Scan Question

Paula G.

I asked the question before about how often people were getting scanned during treatment. Your answer's were different. I am wondering if any of you have had to wait after your treatments end to get scanned? John's Onc say's that after he finishes his twelve treatments he will have to wait a month and then get a scan. Has anyone heard of this and if so what was the reason? John is going to ask him when he goes in for his next treatment but I would like to get some of your ideas.He has only had one scan and that was before he started Chemo. It seems strange to me. Paula G.

mom_2_3

Scans
The first oncologist I went to said that I would do 6 months FOLFOX/Avastin and then we would scan. I sought a second opinion at Memorial Sloan Kettering. The protocol I have had there was to do 2 rounds (4 treatments) as opposed to 6 rounds and then scan. So I had my CT scan about 2.5 months after starting treatment. My oncologist there wanted to track the liver mets closely so we could get into surgery as soon as feasible/possible as she feels there is an optimum window in which to do a liver resection (when the mets are smallest and before the liver takes a major hit from the chemotherapy agents). As it turns out I went into surgery pretty much right after that scan. Since my liver surgery I had another CT scan a month after surgery and then another scan in June (3 months from surgery). My next CT scan is in September at which point I will go into an every 3-month scan cycle. My current treatments will end about the end of October at which point I go into a monitor for recurrence mode.

HTH,
Amy

lisa42

I'd want a scan sooner than that
Hi Paula,

I'm sorry but I don't remember at the moment if John is taking chemo because he's stage 3, or if it's actually spread into other organs (stage 4) already. If he's a stage 3 or lower, then I can easily see waiting until after he's finished with all his treatments- there'd be nothing really to be monitoring.
If he's stage 4, however, I would definitely not want to wait until after all treatments are finished to be scanned. I've read (and it was true in my own case), that most of what the chemo treatments are going to do to tumors takes place mostly in the first few treatments. Most of my good response to the chemo took place in the first 3 chemo treatments. I was scanned after every 3 treatments (approx every 6-8 wks during treatment). This was to monitor progress and see if it was working or not. After just 3 treatments, my liver went from 12 tumors lighting up on the PET to just 3. After 6 treatments, those remaining 3 liver tumors showed up on the CT portion, but no longer on the PET. It pretty much remained the same for the rest of the treatments after that. If I were your husband, I'd definitely want to know fairly early on if things are working or not. Again, if he's stage 4, I think it's unusual to wait to get scanned until after all his treatments are done. I would get another opinion on that, for sure.

Best wishes,
Lisa

luv3jay

I'm with them!
I was scanned after the first 4 cycles of chemo to make sure the regimine they had me on was working as we wanted. After that, I had both of my surgeries and then another scan. I was scheduled for 8 more cycles and was scanned after 4 of those. My next scan will take place on 7/17 right after I complete my last cycle of chemo. I can't imagine them waiting until after all 12 treatments...what if the meds they have him on are not successful? I would think they would want to know that sooner rather than later.

Paula G.

lisa42 said:

I'd want a scan sooner than that
Hi Paula,

I'm sorry but I don't remember at the moment if John is taking chemo because he's stage 3, or if it's actually spread into other organs (stage 4) already. If he's a stage 3 or lower, then I can easily see waiting until after he's finished with all his treatments- there'd be nothing really to be monitoring.
If he's stage 4, however, I would definitely not want to wait until after all treatments are finished to be scanned. I've read (and it was true in my own case), that most of what the chemo treatments are going to do to tumors takes place mostly in the first few treatments. Most of my good response to the chemo took place in the first 3 chemo treatments. I was scanned after every 3 treatments (approx every 6-8 wks during treatment). This was to monitor progress and see if it was working or not. After just 3 treatments, my liver went from 12 tumors lighting up on the PET to just 3. After 6 treatments, those remaining 3 liver tumors showed up on the CT portion, but no longer on the PET. It pretty much remained the same for the rest of the treatments after that. If I were your husband, I'd definitely want to know fairly early on if things are working or not. Again, if he's stage 4, I think it's unusual to wait to get scanned until after all his treatments are done. I would get another opinion on that, for sure.

Best wishes,
Lisa

Thanks for the info. I too think it is a bit strange not to track the progress on the Chemo with a scan. He is going to ask on his next treatment. In the mean time I am calling the Huntsman Cancer Center here in Utah to see what I need to do to get him in to someone there. We are seeing our family Doc. on July 17yh and he is part of the group of Doctors that are in the group that the Huntsman Cancer Center is so if I need a referal he will do it I hope.
Lisa, he is stage 4 with mets to his liver and both lungs and a small spot on one of the adrenal glads. He has had 8 traetment of Folfox+ avastin and has had a reaction to the OXY the last two treatments. He is done with the OXY for now. Thanks Paula

kmygil

I think it depends..
I think it depends on what stage, location, treatment protocol etc etc. In my case I was only Stage II-b. So after the initial scan, I did the surgery & chemo, then had a scan. It was clear, so we went straight to annual scans & colonoscopies. I think if you have to have a tumor shrinkage before surgery, the scans will be done more frequently. Also, depending on mets etc. they may want to check more frequently. I hope this helps.

Kirsten

nanagrandma

Scans
I started my treatment in oct. of 07 and finished in may of 08. I had my first scan in June of 08. I just had my year scan yesterday will find out tomorrow the results.

neon356

Sad to say that in some
Sad to say that in some cases the treatment you get depends on the insurance coverage you have. Every scan you get costs the insurance company big bucks. Your Docs, the hospitals, all those folks usually check you out and they pretty much know how much they can get. Maybe they think that you won't be covered after only a few treatments. You just might want to check with your ins. company to see if they have a policy on when they think it's necessary for you to have a scan. Sometimes you have to argue with them about what's in your best interest. There have been more than a few articles written over the past few years about how insurance companies encourage Docs and sometimes even reward them for not giving the patient the best care. I really hate to bring up this sad reality, but we really have to be our own advocates for making sure that we're getting the best care possible. Everything from getting that second opinion, or asking the necessary questions, and making sure that you're getting the insurance company to pay for what you're entitled to.
Carl

Paula G.

neon356 said:

Sad to say that in some
Sad to say that in some cases the treatment you get depends on the insurance coverage you have. Every scan you get costs the insurance company big bucks. Your Docs, the hospitals, all those folks usually check you out and they pretty much know how much they can get. Maybe they think that you won't be covered after only a few treatments. You just might want to check with your ins. company to see if they have a policy on when they think it's necessary for you to have a scan. Sometimes you have to argue with them about what's in your best interest. There have been more than a few articles written over the past few years about how insurance companies encourage Docs and sometimes even reward them for not giving the patient the best care. I really hate to bring up this sad reality, but we really have to be our own advocates for making sure that we're getting the best care possible. Everything from getting that second opinion, or asking the necessary questions, and making sure that you're getting the insurance company to pay for what you're entitled to.
Carl

I think it is wrong
I think it is wrong to treat people because of insurance but I do know what you mean. We have good insurance and they will pay for other scans. It is sad when people are hit with the words stage 4 colon cancer you just try to trust the direction you are sent in at first. You are in shock and don't really know what you are doing. We also felt it was so urgent to get help and treatment right away.
We have learned so much in so little time. He is going to ask the Onc on his next treatment about the scan. We are going to get a second opinion and I am pretty sure we will be changing to another place for treatment. This Doc has never been in the cure mode or even been hopeful. They have dropped the ball on getting things pre authed which our insuance does require and also went out of our network on the pump he needs. I am doing an appeal for that because how could we have known that. I found out when I got the EOB. It's just not right. Paula

lesvanb

Paula G. said:

I think it is wrong
I think it is wrong to treat people because of insurance but I do know what you mean. We have good insurance and they will pay for other scans. It is sad when people are hit with the words stage 4 colon cancer you just try to trust the direction you are sent in at first. You are in shock and don't really know what you are doing. We also felt it was so urgent to get help and treatment right away.
We have learned so much in so little time. He is going to ask the Onc on his next treatment about the scan. We are going to get a second opinion and I am pretty sure we will be changing to another place for treatment. This Doc has never been in the cure mode or even been hopeful. They have dropped the ball on getting things pre authed which our insuance does require and also went out of our network on the pump he needs. I am doing an appeal for that because how could we have known that. I found out when I got the EOB. It's just not right. Paula

Huntsman scans
Hi Paula

I'm being treated at the Huntsman in Utah and here in WY. My surgeries have all been at the Huntsman and the chemo and radiation in WY. I was diagnosed stage 4 with one met to the liver and was resectable upon diagnosis. So I had radaition/chemo, rectal surgery, a liver resection 6 weeks later, then adjuvant chemo. Both medical oncologists (one in WY and one I use for 2nd opinions at the Huntsman want me to have a scan 3 months after the end of chemo (which will be this August)

Leslie

PS I really like the care I've received at the Huntsman