Scan vs. scope

flaladee
flaladee Member Posts: 15
in Head and Neck Cancer #1
Okay...I have two specialists...the chemo doctor (who I only met 3 times during treatment and did not really care for) telling me he wants me to have PET scans every three months. Then I have my radiation doctor (let me also add he is one of the best radiologists in the nation), who I highly respect and saw every other day for 35 treatments saying there have been national studies that PET scans vs. scoping for post treatment follow -up is safer and just as effective. Both doctors practice at the same hospital (MAYO). Anyone else have an opinion? I sure dont want any more radiation put into my already tired body and really dont mind the scope...I am post RAD treatment since December 9th and cancer free but still have no taste buds. Input would be welcome.....Thanks!!

Comments

  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #2
    Around and around it goes
    This is one of the great debates. It gets talked about a lot on this board, and clearly even among experts there is no concensus of opinion. In the institution where I have been treated, the ENT Oncologist calls the shots. This is logical, because his expertise in ENT cancer is far greater than either of the generalists (Rad onc and med onc are generalists, not specialists in ENT cancer). He has opinions on this matter. Those opinions have changed through the years.

    In 1998 when I had my first cancer, he actually scoped me under general anesthesia and biopsied multiple sites about 3 months after surgery. Now I notice he is alternating CT and PET on a q3 month interval during the first year.

    Honestly, PET and scope are not exactly equal. Both have strengths and both have weaknesses. A scope is not about to see a met to the lung. A PET will, however. A PET has a number of false positives, whereas a scope, and histologic slides of biopxy material don't.

    My conclusion is: Go with whatever makes you comfortable. I've lived through more cancers than most on this board, but less than a few others. I've had generally good care, despite the fact it hasn't been perfect, and one could say that some of the scans haven't necessarily seen the earliest of my malignancies.

    Don't sweat it.

    Pat
  • osmotar
    osmotar Member Posts: 1,006
    #3
    Scans & Scopes
    I see an ENT who is the only one that scopes my throat he wants to see me evcery 6 weeks, my onco and rad doctors work for the same group , I will be going for my first follow-up PET scan this coming monday, so both will see the results. From what my rad dr told me I can expect to get a PET every 3 months, not sure my insurance will go for that , so it may have to be an MRI or CT. I finished all treatmenty on Dec 30th taste buds improve every day

    Linda
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #4
    Different Strokes....
    More than likely a MD personal preference....

    Like Linda, my ENT scopes and takes a lesser after treatment approach. My Chemo MD, likes the scans a little more.

    I'm now nearly three years post treatment. My frist year, my ENT scoped me every 6 - 8 weeks..he's a hands on approach and sees scopes and scans as a tool to confirm his observations.

    My Chemo MD did a CT every three months the first year, a PET the first three months, then CT for the next nine months at three months a part.

    My second year, scopes every four months and scans moved out to six months, a CT, then a PET...and that has continued into year three.

    ENT has moved to six months for scopes....

    Also, welcome to the forum...

    Best,
    John
  • flaladee
    flaladee Member Posts: 15
    #5
    Skiffin16 said:

    Different Strokes....
    More than likely a MD personal preference....

    Like Linda, my ENT scopes and takes a lesser after treatment approach. My Chemo MD, likes the scans a little more.

    I'm now nearly three years post treatment. My frist year, my ENT scoped me every 6 - 8 weeks..he's a hands on approach and sees scopes and scans as a tool to confirm his observations.

    My Chemo MD did a CT every three months the first year, a PET the first three months, then CT for the next nine months at three months a part.

    My second year, scopes every four months and scans moved out to six months, a CT, then a PET...and that has continued into year three.

    ENT has moved to six months for scopes....

    Also, welcome to the forum...

    Best,
    John

    Did I mention...
    That I am severely claustrophobic and have to be medicated before each scan...that is probably why I tend to lean toward scoping than scanning.....
  • jtl
    jtl Member Posts: 456
    #6
    I can only speak to my
    I can only speak to my specific situation but my ENT looks at my throat in the area where I had cancer but not with a scope. He can see the area with just a mirror. I still think you need PET or CT scans.
    John
  • osmotar
    osmotar Member Posts: 1,006
    #7
    flaladee said:

    Did I mention...
    That I am severely claustrophobic and have to be medicated before each scan...that is probably why I tend to lean toward scoping than scanning.....

    Medicated
    I don't like the scans either, but don't do any medication, I just ask that the tech puts something over my eyes, seems to get me thru the scan without problems.
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #8
    jtl said:

    I can only speak to my
    I can only speak to my specific situation but my ENT looks at my throat in the area where I had cancer but not with a scope. He can see the area with just a mirror. I still think you need PET or CT scans.
    John

    you raise a good point
    I'm not certain what we are talking about when people say getting a "scope". As you just said, I get indirect laryngoscopy, using a mirror, every time I see the ENT oncologist. And he scopes me to look at the nasopharynx with a 2mm fiberoptic scope, in the office, frmo time to time. Way back in ancient history, he'd numb my pharynx with a topical spray before doing this. But as he learned, I don't have a big gag reflex, so nowadays, he just threads the scope up my nose and looks. Through the years he's probably done this a dozen times.
  • jtl
    jtl Member Posts: 456
    #9
    longtermsurvivor said:

    you raise a good point
    I'm not certain what we are talking about when people say getting a "scope". As you just said, I get indirect laryngoscopy, using a mirror, every time I see the ENT oncologist. And he scopes me to look at the nasopharynx with a 2mm fiberoptic scope, in the office, frmo time to time. Way back in ancient history, he'd numb my pharynx with a topical spray before doing this. But as he learned, I don't have a big gag reflex, so nowadays, he just threads the scope up my nose and looks. Through the years he's probably done this a dozen times.

    Maybe it just depends on
    Maybe it just depends on what they can see using a mirror vs a scope. Since I did not have any issues with my nasopharynx my ENT and my Rad ONC did not think it was necessary. When I asked that is what I was told, however he said if I wanted him to do it he would oblige. I passed.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #10
    longtermsurvivor said:

    you raise a good point
    I'm not certain what we are talking about when people say getting a "scope". As you just said, I get indirect laryngoscopy, using a mirror, every time I see the ENT oncologist. And he scopes me to look at the nasopharynx with a 2mm fiberoptic scope, in the office, frmo time to time. Way back in ancient history, he'd numb my pharynx with a topical spray before doing this. But as he learned, I don't have a big gag reflex, so nowadays, he just threads the scope up my nose and looks. Through the years he's probably done this a dozen times.

    Scope...
    Well for me, when I say scope, it's like yours Pat...

    The flexible lighted tube through a nostril, down into the throat to the top of the lungs almost, usually turning my head and saying EEEE.

    I used to have the spray, but by the time it takes effect adding another 10 minutes or so to the exam time. I just have him lube it up and thread it through the nostril of choice.

    That in itself was challenging as I had a deviated septum, an between that and sinus swelling left litte room to do the scope.

    But he did a Rhinoplasty a few months ago and it's much easier now...and I can actually breathe through my nose since about 40 years ago.

    The rhinoplasty wasn't performed just to make the scope easier..I have been having problems breathing for years, snored and sleep apnea, all of which have improved a lot.

    That's my routine scope, of course he touches and exams the area each time...

    JG
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #11
    jtl said:

    Maybe it just depends on
    Maybe it just depends on what they can see using a mirror vs a scope. Since I did not have any issues with my nasopharynx my ENT and my Rad ONC did not think it was necessary. When I asked that is what I was told, however he said if I wanted him to do it he would oblige. I passed.

    Location is Everything...
    I'm sure location of the effected area is a major factor as well.

    While mine was tonsils and the ENT does visually exam my mouth and tongue (sight and touch). He also checks the areas he can't see inside my mouth, by using the scope to check my vocal cords, back of the tongue, esophical area...all of those good parts that many here have been diagnosed as infected areas.

    JG

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