No Pet Scan

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colon2
colon2 Member Posts: 183
edited March 2014 in Colorectal Cancer #1
I finished my chemo and my onc. contacted ins. co about approval for Pet scan. They said I don't meet the criteria for pet scan. They approved a CT scan, but not the pet scan. I wonder what the criteria is. I am not a happy camper about this. I keep thinking that a pet scan would show if something small is in there, and a CT scan might miss it. I don't really know if that is true or not, but I wonder about it. What is everyone else's opinion? I thought my insurance was pretty good up until this point.
Carletta

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  • ADKer
    ADKer Member Posts: 147
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    CT vs. PET
    I don't know the complete answer as to when a PET scan is preferable but I do know that sometimes small mets are visible on a CT scan but do not show uptake on a PET scan. In other words, the reason for ordering a PET instead of a CT scan is NOT to find smaller mets.
  • mommyof2kds
    mommyof2kds Member Posts: 519
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    My oncologist told me that
    My oncologist told me that CT's are better because you get the contrast and it shows things up better. He plans to do my next scans in jan and plans to only do CT's... Petrina
  • Kathleen808
    Kathleen808 Member Posts: 2,342 Member
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    same
    Carletta,
    We were told the same thing by Dr. Lenz. He said a CAT scan can detect smaller growths. The PET can tell more accurately if it is cancer or not.

    Best to you.
    Aloha,
    Kathleen
  • mom_2_3
    mom_2_3 Member Posts: 953 Member
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    No PET scans for me
    Carletta,

    My oncologist only orders CT scans as she feels they are more accurate and better able to show suspicious areas. She has never once ordered at PET scan for me.

    Amy
  • Patteee
    Patteee Member Posts: 945
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    I only had a PET scan to
    I only had a PET scan to stage the cancer, that was about a month after surgery. Not sure what you were staged at? mine was a 3B and after treatment the standard recommendation is CT scans along with colonoscopy yearly, CEA every 3 months. A PET scan would be done, but only if the CT or colonscopy came up with anything. I am not sure from what you posted- have you never had a PET or did some other test come back indicating a PET should be done. I don't think PETs are routinely done, that seems to be more the CT scan.
  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
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    Different Story, Of Course
    Hi Carletta

    I've had so many PET scans, that I lose track.

    We always had to get them approved by insurance, but when we did a CT scan, the PET followed the next week.

    I've had as many as 4 a year on the every 3 month scan cycle.

    I've done 2 this year...have since switched doctors and just getting into their flow, so we'll see.

    I guess it just depends on the oncologist - but they were automatic for me - or maybe it was just "automatic" for the cash register and my wallet :)

    My treatments just seem to differ from everybody else's...I must have been the head guniea pig or something....a test case as it were.

    Anyway, that's what happened to me.

    Take care
    -Craig
  • steven12
    steven12 Member Posts: 51
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    Sundanceh said:

    Different Story, Of Course
    Hi Carletta

    I've had so many PET scans, that I lose track.

    We always had to get them approved by insurance, but when we did a CT scan, the PET followed the next week.

    I've had as many as 4 a year on the every 3 month scan cycle.

    I've done 2 this year...have since switched doctors and just getting into their flow, so we'll see.

    I guess it just depends on the oncologist - but they were automatic for me - or maybe it was just "automatic" for the cash register and my wallet :)

    My treatments just seem to differ from everybody else's...I must have been the head guniea pig or something....a test case as it were.

    Anyway, that's what happened to me.

    Take care
    -Craig

    PET vs. CT
    Easy answer: PET scan is more expensive for the Health care then CT.
    Best wishes to everybody,
    Steven
  • PTCruiser4
    PTCruiser4 Member Posts: 1
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    steven12 said:

    PET vs. CT
    Easy answer: PET scan is more expensive for the Health care then CT.
    Best wishes to everybody,
    Steven

    Pet Scans
    I have had so many PET Scans I couldn't count them, I had a CT scan July 10th everything looked good, I had a biopsy Aug. 5th cancer had returned, then a PET scan on Aug. 12th and it showed the cancer, I have a colostomy from first cancer in 2005 and to drink the stuff for CT scan takes it about three to four weeks to get out of my system so I prefer PET scan . thank God for insurance, I pray eveyday for it to go away again. Prayers to all.
  • usakat
    usakat Member Posts: 610 Member
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    Hello Carletta
    First, CONGRATULATIONS on finishing chemo! That is a huge milestone in your fight...good for you!

    Not to start up a debate here, but insurance companies do not routinely approve or decline one test versus another simply because of cost. Cost is but a part of the determination of whether or not a certain test, procedure or treatment is approved.

    As for PET versus CT, everyone who distinguished the difference between PET and CT above is correct. CT provides greater imaging and radiologists are therefore able to see smaller structures. If something abnormal or questionable is seen, certainly for cancer patients, further testing is usually recommended in the CT report issued by the radiologist - typical further testing is PET, MRI, Ultrasound, etc. If further testing is indicated based on CT results, insurance companies would routinely approve the test, unless it's expressly excluded in the policy. As a matter of course, PET scans are more routinely used for Stage IV patients with distant and multiple metastasis and is often indicated to gauge the effectiveness of continual and/or various treatment protocols.

    If I had to guess, Carletta, your doctor probably ordered a CT/PET scan - the combo package where you get a CT first and then a PET second. This is ordered for many post-treatment patients. However, a PET scan may not necessarily benefit a patient for two reasons - subjecting the patient to testing and medications (remember PET is nuclear medicine - the FDG-glucose solution injected into patients is radioactive) may not be prudent if the radiologist is not looking for a specific abnormality, and secondly potentially unnecessarily utilizing hospital services thereby subjecting patients and their insurance companies with undue cost. The undue cost situation is one of the hotly debated issues before Congress right now and is an argument that President Obama and others have been making to help control healthcare costs. In my opinion, it's a good issue to discuss.

    Carletta, I wouldn't say your insurance is good or bad simply because your insurance company refused this particular test - there are far too many factors to determine whether you have a good policy or bad policy. Something you can do is call your insurance company and ask exactly why the PET was turned down - they will most likely tell you a PET scan is not indicated for your particular case or it could be simply because of how the doctor's office ordered the test.

    If you had a CT scan and nothing abnormal is noted, then celebrate your NEDness! If something did pop up, you would either have a PET scan or wait it out. For instance, I had a post treatment CT scan that indicated a new lung nodule, but it was small so a PET would probably not indicate FDG uptake, or "light up", so I repeated the scan three months later and the nodule was stable. Two years after, it was still stable.

    So don't fret Carletta - celebrate your victory and completing chemo. And please, do follow up with your care and follow doctor's orders.

    I hope this helped :)
  • colon2
    colon2 Member Posts: 183
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    usakat said:

    Hello Carletta
    First, CONGRATULATIONS on finishing chemo! That is a huge milestone in your fight...good for you!

    Not to start up a debate here, but insurance companies do not routinely approve or decline one test versus another simply because of cost. Cost is but a part of the determination of whether or not a certain test, procedure or treatment is approved.

    As for PET versus CT, everyone who distinguished the difference between PET and CT above is correct. CT provides greater imaging and radiologists are therefore able to see smaller structures. If something abnormal or questionable is seen, certainly for cancer patients, further testing is usually recommended in the CT report issued by the radiologist - typical further testing is PET, MRI, Ultrasound, etc. If further testing is indicated based on CT results, insurance companies would routinely approve the test, unless it's expressly excluded in the policy. As a matter of course, PET scans are more routinely used for Stage IV patients with distant and multiple metastasis and is often indicated to gauge the effectiveness of continual and/or various treatment protocols.

    If I had to guess, Carletta, your doctor probably ordered a CT/PET scan - the combo package where you get a CT first and then a PET second. This is ordered for many post-treatment patients. However, a PET scan may not necessarily benefit a patient for two reasons - subjecting the patient to testing and medications (remember PET is nuclear medicine - the FDG-glucose solution injected into patients is radioactive) may not be prudent if the radiologist is not looking for a specific abnormality, and secondly potentially unnecessarily utilizing hospital services thereby subjecting patients and their insurance companies with undue cost. The undue cost situation is one of the hotly debated issues before Congress right now and is an argument that President Obama and others have been making to help control healthcare costs. In my opinion, it's a good issue to discuss.

    Carletta, I wouldn't say your insurance is good or bad simply because your insurance company refused this particular test - there are far too many factors to determine whether you have a good policy or bad policy. Something you can do is call your insurance company and ask exactly why the PET was turned down - they will most likely tell you a PET scan is not indicated for your particular case or it could be simply because of how the doctor's office ordered the test.

    If you had a CT scan and nothing abnormal is noted, then celebrate your NEDness! If something did pop up, you would either have a PET scan or wait it out. For instance, I had a post treatment CT scan that indicated a new lung nodule, but it was small so a PET would probably not indicate FDG uptake, or "light up", so I repeated the scan three months later and the nodule was stable. Two years after, it was still stable.

    So don't fret Carletta - celebrate your victory and completing chemo. And please, do follow up with your care and follow doctor's orders.

    I hope this helped :)

    Thanks everyone
    Usakat, thank you for the info. It did help. Yes my onc did order CT/Pet. I guess my ins. company does know what they are doing. Once again thanks
    Carletta