no mets, then did the PET to scan the whole body. Thankfully nothing else was found on her scans. So I guess that a stage iv is a stage iv, and additional mets won't change the course of treatment.

    Sounds like you have your plate full Whitney, I hope you are coping as best you can under the circumstances. I often think of all of you with small children at home, and how that affects your ability to cope and deal with your own emotional issues as a caregiver.
    Be well,
    Chantal

    My husband never had a PET
    My husband never had a PET scan, I believe Chantal is right once you find the mets to organs it really doesn't matter.

    I myself had uterine cancer, which was removed and cured. I never did chemo. I had the PET scan only after sugery just to make sure that not doing the chemo was the right choice. It will be 4 years November.

    Jackie
  • Coveparent
    Coveparent Member Posts: 2
    jax568 said:

    My husband never had a PET
    My husband never had a PET scan, I believe Chantal is right once you find the mets to organs it really doesn't matter.

    I myself had uterine cancer, which was removed and cured. I never did chemo. I had the PET scan only after sugery just to make sure that not doing the chemo was the right choice. It will be 4 years November.

    Jackie

    False positive PET
    Can anyone tell me about your experience with a false positive PET? My husband is postop, 6 months, plus neoadjuvant and adjuvant chemo 12 rounds total. PET showed only small spot at anastomosis, but it biopsied benign with some inflammation. Re-PET in 3 mos.
    Feels great, gaining weight and back at work!

    Thoughts/ experiences?

    J.
  • Tina Blondek
    Tina Blondek Member Posts: 1,500 Member

    False positive PET
    Can anyone tell me about your experience with a false positive PET? My husband is postop, 6 months, plus neoadjuvant and adjuvant chemo 12 rounds total. PET showed only small spot at anastomosis, but it biopsied benign with some inflammation. Re-PET in 3 mos.
    Feels great, gaining weight and back at work!

    Thoughts/ experiences?

    J.

    Hi J
    Nice to meet you. I was

    Hi J
    Nice to meet you. I was a caregiver for my dad. He passed in March 2010 from EC with mets to the liver. My dad had both ct and pet scans. I agree with another post, that it is the insurance co. that want the ct scan vs. the pet scan because the pet scan costs more. We were told that the pet scan showed much more detail as far as shrinking of the tumor. Only a small spot is great news. I have learned through this journey to take the good news and run with it. Live each day to its fullest. It is wonderful that he feels great, is gaining weight and is back to work. Period. Concern yourselves with the re-pet in 3 mos, not now. Live each day like it is your last. I am only speaking from my experience. Hope this helps. Congrats to both of you!
    Tina in Va
  • lilrusty
    lilrusty Member Posts: 49

    Hi J
    Nice to meet you. I was

    Hi J
    Nice to meet you. I was a caregiver for my dad. He passed in March 2010 from EC with mets to the liver. My dad had both ct and pet scans. I agree with another post, that it is the insurance co. that want the ct scan vs. the pet scan because the pet scan costs more. We were told that the pet scan showed much more detail as far as shrinking of the tumor. Only a small spot is great news. I have learned through this journey to take the good news and run with it. Live each day to its fullest. It is wonderful that he feels great, is gaining weight and is back to work. Period. Concern yourselves with the re-pet in 3 mos, not now. Live each day like it is your last. I am only speaking from my experience. Hope this helps. Congrats to both of you!
    Tina in Va

    Live Each Day
    While wish we would have known to live each day likes its your last twenty seven years ago. Seems just when kids are grown, houses paid for, money in the bank, ready to spend winters in Fl. BAM, you hit the wall. Whats it all about? I'm taking your advice and living day by day, good, bad and the ugly. Your post are an inspiration to this newbie.
    SENDING LOVE AND MIRCLES TO ALL
    Chrissy