To scan or not to scan?

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christinecarl
christinecarl Member Posts: 543 Member
edited March 2014 in Colorectal Cancer #1
I posted on another cc support board, about my 1st 3 month checkup going well. That my Onc was doing blood tests and one poster said I should DEMAND scans and not just bloodwork at my checkup?

Here I was feeling all positive and actually giddy over my normal test results today, but now I am thinking, do I need to demand my Onc gives he scans?

I do trust my Onc, he is my cancer warrior and now this person (well intentioned comment) has my mind spinning a bit. I just wanted to breathe a sigh of relief for awhile and now in the back of my mind, I wonder do I need to fight my Dr on this? Is it so important to my mental well begging that I completely trust his vision on this, so I can have complete confidence. What to do, ask for the scan or believe this is going as it should?

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  • Patteee
    Patteee Member Posts: 945
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    I think it depends on your
    I think it depends on your stage? Mine was 3B- colonoscopy and CT scan yearly and every 3 month physical and CEA. This is a standard set by the experts. Scans and PETS would follow from elevated CEA. They really need a reason to do a scan, it isn't like I could demand one.
  • christinecarl
    christinecarl Member Posts: 543 Member
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    Patteee said:

    I think it depends on your
    I think it depends on your stage? Mine was 3B- colonoscopy and CT scan yearly and every 3 month physical and CEA. This is a standard set by the experts. Scans and PETS would follow from elevated CEA. They really need a reason to do a scan, it isn't like I could demand one.

    I was 3b too and he plans
    I was 3b too and he plans bloodwork only, his nurse said he felt that scans were not proven to be better necessarily. Maybe I will try to talk to him at the next appt. about this. Not sure if I will or just carry on though. Confused : (
  • Patteee
    Patteee Member Posts: 945
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    I was 3b too and he plans
    I was 3b too and he plans bloodwork only, his nurse said he felt that scans were not proven to be better necessarily. Maybe I will try to talk to him at the next appt. about this. Not sure if I will or just carry on though. Confused : (

    when was your first/last CT,
    when was your first/last CT, PET and colonscopy
  • mommyof2kds
    mommyof2kds Member Posts: 519
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    Patteee said:

    when was your first/last CT,
    when was your first/last CT, PET and colonscopy

    My oncologist is going to do
    My oncologist is going to do follow up CT's, sait that it is easier to see a tumor on a CT rather than a PET scan. If it will ease your mind, ask your doc while he isn't doing scans. Don't just keep wondering if you are missing out on any diagnostic testing or treatment, ask him/her. then you will feel better.. Take care Petrina
  • PhillieG
    PhillieG Member Posts: 4,866 Member
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    CT Scans
    I've been getting them every 2 months for a very long time. Until they don't see anything it will stay the same, then they will gradually get spaced further apart.

    I would certainly ask for a scan.
    -p
  • dianetavegia
    dianetavegia Member Posts: 1,942 Member
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    Same here
    I completed chemo mid August. My first check up is Dec. 15th for a quick check over and blood work. I'm scheduled for a scan and check up/ blood work in April. My onc said this is the recommended standard for my Stage III.

    I've seen those remarks on another cc board and freaked for a few minutes, too. However, my onc is part of a huge group of oncs in Atlanta. They have a good number of offices in surrounding towns. Once a week, the group meets to determine treatment for each patient who has had any change whether it's end of treatment, change in status, reactions, etc. My thought is if I trust God to heal me, I must also trust my Hindu doctor (LOVE him!) to choose the best options for me.

    Praying that your blood work is pristine and that your anxiety is quickly gone!

    Diane
  • dixchi
    dixchi Member Posts: 431
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    Same here
    I completed chemo mid August. My first check up is Dec. 15th for a quick check over and blood work. I'm scheduled for a scan and check up/ blood work in April. My onc said this is the recommended standard for my Stage III.

    I've seen those remarks on another cc board and freaked for a few minutes, too. However, my onc is part of a huge group of oncs in Atlanta. They have a good number of offices in surrounding towns. Once a week, the group meets to determine treatment for each patient who has had any change whether it's end of treatment, change in status, reactions, etc. My thought is if I trust God to heal me, I must also trust my Hindu doctor (LOVE him!) to choose the best options for me.

    Praying that your blood work is pristine and that your anxiety is quickly gone!

    Diane

    Scans
    Talk to your doctor about why he is not recommending scans;
    if you were posting on the Colon Cancer Connection site and
    the response came from their staff person, I would most
    definitely talk to the doctor. Bloodwork, CEA,
    is not always reliable in results as to what is
    happening inside your body. As a matter of fact,
    I had always heard that scans were the standard procedure
    for followups.

    My story is that I had Stage 2 in 2004 with no lymph node
    involvement, had no chemo but saw the oncologist every
    three months, who was doing scans, one scan eventually
    showed a met on my liver.....and I had an elevated CEA.
    Had liver surgery and chemo and now I am in the followup
    stage with scans every three months, PET/CT scans of
    abdomen chest and pelvic area....so far they have been
    clear, tho they found tiny spots on lung, kidney and
    an endometrial lining that is the highest accepted
    level of thickness.....that's good to know, they
    are not growing, active, or anything but now they
    know to monitor them, I feel a lot more comfortable
    knowing they are being hawks in their followup care.

    Barbara
  • jscho
    jscho Member Posts: 62
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    One thing I would worry
    One thing I would worry about is whether the CEA is a good marker for you or not. I think in roughly 40% of colorectal cases, the antigen is not over-expressed, and tumor growth does not correlate with higher CEA levels. In this case, blood work would not reveal much.

    I have thus far only had my CEA levels checked once (pre-chemo, but post-surgery), and have no idea of whether my primary tumor over-expressed CEA or not.

    You should check with your onc whether it is known to be relevant for you or not.

    My 2 cents,
    Jeremy
  • PGLGreg
    PGLGreg Member Posts: 731
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    I was 3b too and he plans
    I was 3b too and he plans bloodwork only, his nurse said he felt that scans were not proven to be better necessarily. Maybe I will try to talk to him at the next appt. about this. Not sure if I will or just carry on though. Confused : (

    Ask for the scans.
    I'd ask for the scans, and if necessary demand them. Maybe they're not proven to be better necessarily, but they're the current standard. If your oncologist is at all like mine, you won't need to argue with him, but just make clear that you want scans. I get yearly CT scans (after stage 2a rectal cancer) which, if I left it entirely to my oncologist, would not cover my lungs. I don't have a problem insisting my lungs be included. Maybe I'm paranoid, but I have the impression that my doctors are generally reluctant to get on the wrong side of insurance companies by doing precautionary diagnostics in the absence of any specific symptom that would demonstrate medical necessity. Sometimes they need to be pushed a little.

    --Greg
  • Patteee
    Patteee Member Posts: 945
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    PGLGreg said:

    Ask for the scans.
    I'd ask for the scans, and if necessary demand them. Maybe they're not proven to be better necessarily, but they're the current standard. If your oncologist is at all like mine, you won't need to argue with him, but just make clear that you want scans. I get yearly CT scans (after stage 2a rectal cancer) which, if I left it entirely to my oncologist, would not cover my lungs. I don't have a problem insisting my lungs be included. Maybe I'm paranoid, but I have the impression that my doctors are generally reluctant to get on the wrong side of insurance companies by doing precautionary diagnostics in the absence of any specific symptom that would demonstrate medical necessity. Sometimes they need to be pushed a little.

    --Greg

    The standard for stage 3 is
    The standard for stage 3 is yearly scans. Someone on this other board said she should demand a scan at her 3 month check. There has to be some compelling reason to get a scan, generally they are watching something with scan updates or bloodwork up is off and they are following up with a scan. It is not a routine test- the CEA is the routine, that is the one given every 3 months.
  • Patteee
    Patteee Member Posts: 945
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    PhillieG said:

    CT Scans
    I've been getting them every 2 months for a very long time. Until they don't see anything it will stay the same, then they will gradually get spaced further apart.

    I would certainly ask for a scan.
    -p

    But Phil, you are dealing
    But Phil, you are dealing with stage 4, scans are standard then to watch tumor growth. With stage 3, the standard is yearly scans unless a red flag comes up, like an elevated CEA.
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